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Plan could be costly to Nevada
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LAS VEGAS REVIEW-JOURNAL
Updated: Oct. 6, 2009 | 6:02 p.m.
CARSON CITY -- The number of Nevadans receiving free medical care would nearly double by 2015 under provisions of the health care bill being developed in the U.S. Senate Finance Committee.
A record 222,022 residents now receive medical care through the state-federal Medicaid program. That total would increase by 217,000 under the national health care bill, according to an analysis done by the state Health Care Financing and Policy Division.
The move to expand Medicaid comes at a time when the state can least afford it, although Senate Majority Leader Harry Reid, D-Nev., has proposed an amendment to prevent Nevada from absorbing additional costs under the health care bill.
But Charles Duarte, administrator of the division, is not convinced the amendment will be approved.
If it fails, then Duarte said Nevada would be responsible for 13 percent to 18 percent of the costs of adding the 217,000 new Medicaid recipients, along with what it already pays for the current recipients.
Providing Medicaid to Nevadans already costs the state about $1.5 billion a year, of which $450 million is state funds, Duarte said. Medicaid is the second most costly state government expenditure, trailing only the funding of public education.
Already state government faces a potential $2.4 billion shortfall for the 2011 legislative session.
The additional Medicaid costs would be considerable, according to Duarte, although he has not made any estimates yet.
Reid already has run into criticism from Sen. John McCain, R-Ariz., and other Republicans who contend he is trying to bring home extra money for Nevada as his re-election bid approaches.
"There are 574 amendments to the health care bill," Duarte said. "Lord knows what is going to happen. While we are grateful folks are considering 100 percent federal funding for states like Nevada, what happens with the next recession?"
Duarte said recently he will have to seek another $37 million from the Legislature in 2011 because the current Medicaid enrollment already is 11,000 people above the level funded for in June.
A U.S. Census Bureau study last week found 21.3 percent of Nevadans lack health insurance, ranking only behind New Mexico and Texas. Nevada's 20.2 percent unemployment rate for children under 18 was highest in the nation.
Still, state authorities noted that the enrollment in Nevada Check Up, a free health care program for poor children, was down 2,700 recipients in the past year.
Duarte estimated Tuesday that as many as 75,000 Nevadans who qualify for Medicaid have not enrolled in the program.
I don't know why," he said. "You would expect they would apply under the current criteria. Some may view it as a hassle."
Illegal immigrants are not eligible for Medicaid, but under federal law the state must compensate hospitals that provide emergency care for them.
Ben Kieckhefer, a spokesman for the Department of Health and Human Services, said Nevada has some of the strictest requirements for Medicaid qualification in the country.
Adults without children qualify for Medicaid only if they earn less than 25 percent of the federal poverty level of $10,830 per year. That means an adult would have to earn less than $2,708 a year.
Children 6 and younger are eligible for Medicaid if the family earns no more than 133 percent of the poverty level. Children 7 to 18 qualify if the family earns 100 percent of the poverty level. For a family of three, the poverty level would be $18,310 a year.
Kieckhefer said Nevada's Medicaid qualification rules are so strict that unemployed people receiving benefits do not qualify because their compensation is too high.
Under the health reform bill in the Senate, Medicaid would be given to all members of a family if its total earnings do not exceed 133 percent of the poverty level.
In contrast to Nevada, Kieckhefer said New Mexico provides Medicaid to all members of a family whose total earnings are less than 235 percent of the poverty level.
Besides the poor, Medicaid also is provided to foster children, adopted children, the blind and disabled.
Although the state has had difficulty in finding doctors to treat children with special medical problems at the reimbursement rates it pays, Kieckhefer said, for patients needing treatment for more general medical problems, enough doctors have been willing to accept Medicaid patients.
Overall, Duarte is pleased Congress is trying to come up with a plan to ensure everyone has health care coverage.
He noted health care costs in America are increasing three times as fast as wages.
"We can't stay where we are now," he said. "As a public administrator, I am concerned what the states will pay will end up being a lot more if reform doesn't happen."
Contact Capital Bureau Chief Ed Vogel at evogel@reviewjournal.com or 775-687-3901.
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Chopsticks, what do you think happened to those poor suckers that had their money invested with Bernie Maddoff? Did Uncle Sam come in and bail them out (I guess I shouldn't give them any ideas!)? It's called "let the buyer beware!" How is that any different than the Social Security morass we find ourselves in now? And you are quite correct, we should have let CITI, US Bank, Bank of America, AGI, Goldman, Morgan, GM, Ceribus, Mercedes Benz (?) fail. Then out of the ash heap arises more responsible managers of our goods and assets. Instead, we are rewarding poor behavior with money and "it's ok little timmy, we all make mistakes, let me give you this bonus." ENOUGH ALREADY!
Would you please take into account that it is POLITICIANS, R and D, that have foisted this ponzi scheme on us. As far as "hating poor people with a passion", nothing could be farther from the truth. How is putting generation after generation of people in bondage (waiting for that government check to come in the mail) be seen as anything but "hateful"? "Here, poor people, take a little money and go away" has been the $6 trillion boondoggle that DOESN'T WORK. Get it? Any questions? You have to let people be responsible, and held accountable, for their own decisions. Otherwise, you are nothing more than a slave master. And yes, the TARP bailout done by BUSH, was WRONG. But he's a politician, get it? We are merely the sheep. I, am one sheep, that has HAD ENOUGH.
There is a very small middle class now. All the jobs available in Las Vegas don't pay much. I like to see people cry about medicaid recipients. It is so nice that the GOP supporters hate poor people with a passion. Luckily for them there are plenty of rich white people to vote for lil Tark or Susie to beat Reid. We know that the minorities will just stay home on election day so the GOP can take over. The GOP will supply all the answers. Just like they did for the last thirty years. I include WJC, because he signed NAFTA. The budget for ICE was decimated by the GOP controlled congress. ICE is for border patrols. It is OK that they were underfunded by the GOP. The GOP never does any thing wrong. IT is OK the GOP let the multi-national Corporations send all the good jobs to RED CHINA. The GOP is without fault. Regulations are bad. We have to let the Corporations look after us. The Banks and Insurance Companies will take of us. They will be handing out the Chinese made coffin nails and hammers. We will hire undocumented workers at $8.00 to pound the nails.
Hey republicans, get your stories straight... Are the evil Dempcrats cutting off social security and medicare so that grandma can't afford to live, or are the bleeding heart Democrats increasing social security and medicare for the welfare roll at the expense of hardworking taxpayers.... You confuse me when you make either point depending on who you are trying to outrage.....
Harry's only interest in Nevada is "GETTING REELECTED"
He promises everything to the ACORN and SEIU lowlifes --- for their votes, and everybody else gets to pay for all their benefits.
LAWBREAKING ILLEGALS --- SHOULD GET "NOTHING" (except a boot in the ass back to where they came from).
There should be time limits for Welfare (New York has it -- 2 years max and 2 kids max --- it's working just fine).
Wake up folks - before we lose it all.
IT'S WELL PAST TIME TO SEND HARRY REID INTO RETIREMENT -- he can take his snot nosed kid Rory with him.
It is time to discuss the economic situation we are in, compare it to the ideals of our founding fathers, and come up with solutions. Our federal government offers (and spends) $800 billion per year (whether the money is there or not) on straight WELFARE programs. Then there is another $944 billion spent on social security and medicare. Also, welfare programs. I'm sorry we bought into the Bernie Maddoff Ponzi scheme called social security, and medicare; but just like Bernie's plan, there is no money in that lock box, boys and girls. It is, and always has been, a straight transfer of wealth, from the producers (taxpayers) to the first ones in. Now, there is no money.
What are you going to do?