Dennis Myers: Nevada’s week in the health care spotlight
Nevada spent a week being scrutinized after the Nevada Legislature nearly gave the state a new health care system.
Lawmakers enacted a Medicaid-for-all program to be in place in case Congress repeals the Affordable Care Act. No state has ever approved such a system before, and it caught the eye of health care and financial analysts and politicians from coast to coast. Paradoxically, our own in-state media barely covered the story.
Medicaid is an adjunct of Medicare. Medicare is for health care for the elderly. Medicaid is for health care for low-income people and is run by the states. It is optional for states, and not all state governments have it.
The Nevada proposal bewitched policy wonks. Mattie Quinn of Governing, an influential magazine heavily read in D.C. and state capitols, reported, “The bill calls for the state to create the Nevada Care Plan, which would be separate from the state’s Medicaid program but offer nearly all the same benefits.
“It could either be administered by the state’s Medicaid department or officials could contract with an insurer to run it. …” Quinn wrote. “Medicaid recipients pay little or nothing for their coverage, but people who buy into the Nevada Care Plan would most likely have to pay some premiums, deductibles and co-pays. Theoretically, it would be cheaper than what’s currently available on the individual market because Medicaid pays lower rates to doctors, hospitals and other providers.”
CNN Money said, “Theoretically, it would be cheaper than what’s currently available on the individual market because Medicaid pays lower rates to doctors, hospitals and other providers.”
Nevada Gov. Brian Sandoval, a Republican, has long been supportive of the Medicaid component of the Affordable Care Act, which made some observers believe he might sign the measure.
In addition, while Sandoval was studying the bill, he took time out to disagree with U.S. Sen. Dean Heller, who was back in D.C. working on a plan to phase out Medicaid in seven years. And the bill’s sponsor, Assemblymember Michael Sprinkle, had laid some groundwork by putting together a study group that included Sandoval’s chief of staff.
In an interview, Sandoval said he was examining the legislation closely.
“I’ve been doing a deep dive in terms of the policy,” he said. “I’m keenly aware that the repeal of the Affordable Care Act is pending in front of the U.S. Senate. That’s something I’m looking at in terms of what this bill will do. … It’s an interesting concept, one that I’m taking my time to make sure that I’ve answered all my questions before I decide to take action on it.”
Sandoval could easily have politicized the debate around Sprinkle’s bill by demonizing the legislation.
He didn’t do that. “I think it’s giving the impression that it’s free medicine, socialized medicine, which it is not,” he said. “It is providing people with at least an opportunity to … buy into at 100 percent cost into the Medicaid system, and if I do decide to sign it, then it is subject to waivers by the CMS. Those are all things, all the different issues I’m thinking about, but I think it’s important to be able to tell people what it is and what it isn’t.”
In the end, Sandoval decided not to approve the program. He vetoed it, his veto message said, because there had not been enough research done to know the consequences.
“Moving too soon, without factual foundation or adequate understanding of the possible consequences, could introduce more uncertainty to an already fragile health care market, and ultimately affect patient health care,” he wrote.
So the Medicaid-for-all spotlight now moves to other states that are now considering it, including New York and California.
Meanwhile, Republicans in Congress keep on trying to, well, whatever it is they are trying to do on health care.
Dennis Myers is an award-winning journalist who has reported on Nevada’s capital, government and politics for several decades. He has also served as Nevada’s chief deputy secretary of state.
