Still no Sandoval decision on Medicaid expansion proposal

CARSON CITY - Gov. Brian Sandoval said Tuesday he has not yet decided whether to expand the Medicaid program to cover residents earning slightly more than poverty-level wages and might not make that decision until Jan. 16, the date he delivers the State of the State address.

"I won't be tied to a specific moment," Sandoval said. "But we aren't going to wait till February," when the state Legislature meets.

The federal Patient Protection and Affordable Care Act, also referred to as Obamacare, required states to offer Medicaid, or free health care, to people earning up to 133 percent of the poverty level, or about $15,000 a year for a single person. But in upholding the national health care law in June, the U.S. Supreme Court gave states the option of deciding whether to expand the program.

Many governors, particularly Republicans, have balked. Mississippi's governor on Tuesday rejected expanding his state's Medicaid program.

The Medicaid expansion would provide health insurance to 16 million people nationally, including another 71,000 in Nevada. Nevada now has about 313,000 people receiving Medicaid.

Nevada officials have not announced how much money the expansion would cost the state, but advocates for the poor put the cost at $30 million a year. Sandoval estimated $40 million to $50 million a year when he talked with the Review-Journal's editorial board in the summer.

Under the program, the federal government will pay 100 percent of expansion costs for the first three years. States, however, must pay a share of the administrative costs of the program.

"We are still in the process of making that decision," Sandoval said. "We obviously will make that decision prior to the release of the governor's recommended budget," which is the day of his address to the Legislature.

But Sandoval has implemented another Obamacare program: setting up an insurance exchange to help people meet the new law that requires all Americans to have health insurance.

Nevada has created the Silver State Insurance Exchange, a program funded by the federal government, under which uninsured people earning moderate wages can shop for the insurance policies that best fit their income and personal needs.

Sandoval noted that most states have not agreed to form insurance exchanges or have decided to have the federal government run them on their behalf.

Jon Hager, director of the Silver State Insurance Exchange, said during a Board of Examiners meeting Tuesday that it is better for the states to run the programs, and he expects that by doing so there may be some savings in what people must pay for insurance.

Hager said his agency is setting up phone lines and a website to help people in buying their policies once the Silver State program is launched in October 2013.

Contact Capital Bureau Chief Ed Vogel at or 775-687-3901.