Gov. Sandoval Says Effect Unclear On Nevada Medicaid, Delegation, Candidates Weigh In On Affordable Care Ruling

CARSON CITY – Gov. Brian Sandoval said today 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 today that states could not be penalized if they did not go along with the Medicaid provisions in the law.

In an interview today on the Nevada NewsMakers program as the decision was announced, 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.

“Therefore, given what we know today, the governor does not intend to automatically accept the Medicaid expansion,” the statement said. “These serious budgetary implications, including the impact on education spending, require further analysis – not just of the next biennial budget but of the long-term costs. Further information will be provided as the budgeting process unfolds over the next few months.”

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.”

U.S. Sen. Dean Heller, R-Nev., said he too wants to see the law changed.

U.S. Supreme Court.

“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.

“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, and ruled the Affordable Care Act constitutional,” Reid said. “Passing the Affordable Care Act was the greatest single step in generations toward ensuring access to affordable, quality healthcare for every American – regardless of where they live or how much money they make.

“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. 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. We know that a majority of Americans think the law should be repealed and that it will increase health care costs, reduce access to care and add to our deficit.

“Instead of injecting more government into our health care system, our focus should be on patients, especially our seniors who rely on access to quality health care,” Heck said. “Our system is working for most Americans and it can work for all Americans through common sense reforms like 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.

Assembly Speaker John Oceguera said it is time to refocus on jobs.

Oceguera, D-Las Vegas, who is challenging Heck in the 3rd Congressional District, said: “Now that the Supreme Court has ruled, it’s time that those in Washington moved on from trying to score political points instead of finding solutions. This decision doesn’t change the reality that too many Nevada families and small businesses are struggling to pay for the rising costs of health care.

“One thing we know for sure, if Washington politicians don’t stop the bickering and finger pointing and focus on what matters – creating jobs and getting our economy back on track – nothing will get done,” he said. “This shouldn’t be about politics – it should be about getting something done.”

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. “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.

“This 2,700-page monster offends seniors, veterans, middle class families and employers,” he said. “I will continue to take every opportunity to repeal and address this mess for Nevadans in a practical way without picking political winners and losers.”

State Sen. Steven Horsford, D-Las Vegas, said he was pleased with the ruling.

In a campaign email, the 4th Congressional Democratic candidate said: “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 said. “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 law needs to be repealed.

The candidate for the 4th Congressional seat said: “I have consistently stood against Obamacare and remain committed to its full repeal. 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.

“When they should be focusing on promoting economic growth and creating jobs, Democrats insist instead on ramming through job-killing policies that increase taxes on Americans, like Obamacare,” Tarkanian said.

There was no immediate response from Rep. Shelley Berkley, D-Nev.

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.

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Audio clip:

Gov. Brian Sandoval says it would not be his decision to opt into the Medicaid expansion allowed under the Affordable Care Act:

062812Sandoval :24 to opt in.”