Lawmakers wary of high cost estimate to expand Medicaid program

Kiley Russell

Thursday, Feb. 18, 1999 | 9:09 a.m.

CARSON CITY - Members of an Assembly panel said they were skeptical of a multimillion-dollar price tag that Guinn administration officials have put on a plan to expand Nevada's Medicaid program.

The plan to lower the bar for Medicaid eligibility would be prohibitively expensive, officials from the state Division of Health Care Financing and Policy told the Health and Human Services Committee.

"This is substantial. The cost to the state is significant: We'd have to fund new programming ... and hire new staff," Janice Wright, a deputy administrator at the division, said Wednesday.

AB139 would allow people who make less than $1,677 a month to get Medicaid benefits, up from the current $671-a-month benchmark.

The bill would greatly increase the average number of disabled people who could get Medicaid benefits and lead to a potential two-year cost increase of $655 million, Wright said. Half of that cost will be picked up by the federal government as matching funds.

Every month, the state now serves nearly 100,000 Medicaid clients who get their benefits from a combined federal-state Medicaid budget of $658 million per year.

"Boy, that's sure not very good news," said a dubious Vivian Freeman, D-Reno, Health and Human Services chairwoman.

Other committee members said Wright's estimate was too high. They wanted to see the figures reworked before voting on the bill.

"It's my understanding that Nevada is really at the bottom of all the states in terms of what we spend for these services," said Assemblywoman Sheila Leslie, D-Reno.

Lawmakers' skepticism stems from the fact that the plan to lower the bar for the Medicaid program was developed over the last 18 months - and division officials never mentioned the costs estimates before.

"It may be that they are accurate but it strikes me as late. In a year with a tight budget, the easiest way to kill a difficult piece of legislation is to put an unreasonable fiscal note on it," said Jon Sasser of Washoe Legal Services.

The committee also heard from others pushing for the bill's passage.

Paul Gowins of the Disability Forum, who spoke from a wheelchair, said AB139 would allow many disabled people to live more independent lives.

The bill would let them keep their jobs while they get Medicaid benefits, helping them lead more satisfying, productive lives, said Gowins.

Lawmakers also heard from people who work to get disabled people out of their houses and into their communities.

"I am one of those people in the unfortunate position where if a disabled person comes to me looking for a job, I have to tell them they have to keep their income low so they don't lose their benefits," said Mary Jean Thomsen, who works for the Northern Nevada Center for Independent Living. "I feel like I'm cheating the system."