Gov. Sandoval Says Many Questions Must Be Answered Before Medicaid Expansion Decision Can Be Made

CARSON CITY – Gov. Brian Sandoval said today he needs a lot of questions answered before he can decide whether to expand Medicaid eligibility in Nevada, and that it could take several months to resolve all the uncertainties.

“There’s no specific time schedule,” he said. “I mean I understand right now we’ve had the Supreme Court decision. Everyone has been waiting for that. I think there are still people that are trying to interpret it.

Gov. Brian Sandoval. / Nevada News Bureau file photo.

“There’s still a question within the law regarding the penalty provision,” Sandoval said. “That if a state, whether it ops in or opts out, whether it is still subject to some type of a penalty. Although the federal government can’t withhold all of your Medicaid money there is still an outstanding question about whether it can withhold some of it.”

The U.S. Department of Health and Human Services has to interpret the U.S. Supreme Court ruling upholding most of the Affordable Care Act and answer the many questions before a decision can be made in Nevada, he said.

“The answers to those questions will have a lot to do with how we’re going to estimate the expenses in this state,” Sandoval said. “So it’s premature right now. We’re doing the best that we can with the information that we have. And once I have that information then I can make an informed decision.”

State officials are busy preparing information on what expanding Medicaid to 138 percent of the federal poverty level, as proposed in the health care law, would cost Nevada. The information should be in Sandoval’s hands within two weeks. But having that information does not mean that Sandoval will be ready at that time to make a decision.

The federal government will pick up most of the cost of an expansion for the first several years, but there will be costs to the state as well.

Sandoval also said Nevada decided in the 2011 legislative session to establish its own health care exchange under the law, and that the process of doing so is moving forward. This despite the fact that a $72 million contract sought by the Silver State Health Insurance Exchange to create the information technology needed to operate the exchange beginning Oct. 1, 2013, was delayed today.

The contract with Xerox State Healthcare was scheduled for a vote by the Board of Examiners, including Sandoval, but was pulled because the board overseeing the Exchange was unable to approve it on Thursday.

Six dozen Republican members of Congress have called on the nation’s governors not to implement the exchanges, arguing they add to the cost of doing business. Several governors, including Rick Perry of Texas, who is in Nevada today campaigning for Mitt Romney, have said they won’t move forward with establishing an exchange.

“My biggest concern as I’ve said all along is that I don’t want the federal government coming to the state of Nevada running our exchange,” Sandoval said. “This is a state issue that we should be handling. We have a great board. We have a great director. And we’re going to move in accordance with the law.”

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Audio clips:

Gov. Brian Sandoval says there is no timetable to make a decision on expanding Medicaid:

071312Sandoval1 :12 to interpret it.”

Sandoval says questions remain, including the penalty provision for opting out of a Medicaid expansion:

071312Sandoval2 :17 some of it.”

Sandoval says that when he has all the information he can make an informed decision:

071312Sandoval3 :24 an informed decision.”

Sandoval says Nevada needs to run its own health exchange:

071312Sandoval4 :13 with the law.”