Democrats Vote To Restore $90 Million To Medicaid Budget

CARSON CITY – Democrats today voted to reject Gov. Brian Sandoval’s proposed budget cuts to Medicaid programs this morning.
The governor would have saved about $90 million in his budget through the reductions. Republicans on the Legislature’s money committees voted to cut the Medicaid budget in line with Sandoval’s recommendations.
The Medicaid funding would help reimburse hospitals and their staff for caring for Medicaid patients.
The money also would help fund adult day care, eyeglasses for poor adults, dental and ambulance services, as well as reimbursement rates for skilled nursing homes.
Democrats called the cuts unacceptable and argued that all Nevadans end up paying higher insurance premiums when hospitals are not reimbursed for patients on Medicaid.
“We are at the tipping point,” said Sen. Sheila Leslie, D-Reno. “We are going to see services close that affect the entire population … This isn’t just about poor people anymore … we are jeopardizing the health care system for everybody.”
The cuts were personal for Senate Majority Leader Steven Horsford, D-Las Vegas. In an emotional speech before legislative money committees this morning, he said his grandmother had lived in a nursing home for 25 years. He said he has personally seen the effects of inadequate funding at some nursing homes.
“There’s a reason these rates have to be maintained at a certain level because if they drop below, the adequacy of care gets compromised,” Horsford said.
Sandoval had originally proposed reducing skilled nursing home hourly rates by $20 and later reduced that cut from $20 to $15. Some have questioned whether the cuts would be in violation of federal law.
The Nevada Health Care Association, which represents the skilled nursing industry, has also objected to the reductions and suggested that some facilities could close with the Medicaid reimbursement cuts.
“We have repeatedly voiced our concern that physicians (and other providers) simply will not be able to afford the costs associated with providing care at the reduced rates and Medicaid patients face growing accessibility problems,” said Brian Callister, president of the Nevada State Medical Association, in an earlier statement.
Representatives from the state’s Department of Health and Human Services have said that the budget reductions would not violate federal law.
Some questioned whether eliminating the reductions was possible with the money that state currently has.
“If we completely reject this, we’re just continuing to add to a deficit that, at this point in time, we don’t have the revenue to support,” said Assemblyman Randy Kirner, R-Reno.
Although the Democrats’ decisions created a hole in the governor’s budget, they have introduced a tax plan that would pay for these services.
The plan includes extending taxes passed during 2009 and scheduled to end July 1 of this year. Such an extension could net the state $626 million during the next two years.
An additional proposed 1 percent sales tax on services and 0.8 percent business “margin tax” would get the Democrats to about a $7 billion budget, which is $920 million more than the governor recommends the state spend.
Democrats have argued the tax increases represent the best way to avoid harmful budget cuts to education and social services.
Sandoval has repeatedly said he will not support a tax increase. To pass the tax increase, Democrats would need to vote as a group as well convince five Republicans to vote with them to override a likely veto from Sandoval.
The votes taken today to avoid the cuts are not binding. The Legislature can still alter which programs are funded and which are not.