Posts Tagged ‘Medicare’

Tarkanian And Horsford Mix It Up In Feisty 4th Congressional District Debate

By Sean Whaley | 9:26 pm October 4th, 2012

CARSON CITY – Forget the tame, staid, policy driven debates seen in most races in Nevada so far this year.

The debate between Republican Danny Tarkanian and Democrat Steven Horsford for the new 4th Congressional District in northern Clark and several rural Nevada counties was confrontational from the get go tonight on the Ralston Reports television program.

State Senate Majority Leader and CD4 candidate Steven Horsford

Horsford, currently the state Senate majority leader from Las Vegas, and Tarkanian, son of UNV basketball coach Jerry Tarkanian, mixed it up in the first debate between the two candidates on issues ranging from state tax increases to who will best support the middle class in the House of Representatives.

The 30-minute debate tonight saw a lot of time spent by the candidates in denying characterizations made by their opponents, including an ad from Horsford using Tarkanian’s description of himself as a crazy radical.

Tarkanian said the description of himself was made sarcastically, while Horsford said criticisms of his support for taxes in his service in the Legislature failed to mention that Republicans, including GOP Gov. Brian Sandoval, supported the levies as part of a bipartisan compromise.

Horsford said he has a track record as the head of the Culinary Training Academy, which trains people for jobs in the gaming and hospital industry in Las Vegas, in helping reduce Nevada’s highest in the nation unemployment rate.

“It’s what you’ve already done, not just what you talk about doing,” he said. “And that’s the difference between me and my opponent. I’ve actually spent more than 11 years, working in partnership with the private sector, with labor, with the community, helping people get the training that they need.”

In Congress, Horsford said he will push for infrastructure projects that will get the depressed construction industry back to work.

Tarkanian agreed that job creation is the top priority for Congress, but said Horsford’s track record in the state Legislature is one of passing job stifling tax increases instead.

4th Congressional District candidate Danny Tarkanian.

“As a majority up leader, all he did was impose additional taxes on the middle class, for one, let’s say the car registration tax,” he said. “While people can’t afford to pay for their homes, put food on the table for their families, he’s going to double the cost of car registrations for the average Americans.

“He passed a tax bill that doubled the license fee, the business license fees, for business,” Tarkanian said.

In Congress, Tarkanian said he will work to ensure the federal government does not continue to impose costly and burdensome regulations that impede job growth.

Horsford said the tax increases approved in the 2011 Legislature came with GOP support as a way to avoid Draconian cuts to public education.

He cited 25 months of continued growth in Nevada taxable sales as evidence that the tax hikes were not harmful to business.

Horsford defended using the term crazy radical, saying Tarkanian supported the anti-immigration law passed in Arizona even though it would have caused severe economic harm to the Las Vegas convention industry. He said Tarkanian wants to turn Medicare into a voucher program.

Tarkanian said he supported the right of Arizona citizens to deal with illegal immigration, but added that it might not be appropriate for Nevada. Tarkanian also said he has not endorsed the budget plan proposed by GOP Vice Presidential candidate and Rep. Paul Ryan to change Medicare to a voucher plan for younger Americans. He called it a “great start” to an important dialogue on the federal budget.

Tarkanian said Horsford has constantly misrepresented his positions in the race.

“The difference between him and myself was telling in the last statement that he said,” Tarkanian said. “He believes you can pay down the debt by raising taxes on individuals here in our country. Every economist will tell you, if you raise taxes on people in a recession you’re going to lose revenue. It happened when he did it in the state Legislature; it will happen if you do it in Washington, DC.”

Horsford said Tarkanian has never held elective office and so does not know how efforts at compromise work.

“He has never been elected to anything so he doesn’t understand that you have to work together to get things done,” he said.

“My opponent is not being very clear on his position on this, because what he is saying is that it is OK to end, change, modify Medicare, and then to give a tax break to those at the top,” Horsford said. “That is the proposal, and that is what will happen if he is elected to Congress.”

The level of vitriol in the campaign can be seen in ads running in the contest.

Horsford’s ad using Tarkanian’s own words calling himself “one of those crazy radicals” attempts to associate Tarkanian with the conservative Tea Party, including support for such concepts as privatizing social security and eliminating the federal Department of Education.

An ad run on behalf of Tarkanian, funded by the National Republican Congressional Committee, calls Horsford one of the 10 most corrupt candidates running for Congress. The ad cites in part a story the Nevada News Bureau first reported in August 2010 about Horsford seeking contributions from lobbyists and special interest groups for face time with Senate Democrats. Horsford abandoned the concept after it was disclosed by the NNB.

The 4th Congressional District, newly created as a result of redistricting based on the 2010 census, encompasses the northern part of Clark County and parts or all of six rural counties.

The district has a strong Democratic advantage, 131,173 active voters compared to 96,716 Republicans as of the end of September, but a recent poll by the Las Vegas Review-Journal gives Tarkanian a slight edge of 45 percent to 42 percent, in part due to his name recognition. There are also 47,000 nonpartisan voters in the district.


Audio clips:

Sen. Steven Horsford says he has a track record of job creation:

100412Horsford1 :14 that they need.”

Horsford says Tarkanian does not support the middle class:

100412Horsford2 :22 elected to Congress.”

Danny Tarkanian says Horsford supported taxes that hurt the middle class:

100412Tarkanian1 :23 fees, for businesses.”

Tarkanian says higher taxes in a recession won’t generate more revenue:

100412Tarkanian2 :14 in Washington, DC.”


Jobs, Support Of Middle Class Focus Of Spirited Senate Debate Between Heller, Berkley

By Sean Whaley | 2:10 pm September 28th, 2012

CARSON CITY – It took all of about ten minutes for Sen. Dean Heller and Rep Shelley Berkley to mix it up in their first debate in the U.S. Senate race Thursday, criticizing each other on campaign issues ranging from ethics to Medicare to big oil subsidies.

The hour-long debate on KNPB-TV in Reno was the first chance for many voters to see the two candidates spar on the issues, most of which have already been the focus of campaign attacks in the race to date.

Heller, the Republican appointed to the seat last year, and Berkley, a seven-term Democrat Congresswoman representing the 1st District, will debate twice more before election day on Nov. 6.

Rep. Shelley Berkley, D-Nev.

Heller criticized Berkley for supporting big government bailouts and sequestration, a process which could see massive cuts in military and domestic spending, called the “fiscal cliff,” beginning in January if Congress cannot reach agreement on how to reduce spending. He also commented on the ethics issues that are dogging her through the campaign.

Berkley went after Heller for supporting tax breaks for big oil and for supporting a plan by Vice Presidential candidate Paul Ryan to change the Medicare program for younger Americans when they retire in the years to come.

Heller’s alleged ‘hobos’ remark starts the back-and-forth

One of the first questions to provoke Heller was in reference to his alleged comment in Elko in February of 2010 when unemployment benefits were being extended. He supposedly asked if by continuing the program that “the government is now creating hobos.”

“This is the most difficult part of an election; that is proving something that you didn’t do or say,” Heller said in response to the question. “And in this case this is something that I did not do and something that I did not say. Let’s be very specific. I did not say that.”

Berkley used the opportunity to try to align Heller with Mitt Romney’s controversial comments about 47 percent of Americans being dependent on the federal government.

Heller has disavowed Romney’s comments.

U.S. Sen. Dean Heller, R-Nev.

Did Heller say that the government is creating hobos?

Yes, according to the Elko Daily Free Press, which reported his comments as: “Heller said the current economic downturn and policies may bring back the hobos of the Great Depression, people who wandered the country taking odd jobs.

“He said a study found that people who are out of work longer than two years have only a 50 percent chance of getting back into the workforce. ‘I believe there should be a federal safety net,’ Heller said, but he questioned the wisdom of extending unemployment benefits yet again to a total of 24 months, which Congress is doing. ‘Is the government now creating hobos?’ ”

But the Heller campaign, in a statement released during the debate, said: “Dean Heller never called unemployed individuals hobos. Then-Congressman Heller was referring to a presentation made by Lawrence B. Lindsey, former Director of the National Economic Council at the White House, before the Republican Members of the House Ways and Means Committee.”

The statement cited a number of times Heller voted to extend unemployment insurance during his career in Congress.

Debate moves to who is a bigger supporter of the middle class

Heller used the opportunity to question Berkley’s claims that she supports the middle class.

“She’s bailed out Detroit, she’s bailed out Wall Street, you name it she’s bailed out everybody time and time again,” he said. “And the question is when are you going to bail out the middle class. What are you going to do for the middle class. You continue to support big bailouts.”

Berkley cited five votes Heller has made “to protect tax breaks for corporations that ship American jobs overseas.”

The Heller campaign pointed to Berkley’s vote in July to extend tax breaks for all but those earning over $250,000 a year. Eliminating those tax breaks “could cost Nevada 6,000 jobs and more than 900,000 nationwide,” the statement said.

Berkley voted for an energy tax, opposed the Keystone Pipeline which will mean the oil gets shipped to China, and supported the Affordable Care Act, Heller said.

Berkley has supported energy tax breaks in Congress, but those breaks have focused on alternative energy development. She introduced the  “Clean Energy Jobs Act,” which would extend a 30 percent tax credit for domestic companies that manufacture products used in clean energy projects such as wind turbines and solar panels.

Heller too said he supports renewable energy development, including some federal support.

Berkley’s ethics investigation initiates another round of discussion

Berkley, who is the subject of a House ethics investigation over whether her support of a kidney transplant program in Southern Nevada benefited her physician husband, was asked about the charges. The investigation is under way and is not expected to be resolved before the election.

Berkley did not respond directly to the question, saying only that her only motive was to help Nevadans. Instead she used the opportunity to again attack Heller for voting for big oil subsidies.

Heller said “character matters,” and called Berkley’s ethics issues “a pattern” that existed prior to her being elected to Congress in 1998.

Heller was referring to a memo Berkley wrote to her then-Las Vegas Sands Inc. boss Sheldon Adelson about needing to do favors to local elected officials to get favorable treatment. The memo was made public in 1998.

The Berkley campaign has called the memo old news and not a factor in her election to Congress.

“I think character does matter, and you know what’s important to the people of the state of Nevada? Who’s going to protect them. Who is going to be fighting for them in the U.S. Senate,” Berkley said in the debate. “The middle income families, who’s working for them, who’s making sure that we get people to go back to work.”

Questions about who supports Medicare take center stage

The candidates also debated the future of Medicare, and Heller’s two votes for changing the program to a voucher plan for those under age 55.

Heller said Berkley’s vote for the health care act meant taking $700 billion from Medicare.

“She needs to quit stealing,” from Medicare, he said.

Berkley said moving Medicare to private insurance companies will cost Nevadans more, and “put private insurance company bureaucrats in-between doctors and their patients.”

Berkley said she did not cut money out of Medicare benefits, but instead voted to eliminate over-payments to insurance companies.

Does Heller want to eliminate the Department of Education?

Another issue that provoked a dispute between the candidates is whether Heller has in fact called for the elimination of the U.S. Department of Education.

Heller said he does not support closing the agency, but that it should be downsized to provide more money directly to local school districts.

The Berkley campaign argues that Heller has called for the elimination of the agency.

The Pahrump Valley Times reported: “Heller singled out the U.S. Department of Education for elimination. ‘Just to give you an idea of how they decide how Pahrump Valley High School should be run, we have 3,500 people back in Washington D.C. in the Department of Education that average more than $100,000 per year per person. Now you can’t tell me you can’t take that money, move it to the states and be able to teach better, giving it to the teachers, the principals and the parents.’ ”


Audio clips:

Sen. Dean Heller says he did not make “hobos” remark:

092812Heller1 :10 not say that.”

Heller says Shelley Berkley has voted to bailout big business, not the middle class:

092812Heller2 :12 support big bailouts.”

Rep. Shelly Berkley says Heller supports big business and shipping jobs overseas:

092812Berkley1 :10 their tax subsidies.”

Berkley says the question is who is going to fight for the middle class in the U.S. Senate:

092812Berkley2 :14 back to work.”


Rep. Berkley Launches Two Ads In Ongoing Fight With Sen. Heller On Medicare, Ethics Issues

By Sean Whaley | 6:12 pm July 12th, 2012

CARSON CITY – The Shelley Berkley for Senate campaign today launched two new ads, one criticizing Sen. Dean Heller for voting to “essentially end Medicare” and a second telling viewers that her work to preserve a kidney transplant program was only aimed at helping Nevadans.

One ad focuses on Heller’s two votes in support of a plan introduced by Rep. Paul Ryan of Wisconsin that would have kept Medicare in place for people 55 or older but changed it for others by privatizing it and relying on government subsidies.

The other is a response to a decision by the House Ethics Committee announced last week to establish an investigative subcommittee to determine whether she inappropriately furthered the business interests of her husband, Dr. Larry Lehrner by working to preserve a kidney transplant program at the University Medical Center in Las Vegas in 2008.

Rep. Shelley Berkley, D-Nev.

In the ad, Berkley notes that the complaint about her activities was filed by the Nevada State Republican Party.

The ad says in part: “The Las Vegas Sun says Berkley’s advocacy wasn’t driven for personal gain. It was aimed at helping Nevadans.” It also mentions Heller’s two votes to “end Medicare as we know it.”

Heller launched an ad focusing on the ethics allegations against Berkley earlier this week.

The new Berkley ad campaign was first reported by the Las Vegas Sun.

Heller, a Republican appointed to the Senate in April 2011, and Berkley, a longtime Democratic Congresswoman representing Las Vegas, are locked in a tough battle for the Senate seat.

An announcement today from the Berkley campaign  commented on the new ads.

“While Dean Heller continues to look out for his special interest friends on Wall Street by voting to essentially end Medicare by turning it over to private insurance company bureaucrats, Shelley Berkley is a champion for Nevada seniors and patients  – working tirelessly to protect and strengthen Medicare and Social Security,” said Xochitl Hinojosa, Berkley for Senate communications director. “This fall, Nevadans will understand the clear choice they have in this election between a fighter for the middle-class like Shelley Berkley and someone like Dean Heller, who would throw seniors under the bus to protect taxpayer giveaways to Big Oil companies and corporations that ship jobs overseas.”

In response to the ads, Chandler Smith, Heller for Senate spokeswoman, said: “How about the truth, Congresswoman? For the first time since 2009, a bipartisan committee of five Democrats and five Republicans unanimously decided Congresswoman Berkley’s actions required a formal investigation on the basis of a non-partisan report. In the very same ad she asks for the ‘truth,’ Shelley Berkley desperately tries to shift blame and repeats PolitiFact’s Lie of the Year over and over again. No matter how much she may want to distract from her own problems, Congresswoman Berkley’s ethics troubles do not give her a free pass to lie to Nevadans.”

In a media event today to highlight the fact that early voting for the November general election is 100 days away, U.S. Sen. Majority Leader Harry Reid said Berkley worked to help Nevadan’s in need of care. He mentioned his own experiences with his wife Landra who has undergone treatment for breast cancer.

“I think this is going to be fine for Shelley,” he said. “She’s a terrific candidate. She is a person who has always fought for Nevadans. And certainly she should fight for these people who are sick and in danger of dying.”

He also responded to a question about whether Berkley adequately disclosed that her husband was affiliated with the kidney transplant program. Questions about her work to preserve the program were first raised by the New York Times in a report published in September 2011.

Berkley and other members of Nevada’s Congressional delegation were able to preserve the program. But the New York Times said her efforts, “also benefited her husband, a physician whose nephrology practice directs medical services at the hospital’s kidney care department — an arrangement that expanded after her intervention and is now reflected in a $738,000-a-year contract with the hospital.”

Reid said anyone who lived in Southern Nevada knew that Berkley’s husband was a nephrologist.

“Well I think you will find she didn’t violate any rules whatsoever,” Reid said. “They can look into this more and I’m sure they will, but I don’t think there is a problem with that.”



Sen. Harry Reid says Berkley was right to fight for the kidney transplant program:

071212Reid1 :15 danger of dying.”

Reid says any ethics review will find no rules violations:

071212Reid2 :11 problem with that.”


Heller Senate Campaign Calls Patriot Majority Attack Ads On Medicare Votes False

By Sean Whaley | 11:50 am July 10th, 2012

CARSON CITY – A television ad campaign sponsored by the pro-Democrat Patriot Majority attacking GOP Sen. Dean Heller on his Medicare votes has expanded to Las Vegas and is again being called false by his campaign.

The ads say Heller voted to “end Medicare,” twice, once while serving in the House from the 2nd Congressional District and once after being appointed to the Senate by Gov. Brian Sandoval in April 2011

Heller voted in April 2011 in support of a plan introduced by Rep. Paul Ryan of Wisconsin that would have kept Medicare in place for people 55 or older but changed it for others by privatizing it and relying on government subsidies. It was part of an overall deficit reduction plan that passed the House on a mostly party-line vote.

He voted in the Senate in May 2011 to proceed with the Ryan bill. The vote failed on a 57-40 mostly party-line vote.

U.S. Sen. Dean Heller, R-Nev.

The ads have been running in Northern Nevada and have now expanded to the Las Vegas area. The Northern Nevada ad features Washoe Valley residents Jimmie and Dexter Sale who would not have been affected by the Ryan Medicare plan because of their age.

The new ad says Heller voted twice to “end Medicare as we know it” and that the legislation would have “raised seniors’ health costs nearly $6,000 a year.”

Heller, who is running for his first full-term in the Senate, is being challenged by Rep. Shelley Berkley, D-Nev. The race is considered critical to both parties’ efforts to control the Senate in the 2012 general election.

“Shelley Berkley and Harry Reid just keep repeating the same ‘Lie of the Year,’ hoping they can keep misleading seniors all the way through November,” said Chandler Smith, spokeswoman for the Heller for Senate campaign. “Shelley Berkley has always done whatever it takes to score political points, so her ‘Mediscare’ tactics really come as no surprise.”

The Berkley campaign did not immediately respond to a request for comment on the ads, which are being paid for by the third-party political action committee.

The Heller campaign said Democrat attacks in the Medicare ad were deemed PolitiFact’s “Lie of the Year” in 2011. The analysis by the group said Democrats ignored the fact that the Ryan plan would not have affected people currently in Medicare or those 55 to 65 who would join the program in the next 10 years.

Democrats also used harsh terms such as “end” and “kill” when the program would still exist, although in a privatized system, PolitiFact said. And they used pictures and video of elderly people who clearly were too old to be affected by the Ryan plan, the analysis said.

The Heller campaign said Berkley voted for the Affordable Care Act “that cut $500 billion out of the Medicare program.”

Heller has voted to preserve the Medicare program, the campaign said, by voting against both the Affordable Care Act and the Budget Control Act, which provides for possible Medicare cuts of up to $11 billion a year (about $140 billion over ten years) if deficit reduction targets are not reached.

Heller has consistently voted to ensure physicians are properly reimbursed so they will continue participating in the Medicare program and provide necessary services for seniors, the campaign said.

Federal Agency Names New Accountable Care Organization in Nevada

By Nevada News Bureau Staff | 11:30 am July 9th, 2012

CARSON CITY – The Centers for Medicare & Medicaid Services (CMS) announced today that Nevada is among 40 states where people with Medicare can receive health care from an Accountable Care Organization (ACO).

ACOs are organizations formed by groups of doctors and other health care providers that have agreed to work together to coordinate care for people with Medicare.

The ACO is called the Nevada Primary Care Network and is based in Las Vegas. The ACO has 89 physicians and will serve Medicare beneficiaries in Nevada.

The new ACOs named today around the country will be serving 1.2 million people with Medicare. All ACOs have entered into agreements with CMS, taking responsibility for the quality of care they provide to people with Medicare in return for the opportunity to share in savings realized through high-quality, well-coordinated care.

“Better coordinated care is good for patients and it saves money,” said HHS Secretary Kathleen Sebelius. “We applaud every one of these doctors, hospitals, health centers and others for working together to ensure millions of people with Medicare get better, more patient-centered, coordinated care.”

U.S Department of Health and Human Services Secretary Kathleen Sebelius.

Participation in an ACO is purely voluntary for providers. The Shared Savings Program and other initiatives related to Accountable Care Organizations are made possible by the 2010 Affordable Care Act. Federal savings from this initiative could be up to $940 million over four years.

“This new group of ACOs adds to a solid foundation,” said CMS Acting Administrator Marilyn Tavenner. “The Medicare ACO program opened for business in January, and already, more than 2.4 million beneficiaries are receiving care from providers participating in these important initiatives.”

The 89 ACOs announced today bring the total number of organizations participating in Medicare shared savings initiatives on July 1 to 154.

The selected ACOs operate in a wide range of areas of the country and almost half are physician-driven organizations serving fewer than 10,000 beneficiaries, demonstrating that smaller organizations are interested in operating as ACOs. Their models for coordinating care and improving quality vary in response to the needs of the beneficiaries in the areas they are serving.

To ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe, and timely, an ACO must meet quality standards. For 2012, CMS has established 33 quality measures relating to care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and patient and caregiver experience of care.

CMS also announced that beginning this year, new ACO applications would be accepted annually. The application period for organizations that wish to participate in the Shared Savings Program beginning in January 2013 is from Aug. 1 through Sept. 6, 2012.

Nevada Among States With Lowest Spending On Health Care And Least Number Of Insured

By Sean Whaley | 2:35 pm December 20th, 2011

CARSON CITY – Nevada ranks 46th among states on spending on health care per capita, according to a report released this month by the Centers for Medicaid & Medicare Services.

Nevada spends $5,735 per person on total personal health care as of 2009, the report says. The national average is $6,815. The highest per capita spending was found in Massachusetts at $9,278.

Larry Matheis, executive director of the Nevada State Medical Association, said Nevada’s low spending on health care is a reflection of the large number of residents who don’t have health insurance.

U.S. Census data released in October shows that Nevada is the third most uninsured state per capita in the U.S as of 2009.

“On first blush it’s good news that we’re not on the high end of spending per person,” Matheis said. “But a more balanced look at the data says we have a lot of warning signs in this pool of data. It renders a number that looks like we’ve got costs under control. It actually just means we have a big access problem.”

The report found that eight of the ten top states for total health care spending per capita, including Massachusetts, Connecticut, and New York, are also ranked in the top third in the nation for annual personal income per capita.

Photo by James Gathany, Centers for Disease Control and Prevention.

“Income appears to have an important and positive relationship with health spending,” the report said.

Matheis said the study provides much-needed information as the country moves forward with full implementation of the national health care law.

“They need much better baseline information about how much they are spending and on what with every population and in every part of the country, because a big part of the reform proposals are aimed at trying to, if not reduce costs, reduce the things that lead to higher costs,” he said.

Report also looks at Medicare and Medicaid spending

The report shows that Nevada is in the middle of the pack in terms of Medicare spending per enrollee at $9,692, and ranks toward the bottom of the states on Medicaid spending per enrollee at $6,003. The national averages are $10,365 and $6,826, respectively.

But in terms of the percentage of health care dollars spent on Medicaid, Nevada is lowest among all states at only 8.6 percent. Nevada is the only state where spending is in the single-digits. The highest is New York, where 29.2 percent of all personal health care spending is via Medicaid.

Medicaid is the health care program for low income seniors, disabled and families, the cost of which is shared by states and the federal government.

Charles Duarte, administrator of the state Division of Health Care Financing and Policy, which oversees the Medicaid program, said Nevada’s spending is low because of the policy decision to restrict eligibility. The program also doesn’t offer many optional services that can increase costs.

“We’ve made decisions as a state that we’re not going to expand the program from an eligibility perspective,” he said. “And so in other states Medicaid makes up 14, 15, 16 percent of coverage for people in the state. In some states it is as high as 30 percent.

“We don’t cover as many people in our public programs, but our employers are kind of right in the middle there, slightly above the national average,” Duarte said. “And what the means is the uninsured group are those that could be covered by Medicaid if our rules allowed it.”

Federal health care law expected to affect Nevada Medicaid spending

This situation is expected to change as the Medicaid program expands beginning in 2014 as part of the implementation of the federal health care law, he said. As many as 100,000 new residents could be eligible for Medicaid. There are residents eligible for Medicaid now who are not participating in the program who will have to be covered as well, Duarte said.

The cost of the newly eligible residents will be covered almost entirely by the federal government, but the state will share in the cost of those who are eligible now but who have not signed up for the program, he said.

This Medicaid expansion is one reason Nevada joined with many other states in challenging the constitutionality of the health care law. The U.S. Supreme Court has agreed to review the law. Former Gov. Jim Gibbons in 2010 estimated the Medicaid mandate will cost Nevada $613 million over six years beginning in 2014. Gibbons initiated Nevada’s participation in the challenge to the law which is being continued by Gov. Brian Sandoval.

Matheis said there is a strong feeling in the Nevada medical community that the state is under-spending on this population, which will have to change with the implementation of the health care law.

“Nevada is going to go from where we are now, which is a very low spending per Medicaid patient; we’re going to jump a huge amount because there are going to be so many people that will be identified for the new Medicaid expansion that is coming under the Affordable Care Act,” he said.

This rapid expansion will create budget challenges for state lawmakers, Matheis said.

Policy-makers need to seriously consider the data and build it into the state’s planning efforts, he said.

“At some point we do have to invest in a health care system that we want,” Matheis said. “Right now we’re doing that in Nevada minimally and that’s what this report really shows.”


Audio clips:

Larry Matheis, executive director of the Nevada State Medical Association, says the report provides much needed baseline information:

122011Matheis1 :24 to higher costs.”

Matheis says Nevada will see a big jump in Medicaid spending because of the new health care law:

122011Matheis2 :25 Affordable Care Act.”

Matheis says the news looks good at first, but it suggests there are concerns:

122011Matheis3 :19 pool of data.”

Charles Duarte, administrator of the state Division of Health Care Financing and Policy, says Nevada’s Medicaid spending is low because eligibility is restricted:

122011Duarte1 :15 high as 30 percent.”

Duarte says the uninsured group in Nevada are those who could be covered by Medicaid if eligibility was expanded:

122011Duarte2 :18 rules allowed it.”


Medicare’s 2012 Open Enrollment Drug And Health Plan Data Now Accessible Online

By Nevada News Bureau Staff | 12:44 pm October 3rd, 2011

CARSON CITY – In advance of a new, earlier annual enrollment period, people with Medicare can now begin reviewing plan benefit and cost information via a popular web-based Medicare Plan Finder operated by the Centers for Medicare & Medicaid Services (CMS).

The plan finder lets beneficiaries, their families, trusted representatives, and senior program advocates to look at all local drug and health plan options that are available for the 2012 benefit year. It became available Saturday.

“With open enrollment coming early this year, it is important that people with Medicare take advantage of the next couple weeks to review their current coverage and compare it with the options that are available for next year,” said CMS Administrator Donald M. Berwick, M.D. “The information that’s available now on the Plan Finder will also help caregivers, health providers, and partners that support and counsel seniors and people with disabilities in selecting the best plan for their needs.”

A Federal Emergency Management Agency official speaks to senior citizens in Gautier, Miss. In 2009. / Photo: Jane Feehan/FEMA.

The annual enrollment period begins earlier this year, on Oct.15, and runs through Dec. 7. People with Medicare will have seven weeks to review Medicare Advantage and Part D prescription drug coverage benefits and plan options, and choose the option that best meets their unique needs. The earlier open enrollment period also ensures that Medicare has enough time to process plan choices so that coverage begins without interruption on Jan. 1, 2012.

This year, as beneficiaries look over their available plan options, they will see better value in the Medicare Advantage (Part C) and Prescription Drug (Part D) plan benefits. All beneficiaries will have access to Medicare-covered preventive services at zero cost-sharing, including an annual wellness visit.

Those in the Part D coverage gap, or donut hole, will continue to receive 50 percent discounts on covered brand name drugs due to passage of the Affordable Care Act. On average, Medicare Advantage premiums will be four percent lower in 2012 than in 2011, and plans expect enrollment to increase by 10 percent. Average premiums for Part D prescription drug plans will also decrease to $30 in 2012, about 76 cents less compared to the average 2011 premium.  The premium amount is based on bids submitted by Part D plans for the 2012 plan year. Benefits in 2012 remain consistent with those offered in 2011.

People can use the Plan Finder by inserting their home zip code to find out which Medicare Advantage (Part C) and Prescription Drug (Part D) plans are available in their areas. If the zip code search shows multiple counties it will prompt users to select one county to continue the search. For 2010, the Plan Finder was the most popular tool on, with more than 280 million page views. Also available online is Medicare’s Formulary Finder, which allows beneficiaries to insert their prescribed medications and zip code to see a display of plans offered locally that cover their drugs.

Due to provisions in the Affordable Care Act, Medicare will begin to financially reward Medicare Advantage plans which achieve high quality ratings. Part D plans will also continue to receive quality ratings. Beginning Oct. 12, the Medicare Plan Finder will include each plan’s quality star rating for 2012.

For the first time this year, people who use the Plan Finder will also see a gold star icon designating the top rated 5-star plans, and will continue to see warnings for those plans who consistently are poor performers.

“We encourage all Medicare beneficiaries enrolled in private plans to know their plan’s overall star rating and to consider enrolling in plans with high ratings,” said Jonathan Blum, CMS deputy administrator and director, Center for Medicare.

In Case You Missed It: Political Blurbs

By Elizabeth Crum | 11:52 am August 20th, 2011

Welcome to a new weekend feature here on the blog. We’ll bring you recent links, snippets, stories and Tweets you may have missed in Nevada and national politics. Enjoy. Feel free to post your own favorites in Comments.

Presidential Primary

Governor Sandoval’s name keeps popping up in stories about possible vice-presidential picks for the Republican ticket. This week Politico listed him among “the geographically and demographically ideal” along with Mark Rubio and New Mexico Gov. Susana Martinez.

This “270 to Win” interactive electoral map is fun to play with.

GOP presidential contenders are seeking Nevada endorsements. So far, Rep. Joe Heck, Lt. Gov. Brian Krolicki and nine state legislators have given Romney their nod.

CD-2 Special Election

The four candidates debated this week in Reno.

John Boehner hearts Mark Amodei. Really. And so does Mitt Romney.

Emily’s List (now over 900,000 members strong) endorsed Kate Marshall. So did the Alliance for Retired Americans.

The federal healthcare overhaul legislation is at issue on the airwaves. Amodei is linking Kate Marshall to the health care law approved by President Barack Obama and Congress, while Marshall released an ad slamming Amodei for supporting a Republican plan to privatize Medicare.

Republicans blame Marshall for Nevada’s credit rating downgrade.

AD does a fact check on the NRCC’s claim that Marshall was responsible for a huge business tax increase.

Kate Marshall chimed in (sorta) on Carson City District Judge James Todd Russell’s failure to disclose his business relationship with Mark Amodei in the special election case.

Marshall pointed out that she has raised more money than Amodei.

Americans for Prosperity commissioned a Magellan robo-poll. The survey says Amodei is up by 13 points.


Duck! Political canons are being fired every five minutes re: which party (or candidate) wants to kill Medicare. The latest:

– The national parties both try to control the Medicare message in the CD-2 special election race.

– Case and point:  The National Republican Congressional Committee TV ad attacking state Treasurer Kate Marshall.

– The Kate Marshall campaign responded with this TV ad claiming Mark Amodei wants to end Medicare.

– Mark Amodei’s mom defends him on the issue in this new TV ad.

Ever wonder what the truth is about rising Medicare costs? A Columbia Journalism Review reporter gives us an overview of a new Annals of Emergency Medicine report that explains.

Politifact evaluated DCCC claims that certain Republicans have voted to end Medicare.

Heller & Berkley

Medicare is an issue in this race, too.

In a June (internal) poll, Berkley was up 42-37 over Heller. The last PPP poll had Heller up over Berkley 46-43 (but within the margin of error). Most pundits are calling it a toss-up or giving a slight edge to Heller with disclaimers that it is too soon to say.

Both candidates seek the support of Nevada’s veterans who make up roughly 10 percent of the state’s population.

Dean Heller has gathered some D support for his call for debt committee transparency.



The Clark County School District and the teachers union have reached a bargaining impasse that is “unlikely to be resolved” by Aug. 29, the first day of school.

State superintendent of schools Keith Rheault said Nevada will seek exemption from the No Child Left Behind Act after comments in which U.S. Secretary of Education Arne Duncan called the program an “impediment” and “disincentive” for educators. States can ask for relief beginning in September.

Various & Sundry

A Nevada judge fined the now defunct ACORN $5,000 for a voter-registration compensation scheme. The field operative who created and ran the incentive program is serving three years of probation. (I had fun blogging about the FBI raid on the Las Vegas ACORN office back in 2008.)

The Clark County Commission decided against packing electoral districts with minorities. The same issue is at the center of disagreements over state legislative and congressional redistricting.

Lorne Malkiewich, the longtime director of the Legislative Counsel Bureau, says he is going to retire before the beginning of the 2013 session.

Your 401(k) may in the tank, but Nevada mining company shareholders are doing well.

After push-back via recent public comment, the BLM says it is now going to evaluate the cost-benefits of that controversial pipeline project.




Differences Between Major Party Candidates In CD2 Race On Display At Reno Debate

By Sean Whaley | 10:54 pm August 17th, 2011

RENO – The two major party candidates running in the 2nd Congressional District special election to replace Dean Heller stuck to their talking points in a tame hour-long debate here today.

But the verbal jousting in front of about 150 people at the California Building in Idlewild Park still managed to illustrate the contrasts between Republican Mark Amodei and Democrat Kate Marshall.

Marshall, the Nevada state Treasurer in the midst of her second term, said she would protect social security and Medicare while seeking to balance the federal budget. She also pointed to her successes as treasurer, making money on the state’s investments in every quarter she has been in office.

Nevada state Treasurer and Democrat CD2 candidate Kate Marshall. / Photo: Sean Whaley, Nevada News Bureau.

“There is only one candidate here who will protect your social security and Medicare, and that is me,” Marshall said.

Amodei,  a former state Senator who served in several sessions of the Legislature, said he is a candidate who does not think the federal government is too small, that there aren’t enough regulations and that there isn’t enough taxing and spending. Amodei said his legislative experience will allow him to tackle the tough issues facing the country the day after the Sept. 13 special election.

“I hope you take a look at who has worked for 24 years in the private sector to earn their living,” he said. “When you’re worried about unemployment, you’re worried about foreclosures, you’re worried about the economy, I think it’s a good thing to have somebody who comes from the private sector.”

Marshall touted her advocacy of Senate Bill 75 passed in the 2011 legislative session, which will allow the treasurer’s office to invest school funds in start-up businesses to create jobs, and criticized Amodei for proposing what she said would have been the largest tax increase in Nevada history as a lawmaker in 2003. The tax bill that was ultimately approved included a payroll tax, which means businesses that hire new employees pay more tax, she said.

“It’s no wonder our unemployment rate is the highest in the nation,” she said.

Amodei said his tax proposal was designed to head off the possibility of an income tax in Nevada. It was also intended to prevent a tax on gross receipts. Amodei also noted he opposed a $781 million tax increase in 2009.

Former Nevada state Sen. and CD2 GOP candidate Mark Amodei. / Photo: Sean Whaley, Nevada News Bureau.

Also participating in the hour-long debate were American Party candidate Tim Fasano and independent Helmuth Lehmann, both of whom argued that they were better choices than the establishment party candidates.

Fasano said the two major party candidates are “out of the same cloth” and voters who want change should vote for him on Sept. 13.

“I will stand for the rule of law,” he said.

The special election was made necessary when Gov. Brian Sandoval appointed former Rep. Dean Heller to the U.S. Senate to replace Sen. John Ensign, who resigned. The district encompasses 16 of Nevada’s 17 counties and part of Clark County.

The district has a more than 30,000 Republican voter edge, but there are also more than 60,000 independent voters.

Audio clips:

GOP candidate Mark Amodei says his 24 years of private sector experience are a big part of his qualifications for Congress:

081711Amodei :22 the private sector.”

Democrat candidate Kate Marshall says she will work to balance the budget while protecting social security and Medicare:

081711Marshall :32 and that’s me.”

Sandoval Offers Budget Plan for Nevada

By Elizabeth Crum | 3:05 pm January 13th, 2010

LAS VEGAS — Gubernatorial candidate Brian Sandoval today announced his plan to address the state’s current budget shortfall.

Sandoval’s plan proposes temporary 4% salary reductions for all state employees including K-12 education personnel, state health plan modifications, privatizing selected state services and targeted budget cuts.  Sandoval’s plan aims to realize a savings of between $200 and $500 million.

Sandoval’s plan for the Public Employee Benefits Program (PEBS) would implement the four proposed SAGE Commission recommended 2009 PEBS reforms which are:

1) Immediately change employer contribution to 75% from 95%,

2) Eliminate subsidy for Medicare retirees beginning July 1, 2010,

3) Eliminate the entire subsidy for anyone who retires after July 1, 2010,

4) Reduce subsidy for non-Medicare retirees by 25% on July 1, 2010, and by 25% more on July 1, 2011

The proposal for privatization of selected state services would occur through a public bidding process.  Sandoval’s plan assumes an average savings of 10 percent for services including prison medical services, building and grounds maintenance, the state motor pool, mail services, and the state personnel and purchasing departments.

In addition, Sandoval’s proposal would divert $110 million from the Clark County School District portion of the state class size reduction program to the state general fund.  The temporary diversion would be offset by seeking statutory changes necessary to allow, on a temporary basis, the district to utilize its capital account reserves for operating expenses, salaries and program integrity.

“All Nevadans are facing tough times and our state budget is experiencing unprecedented deficits,” Sandoval said. “Revenues are down significantly, caseloads are up, and tough decisions will have to be made to keep our state solvent.”

“I understand the impact of these proposed salary and benefit reductions on our state employees, but I believe these reductions are a better alternative than mass layoffs, tax increases, or deficit spending,” he said.

“Make no mistake, there is a difficult road ahead and none of the choices to address this problem are easy or painless,” Sandoval said.

“Given the importance of this issue, I have studied the problem for months, enlisted the best and brightest minds in our state to aid me, and offer this plan as means to help our current leaders in their efforts to shore up our ailing state budget,” he said.

View or download a PDF of Sandoval’s plan here.