Nevada governor considers dropping out of Medicaid

State governors and other lawmakers continue to worry that an expansion of Medicaid could put their budgets in crisis.

Nevada Gov. Jim Gibbons, a Republican, "is considering whether Nevada should drop out of the federal Medicaid program," the Las Vegas Sun reports. "The state has estimated that the federal requirement to expand Medicaid under the bill will cost Nevada $636 million from 2014 to 2019...."

Stacy Woodbury, Gibbons' deputy chief of staff, "says that dropping Medicaid is not as dire as it sounds, citing a report from the Heritage Foundation, a conservative think tank. Instead of being on Medicaid, in which the state pays a portion of the costs, the poor would be eligible for federal subsidies to buy private insurance on health care exchanges. Money that had been used to fund the state's portion of Medicaid, $868 million over the next two years, would be used to pay health care premiums for the elderly, blind and disabled, said Woodbury, who emphasized that the governor's staff is still just looking at the option. But others said the shift from Medicaid to federal subsidies would leave thousands of poor people without health care access" (Schwartz, 1/15).

Las Vegas Review-Journal: "But legislative leaders said Gibbons' idea would not receive their approval, which might be required. And a nonpartisan policy research group that monitors Congress said dumping Medicaid would leave many Nevadans without health care. Assembly Speaker Barbara Buckley, D-Las Vegas, questioned whether the governor's talk about ending Medicaid was serious or an attempt to improve his re-election chances. 'It appears they are veering from sound bite to sound bite,' she said. 'It just seems to me this is all about bolstering his poll numbers and not about serious government at a critical time in our state'" (Vogel, 1/15).

Florida lawmakers are also worried about the proposed Medicaid expansion, The Tampa Tribune reports. "Growing Medicaid rolls are deepening the hole in the state budget, even as Congress weighs whether and how to dramatically expand the program as part of their proposed overhaul of health care. But while that proposal has some state lawmakers balking, the same legislation could deliver hundreds of millions of dollars they need for Florida's budget. All in all, Medicaid promises to be one of the trickiest issues that lawmakers face when they return to the Capitol this spring's session."

The article continues: "Part of the problem is timing. As part of the federal government's economic stimulus package, Congress and President Barack Obama's administration last year hiked the rate at which the federal government matches state spending on Medicaid. But that extra money is due to end in December -- costing Florida $745 million next fiscal year. The U.S. House version of the health care overhaul bill proposes to extend the higher Medicaid spending rate through June 30, 2011. That doesn't appear in the U.S. Senate's version, although some senators are already urging their colleagues to embrace the idea" (Whittenburg, 1/14).

The Intelligencer/Wheeling News-Register: "Proposed health care reform presently before Congress could cost West Virginia as much as $725 million in extra Medicaid costs by 2019 under the House-passed plan, U.S. Rep. Shelly Moore Capito said. Or it could cost the Mountain State more than $147 million if the Senate bill reigns supreme, she continued. Either way, the price of expanding Medicaid to cover those at 150 percent of the poverty level or less will trickle down to states already grappling with budget shortfalls, according to Capito, R-W.Va." (King, 1/15).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.