Nevada lawmakers warned about Medicaid costs

Lawmakers were told Monday that the Bush administration's Medicaid proposal will shift future risks and costs to Nevada and other states.

Legislative committees dealing with health issues got the warning from Melanie Nathanson of the Center on Budget and Policy Priorities, a nonpartisan Washington, D.C., think tank that focuses on policies that affect poor people.

While Nevada has a big budget deficit, Nathanson said it would be "penny-wise and pound-foolish" to try to reduce the deficit by cutting the state's expensive Medicaid program.

"If you're looking at cuts, this is not the best place to look at first," she said, explaining that every state dollar that's cut results in the loss of a federal dollar.

People who lose Medicaid benefits often won't seek routine medical care for health problems, and those problems can get so bad that they'll wind up as indigents requiring costly care in local hospital emergency rooms, Nathanson added.

About 165,000 low-income Nevadans are insured through Medicaid, but Nathanson said that Nevada, like other states, can't sustain its service level under the current revenue structure.

She also said that the Bush administration has proposed offering states much-needed Medicaid funds this year -- but only if they agree to Medicaid caps and long-term yearly decreases in such funds.

Nathanson said the Bush proposal is especially risky for Nevada and other states with high growth in elderly populations.

Lawmakers also got letters from the Nevada Women's Lobby saying the Bush proposal would be "disastrous to the health of Nevadans" because of its funding method.

Nevada already puts less into Medicaid than any other state on a per-capita basis, and while federal funds would be welcome "the cost of this temporary relief is too high," Arley Goris of the Women's Lobby stated.

Medicaid is expected to cost Nevada $646 million over the next two budget years. It's the biggest segment of the Human Resources Department's budget, which eats up 28 percent of the state's general fund dollars.

In arguing for a record $1 billion tax increase, Gov. Kenny Guinn has said $145 million is needed just to keep pace with growth in the number of Medicaid and welfare cases.

By 2005, Nevada is projected to have more than 200,000 Medicaid cases. That's double the number of cases in 1999.