Lawmakers consider co-payments for Medicaid

Wednesday, Oct. 26, 2005 | 8:20 a.m.

CARSON CITY -- More than 173,000 poor and disabled Nevadans who currently receive free medical care and prescription drugs may be required to start making nominal co-payments.

With Medicaid being one of the state's fastest growing expenditures, the Legislative Committee on Health Care agreed Tuesday to study all facets of the program, including the possibility of requiring co-payments.

For its share of Medicaid costs, the state has budgeted $813.4 million during the current biennium, an increase of 24.5 percent over the prior biennium.

"We can't keep asking the taxpayers of the state to bear a bigger and bigger burden," said Sen. Maurice Washington, R-Sparks, chairman of the committee. "Everything is on the table."

Although the federal government authorizes states to charge co-payments from 50 cents to $3, Nevada has never required a co-payment since the program began in 1965.

The House Energy and Commerce Committee is looking at raising the maximum co-payment rate to $5 per service by 2008. Although the co-payment charges would increase as the overall cost of health care goes up, the committee is considering capping co-payments at 5 percent of a family's income.

Assemblywoman Sheila Leslie, D-Reno, a member of the legislative study committee, said she would be reluctant to impose any fee on the poor, parents, the elderly and the disabled.

Mike Hillerby, chief of staff for Gov. Kenny Guinn, said any co-payment could be waived for the lowest income citizens.

Leslie, noting that Nevada ranks last nationally in per capita Medicaid spending, said she is worried that imposing any co-payments will keep people from seeking medical care for themselves or their children until they are so ill that they have to go to already overcrowded emergency rooms.

Leslie said a major issue of the Medicaid study will be increasing the rates to medical providers. Physicians and others are reluctant to see poor patients because of the state's low reimbursement rates, she said.

The U.S. Senate Finance Committee is not considering increasing the authorized co-payments in Medicaid, but is studying possible reductions in payments to pharmacies for filling prescriptions.

The 2005 Nevada Legislature authorized money to raise pharmacy reimbursement rates by 12.1 percent this year and by an additional 11.7 percent in the next fiscal year.