Wednesday, March 2, 2005 | 11:09 a.m.
CARSON CITY -- Gov. Kenny Guinn said today the Bush administration is agreeable to letting the state have more flexibility in Medicaid, such as allowing the charging of co-payments to the recipients.
Guinn, who returned to his office after attending the National Governors Conference in Washington, D.C., said the administration would also back plans to permit the states more leeway in the purchase of drugs for Medicaid.
The Bush budget, he said, intends to reduce Medicaid spending by $60 billion over 10 years. He said that would permit a 7.2 percent growth in funding, instead of a 7.4 percent increase.
It's too early, he said, to tell the impact on Nevada. But state officials are bracing for millions of dollars in cuts in Guinn's proposed budget if Congress agrees to Bush's plan.
Guinn agreed with legislators who complained it will be hard to build a budget for Medicaid without knowing what the federal participation will be.
The governor said he had a private meeting with Health and Human Services Secretary Mike Leavitt while in Washington to talk about Medicaid. He said Leavitt was agreeable to some of the suggestions of the governors.
Guinn has not suggested that Medicaid's low-income recipients be charged a co-pay for their medical care. At present those enrolled in Medicaid are not charged a co-pay.
Medicaid trails only the public schools and the University and Community College System of Nevada in the amount of money in the state's proposed $5.7 billion two-year budget. It calls for $836,898,135 to go to the state Division of Health Care Financing and Policy, the agency that runs the Medicaid program.
The total program cost is more than $2.4 billion with the federal government chipping in 55.6 percent of the money.
The average caseload in 2004 of 177,000 is expected to rise to 205,373 in fiscal 2006 and to 227,727 in fiscal 2007.
Guinn said there was good news that the Bush administration is not proposing a block grant in Medicaid to the states. That would hurt a fast growing state such as Nevada. In addition, he said, Bush is not proposing putting caps on Medicaid.
Leavitt has asked the governors to go to Congress to back getting more leeway in allowing the states to run the program.
Some of the governors have stayed in Washington to work out a strategy to approach Congress. He said the budget goes to Senate and House committees, and he said the next 15 days is crucial to convincing Congress of the needs of the state.
After these hearings, the program goes before the finance committees of each house. The federal fiscal year starts Oct. 1.
Charging a co-pay to the Medicaid recipients, Guinn said would not be mandatory. Each state would have the option. "Some may want to do it," he said.
On the purchase of drugs for Medicaid, Guinn said the Bush administration is agreeable to easing the regulations on where they could be purchased.
There was no discussion of buying drugs from Canada at a lower price. Guinn said that is illegal under federal law.
Democrats in the Legislature are putting together a plan to allow residents to purchase their prescription drugs through Canada.
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