Gov. Kenny Guinn said Wednesday while the Bush administration is willing to work with governors on Medicaid, it wants to cut the program by $60 billion over the next decade.
He said the good news is Bush isn't proposing caps on Medicaid or turning it into a block grant - which would hurt rapidly growing states like Nevada.
Human Resources Director Mike Leavitt assured those attending the National Governor's Conference last week the administration will support giving states more flexibility - perhaps allowing them to charge participants a co-payment for services and giving more freedom in how and where they purchase pharmaceuticals.
Guinn said one possibility is that states could join together to contract for pharmaceuticals and get a better deal from suppliers. He said the subject of letting states buy drugs form Canada wasn't discussed. That is currently illegal under federal law.
Nevada doesn't charge a co-pay for Medicaid services at present, and Guinn said he hasn't suggested one. He said that would be up to individual states.
Guinn said Leavitt told the governors the budget has been put in Congress's hands, and that they need to work with the administration and their own congressional delegations to get some of the changes they need.
But he said administration officials made it clear "there are going to be some areas where we are going to have to tighten the belt."
Medicaid is one of the state's biggest budgets at more than $2.4 billion. More than half of that is federal money.
There were about 177,000 Medicaid recipients in Nevada last year. The total is expected to rise to more than 225,000 by the end of fiscal 2007.
Guinn said the president's proposal to take most of the proceeds from Southern Nevada land sales to reduce the federal deficit also wasn't on the agenda, but he is "100 percent" with the congressional delegation in fighting that plan. The money, he said, should remain in Nevada because the land being sold is the state's land.
Guinn said that subject will be taken up with Interior Secretary Gail Norton in April.
n Contact reporter Geoff Dornan at gdornan@nevadaappeal.com or at 687-8750.
