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Gov. Sandoval to Congress: States need say in future of health care

CARSON CITY — Nevada Gov. Brian Sandoval on Friday said overtures by Republican leadership in the U.S. House of Representatives seeking input from states on the Affordable Care Act was a “positive consultation process” that he hopes continues as Congress considers repealing the law.

Sandoval was the first Republican governor in the nation to expand Medicaid eligibility as allowed under President Barack Obama’s signature health care law. With Republican President-elect Donald Trump about to take the reins of the nation and Republicans in control of both the Senate and House, GOP members in Congress have made it a priority to repeal the law, creating angst for many who have received health coverage under its provisions given the uncertainty of what will replace it.

In a response to a letter from House Republican leadership, Sandoval said states are “integral players” in the conversation “and the decisions that are made going forward will have a profound impact on our citizens’ lives and the health care providers who serve them.”

The two-term governor, in an interview with the Review-Journal, described the correspondence with congressional leaders a “positive consultation process.”

“I don’t want there to be a false confrontational narrative created,” he said. “It is a positive consultation process.”

Sandoval said states are also anxious to learn details on what a replacement might mean.

“We’re monitoring this. We still haven’t heard a word on what its going to be,” he said, adding, “All we’ve heard is repeal and replace.”

In his letter dated Jan. 5, Sandoval noted more than 400,000 Nevadans obtained coverage under the law, either through expanded Medicaid or the state insurance exchange.

Sandoval agreed that states “deserve more choices, fewer federal mandates and the freedom and flexibility” to create options. But he stressed in the letter that going forward, “we must ensure first that any new reforms do not mandate additional costs, and second leverage the advancements already made and paid for under the ACA.”

“Moreover, you must ensure that individuals, families, children, aged, blind, disabled and mentally ill are not suddenly left without the care they need to live healthy, productive lives.”

Sandoval was among at least five Republican governors who wrote to House leaders expressing concerns about what repealing the law would mean without a plan to replacement it, Politico reported Friday. All of those governors are from states that expanded Medicaid with federal money.

Under the law, the federal government covered the cost of expanding Medicaid to childless adults who meet income eligibility. Beginning this year, that federal government’s share falls to 95 percent, meaning the state will have to pick up some of the expense.

More than 650,000 Nevadans are covered by Medicaid, many of them newly eligible. The Affordable Care Act also allows lower income people to receive federal subsidies to purchase insurance through state exchanges.

A report issued last week by the Center on Budget and Policy Priorities, an independent think tank, estimated 370,000 Nevadans would lose health insurance by 2019 if the law is repealed and the number of uninsured would jump to more than 760,000.

Contact Sandra Chereb at schereb@reviewjournal.com or 775-461-3821. Follow @SandraChereb on Twitter.

Sandoval Letter by Las Vegas Review-Journal on Scribd

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