By Sean Whaley, Nevada News Bureau
CARSON CITY – Nevada State Medical Association President Florence Jameson said today that Gov. Brian Sandoval made a “politically courageous and correct” policy decision to expand the Nevada Medicaid program.
The decision will ensure that there will not be a new class of uninsured Nevadans when the federal health coverage changes are implemented in January 2014, said Jameson, a physician.
This decision assures coverage for low income uninsured Nevadans who would not be eligible for the new health insurance products provided through the Silver State Health Insurance Exchange. While controversial, the principal achievement of the Patient Protection and Affordable Care Act (PPACA) is the development of a complex scheme for providing health care coverage for most Americans, the announcement said.
The association recommended in September that Sandoval opt for the expansion, but Nevada physicians remain concerned that it does not improve the current Medicaid program, which is significantly underfunded, Jameson said.
The association “urges Governor Sandoval and the state Legislature to address the access to care needs of the patients who are, and will continue to be, covered by the current Medicaid program,” she said.
This medical care access issue is one reason the Nevada Policy Research Institute, a libertarian think tank, has criticized the decision.
NPRI Deputy Policy Director Geoffrey Lawrence said that because the Medicaid program systematically under-reimburses health-care providers, many are not taking new patients. This means current Medicaid enrollees – by definition the most vulnerable populations – will now be competing with healthy adults for fewer and fewer doctors. Sandoval’s decision will exacerbate the doctor shortages already faced by the children and the disabled who use Medicaid, he said.
“All this said, one must applaud the governor’s decision to finally institute consumer co-pays and thus introduce some real-world price sensitivity into the calculations of Medicaid consumers,” Lawrence said. “The primary reason for the health-care system’s high costs is the government-induced breakdown of the price system.”
Imposing co-pays is a proven way of encouraging individuals to seek only the care they really need, helping to control cost growth, he said.
Another concern cited by NPRI with the expansion is the increasing cost of the Medicaid program to taxpayers.
State Medicaid spending is already growing at an unsustainable pace and will soon displace K-12 education as the state’s largest budget item, Lawrence said. While Congress has pledged that federal taxpayers will cover a majority of costs for the newly eligible population through 2020, that will likely shift more to state taxpayers in later years, he said.
