Reno Gazette Journal: Would Medicaid changes hurt Nevada's 'fragile' health system? Legislature hears worst case
- Feb 28
- 7 min read
Updated: Mar 19
Reno Gazette Journal
Although the fate of Medicaid is unclear, it’d be a disaster for Nevada if the federal government decides to cut its funding.
That was the uncontradicted message at a joint hearing of Senate and Assembly members Wednesday evening at the Nevada Legislature.
The meeting was intended to give a forum to those who use and work with Medicaid so they could explain the potential effects on the state under different scenarios caused by uncertainty in Washington, D.C.
Hospitals, private clinics, nonprofits, parents of children with severe behavioral issues and one woman who said Medicaid-covered prescriptions kept her from committing suicide were among those who spoke.
“We have a fragile health care system,” said Richard Whitley, who heads Nevada’s Department of Health and Human Services.
He and Stacie Weeks, who oversees the department’s Medicaid program, gave the evening’s first presentation. They covered possibilities such as what happens if federal reimbursements to the state are lowered for people who get health insurance through the Affordable Care Act or if some adults on Medicaid are required to get jobs.
Depending upon the scenario, they said, Nevada would have to take on almost $2 billion in spending the federal government currently handles, almost half the state’s Medicaid recipients could lose coverage, and rural hospitals and nursing homes would likely cut services.
One change discussed would lower state Medicaid costs.
Weeks said that based on programs in Arkansas and Georgia requiring that some Medicaid recipients work, Nevada could see a “total spending reduction of between $441 million and $705.6 million” during the next two years if the state tried a similar requirement.
But, Whitley said, “it's hard to play out scenarios with (Medicaid’s fate) still being unknown at a federal level.”
This fact — that no one knows what will happen with Medicaid — was acknowledged by participants but many expressed a desire to raise alarm bells now in order to make sure cuts don’t happen later.
Some Nevada Republicans express worry, others say Medicaid cuts won't happen
The hearing was inspired in part by the passing of a U.S. House budget resolution this week aimed at fulfilling President Donald Trump’s agenda for spending reductions. It calls for the committee that oversees Medicaid to come up with $880 billion in savings over 10 years.
Because of bureaucratic maneuvering needed to increase the chance it’ll also pass the U.S. Senate, the budget blueprint strongly implies that changes to Medicaid are likely, although not necessarily in the form of cuts.
“Look, Medicaid has never been on the chopping block,” said House Speaker Mike Johnson earlier this month.
Instead, he floated savings from requiring “able-bodied” Medicaid recipients to work and weeding out fraud, waste and abuse.
After the budget resolution passed, eight Republicans in the Congressional Hispanic Conference sent a letter to Johnson “to express concerns regarding possible funding decisions” for Medicaid.
Minutes before Wednesday’s Medicaid hearing in the Nevada Legislature, Republican Gov. Joe Lombardo released a letter of his own.
“Medicaid was created to serve low-income individuals, children, seniors and people with disabilities, and I share many of your concerns regarding any changes to the program that may negatively impact Nevadans,” he said.
Lombardo said he’s actively talking with federal officials to make sure any Medicaid changes don’t hurt the state.
“An abrupt reduction in federal funding would not only disrupt care for those who rely on Medicaid, but would also destabilize public and private health care providers, leading to workforce reductions, service limitations, and financial strain on already overburdened health care facilities,” he said.
Other Republicans portrayed claims of Medicaid cuts — and even Wednesday’s hearing — as political theater ginned up by Democrats.
“I would like to assure the public not to panic or worry, the sky is not falling,” said state Sen. Jeff Stone from Henderson during a brief news conference where he took no questions Wednesday afternoon.
Would Medicaid changes hurt Nevada's 'fragile' health system? Legislature hears worst case
Reno Gazette Journal
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Although the fate of Medicaid is unclear, it’d be a disaster for Nevada if the federal government decides to cut its funding.
That was the uncontradicted message at a joint hearing of Senate and Assembly members Wednesday evening at the Nevada Legislature.
The meeting was intended to give a forum to those who use and work with Medicaid so they could explain the potential effects on the state under different scenarios caused by uncertainty in Washington, D.C.
Hospitals, private clinics, nonprofits, parents of children with severe behavioral issues and one woman who said Medicaid-covered prescriptions kept her from committing suicide were among those who spoke.
“We have a fragile health care system,” said Richard Whitley, who heads Nevada’s Department of Health and Human Services.
He and Stacie Weeks, who oversees the department’s Medicaid program, gave the evening’s first presentation. They covered possibilities such as what happens if federal reimbursements to the state are lowered for people who get health insurance through the Affordable Care Act or if some adults on Medicaid are required to get jobs.
Depending upon the scenario, they said, Nevada would have to take on almost $2 billion in spending the federal government currently handles, almost half the state’s Medicaid recipients could lose coverage, and rural hospitals and nursing homes would likely cut services.
One change discussed would lower state Medicaid costs.
Weeks said that based on programs in Arkansas and Georgia requiring that some Medicaid recipients work, Nevada could see a “total spending reduction of between $441 million and $705.6 million” during the next two years if the state tried a similar requirement.
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But, Whitley said, “it's hard to play out scenarios with (Medicaid’s fate) still being unknown at a federal level.”
This fact — that no one knows what will happen with Medicaid — was acknowledged by participants but many expressed a desire to raise alarm bells now in order to make sure cuts don’t happen later.
Some Nevada Republicans express worry, others say Medicaid cuts won't happen
The hearing was inspired in part by the passing of a U.S. House budget resolution this week aimed at fulfilling President Donald Trump’s agenda for spending reductions. It calls for the committee that oversees Medicaid to come up with $880 billion in savings over 10 years.
Because of bureaucratic maneuvering needed to increase the chance it’ll also pass the U.S. Senate, the budget blueprint strongly implies that changes to Medicaid are likely, although not necessarily in the form of cuts.
“Look, Medicaid has never been on the chopping block,” said House Speaker Mike Johnson earlier this month.
Instead, he floated savings from requiring “able-bodied” Medicaid recipients to work and weeding out fraud, waste and abuse.
After the budget resolution passed, eight Republicans in the Congressional Hispanic Conference sent a letter to Johnson “to express concerns regarding possible funding decisions” for Medicaid.
Minutes before Wednesday’s Medicaid hearing in the Nevada Legislature, Republican Gov. Joe Lombardo released a letter of his own.
“Medicaid was created to serve low-income individuals, children, seniors and people with disabilities, and I share many of your concerns regarding any changes to the program that may negatively impact Nevadans,” he said.
Lombardo said he’s actively talking with federal officials to make sure any Medicaid changes don’t hurt the state.
“An abrupt reduction in federal funding would not only disrupt care for those who rely on Medicaid, but would also destabilize public and private health care providers, leading to workforce reductions, service limitations, and financial strain on already overburdened health care facilities,” he said.
Other Republicans portrayed claims of Medicaid cuts — and even Wednesday’s hearing — as political theater ginned up by Democrats.
“I would like to assure the public not to panic or worry, the sky is not falling,” said state Sen. Jeff Stone from Henderson during a brief news conference where he took no questions Wednesday afternoon.
“This joint Health and Human Services hearing is premature, political theater and a waste of staff resources.”
Even if some cuts happen, he said, Nevada ranks near the bottom nationally for states receiving Medicaid grants.
“If we experience any pause of funding that we need to backfill, we have monies to stop the gap,” Stone said.
Nevada Democrats say understanding disaster possibilities is part of their job
Assemblymember Tracy Brown-May, a Democrat from Las Vegas who chaired the hearing, started by saying legislators have a responsibility to understand different eventualities because Medicaid funding has such deep effects into all corners of Nevada.
“This really is information gathering at this point so that we can be strategic and thoughtful as we plan to care for Nevadans receiving health care and community-based services,” she said.
Blayne Osborn, who represents rural Nevada hospitals, said it was very early to talk about cuts but that he’d recently met with U.S. Sens. Catherine Cortez Masto and Jacky Rosen and U.S. Rep. Mark Amodei in Washington.
“I believe all three of them understand the very serious nature of the proposed House package and the potential that it could have on Medicaid cuts,” he said.
“And I have a lot of faith in our federal delegation. Without speaking for them, but considering some of the comments we've heard from the Senate and from President Trump, the takeaway I had was that this House budget proposal is not likely to pass as is, so I look at a lot of these questions as kind of, what is the worst-case scenario that could happen?”
For him, significant Medicaid cuts would mean that Nevada’s rural hospitals would likely need to cut long-term care units, physical therapy programs and delivering babies.
Osborn said hospitals in Caliente, Lovelock, Yerington, Hawthorne and Battle Mountain would be especially hit hard.
Assemblymember Heather Goulding, a Democrat from Reno, said afterward that she didn’t see any theatrics during the hearing.
“I just heard people concerned about a real threat to the well-being of Nevada,” she said. “Let’s hope (Medicaid cuts) don’t happen because we can see here tonight the unbelievable impact it would have on Nevada and on Nevadans.”
This story has been updated to correct the amount of $880 billion in cuts.
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