Reid pursues bill changes to aid Nevada

Changes to a health care reform bill in the U.S. Senate increased to $2.3 billion the extra money that would assist low-income residents in Nevada.

That is the word from Sen. Harry Reid, D-Nev., who sought changes to a proposal from Sen. Max Baucus, D-Mont. The changes would provide more health care help for Nevadans without dipping into the state's budget at least temporarily.

Under changes made by the Senate Finance Committee, Nevada would be one of four states to be reimbursed 100 percent by the federal government over five years for the cost of increasing the number of people eligible for Medicaid.

After five years, the federal government would pay 82.3 percent of the cost to provide care to the newly eligible people. Nevada would pay 17.7 percent, said sources who worked on the legislation.

"I promised the people of Nevada that I wouldn't support any health insurance reform proposal that wasn't good for our state, and I meant it," Reid said in a statement.

An earlier version of the bill would have required states to increase the percentage rate they pay for Medicaid. Reid said that was unacceptable and sought changes to shield Nevada from such an increase.

The five-year period of eligibility expansion would span 2014-19. The $2.3 billion would be on top of the projected $7.6 billion the state expects to spend on Medicaid over 10 years, which the federal government is set to match.

The state would have to put up an estimated $201 million in matching funds to access the $2.3 billion. But with $77 million in savings elsewhere in the legislation, the true cost to Nevada would be $124 million.

Reid had expressed concern earlier that Baucus' proposal to expand access to Medicaid was untenable if it required cash-strapped states such as Nevada to help pay to provide care to people who were not previously eligible.

But even picking up 100 percent of the cost to expand Medicare eligibility from 2014-19 might not be enough for Gov. Jim Gibbons, who, with legislators, is facing a $2.4 billion gap between projected revenue and projected expenses by 2011.

"If it is a federal government mandate, the federal government should pay for it," Gibbons spokesman Dan Burns said. "Time limits are a smoke screen."

Burns complimented Reid for pressing for changes that would bring more health care money to Nevada. But Burns said the state might not be able to kick in its own money for 2019 and beyond.

"The state general fund is in serious trouble. We are not in a position to say, 'Yes, we can match X percent,'" he said.

More light was shed Tuesday on other Senate health care reform plans in the works.

A spokeswoman for the Nevada Cancer Institute said an amendment by Sens. Debbie Stabenow, D-Mich., and Robert Menendez, D-N.J., that is supported by Reid would change the way the Summerlin-based institute is reimbursed through Medicare.

The amendment covers a few cancer centers nationwide, including the Nevada Cancer Institute.

It would allow the institute to be reimbursed based on the actual cost of treating Medicare patients, as opposed to applying pre-set reimbursements.

Adding the Nevada Cancer Institute to the exemption program, which has existed for decades, will allow the nonprofit center to put more money back into research and care, Jennifer McDonnell said. The exemption is needed because the institute treats only cancer patients and does not have revenue streams typical hospitals use to recoup costs, she said.

"It just broadens the therapies we are able to bring to Nevada," McDonnell said.

Contact reporter Benjamin Spillman at or 702-477-3861.