By SEAN WHALEY
Nevada News Bureau
Gov. Brian Sandoval said last week that the effects of the U.S. Supreme Court decision upholding much of the Affordable Care Act on the state’s Medicaid program remain unclear.
“The implications for Medicaid costs are still unclear, but Nevada will prepare to meet the serious financial implications of this decision,” he said in a statement shortly after the court ruled.
The court said in the ruling, made on Thursday, that states could not be penalized if they did not go along with the Medicaid provisions in the law.
In an interview last week on the Nevada NewsMakers program, Sandoval said his intention would be not to opt in to the Medicaid expansion because of the costs to the state.
“And as I have said all along, that if that component had been found constitutional, it would cost us $60 million in this budget and $100 million in future budgets,” he said in the interview. “We can’t afford that. And to make that decision and to opt into that program, would mean that I would have to look at cutting education, at other what I think are untenable outcomes. So as I sit here today, it wouldn’t be my intention for this state to opt in.”
A statement from Sandoval’s office issued later in the day said the decision indicates states will have an option to expand Medicaid, but, “additional guidance is needed in order to understand the penalties for not expanding the Medicaid program and we must determine if there are savings to the general fund by shifting existing costs to the federal government. We will continue to examine today’s opinion to fully understand its implications.”
In his initial statement on the ruling, Sandoval also said: “I believe the Congress should act to reform this law and ease the serious burdens it places on the states and the nation’s businesses. The American people remain deeply divided on the wisdom of this law and they are still entitled to see it changed.”
The members of the Nevada Congressional delegation had strong words on both sides for the court’s decision and the future of the Affordable Care Act.
U.S. Sen. Dean Heller, R-Nev., said he too wants to see the law changed.
“This law has now been affirmed as a colossal tax increase on the middle class, and its excessive regulations are stripping businesses of the certainty they need to hire at a time when Nevadans and the rest of the country are desperate for jobs,” he said. “The president should work with Congress to find real solutions to healthcare reform so the excessive mandates and taxes in this law do not further add to our national debt or continue to stifle economic growth.”
“This onerous law needs to be repealed and replaced with market-based reforms that will provide greater access, affordability, and economic certainty to our nation,” Heller said.
U.S. Senate Majority Leader Harry Reid, D-Nev., said the matter is now settled at last.
“It’s time for Republicans to stop refighting yesterday’s battles,” he said. “I’m pleased to see the Supreme Court put the rule of law ahead of partisanship.”
“No one thinks this law is perfect,” Reid said. “But Democrats have proven we’re willing to work with Republicans to improve the Affordable Care Act.”
Rep. Mark Amodei, R-Nev., said it is time to repeal the law.
“Advocates for Washington-based management of health care and unprecedented tax increases on the middle class won today,” he said shortly after the ruling. “However, I will continue to work for patient-centered solutions, reductions in health care costs, and improving health care access for all Nevadans.
“I look forward to the opportunity to vote the week of July 9 for full repeal of this harmful government intrusion into health care,” Amodei said. “Congress created this mess and it’s our responsibility to clean it up. We owe it to the middle class to give them specific, well-thought out options focusing on portability of insurance across state lines and affordability, while not interfering with the patient-doctor relationship.”
Rep. Joe Heck, R-Nev., said the ruling doesn’t make the health care act a good law.
“This is still the same flawed bill that was forced through Congress on a party line vote in the dead of night with special interest provisions like the ‘Cornhusker Kickback’ and the ‘Louisiana Purchase’,” he said. “And today we have learned that the law amounts to a huge tax increase on the American people in a struggling economy.
“Our system is working for most Americans and it can work for all Americans through common sense reforms,” Heck said.
These reforms would include moving insurance coverage towards an individual-based model, increasing competition by allowing the purchase of insurance across state lines, incentivizing the purchase of insurance through tax credits, and letting people, not the government, decide what services they need and want.
“The Supreme Court had their word on June 28, but the American people will have the final word on November 6,” Heck said.
There was no immediate response from Rep. Shelley Berkley, D-Nev.
The candidates for the new Nevada Congressional District 4 each weighed in on the issue following the court’s ruling.
State Sen. Steven Horsford, D-Las Vegas, said he was pleased with the ruling. In a campaign email, the 4th Congressional Democratic candidate wrote: “Today’s decision is a victory for those with pre-existing conditions, for women who now don’t have to pay more than men for care, and for Nevada seniors who will save on prescription drugs.
“Now Republicans in the House are scheduling a vote to repeal the health care law, instead of working on a jobs bill,” Horsford continued. “The Republican Congress needs to stop playing political games and start working on getting our economy moving and creating jobs for Nevadans.”
GOP Congressional candidate Danny Tarkanian said the healthcare law needs to be repealed.
“I have consistently stood against Obamacare and remain committed to its full repeal,” Tarkanian said. “Rather, we need to press forward with legislation that will extend the same tax incentives that businesses receive for providing health insurance to individuals who purchase their own plans. We need to get serious about tort reform and stabilize Medicare reimbursement rates. We need to make insurance portable and purchasable across state lines.”
A big issue for Nevada is what the ruling means to the state’s Medicaid program.
The head of Nevada’s Department of Health and Human Services said in May that as many as 150,000 more residents will be eligible for Medicaid coverage if the state has to comply with the Medicaid provisions. Bringing new residents onto the rolls was estimated to cost the state an estimated $574 million between now and 2020, said HHS Director Mike Willden.
