Sandoval urges flexibility for states in health-care reform

WASHINGTON — Nevada Gov. Brian Sandoval told the National Governors Association on Wednesday that health care reform should provide states flexibility to care for vulnerable populations.

Sandoval, a Republican, also said the federal government should provide sufficient funds without shifting that burden to the states.

President Donald Trump and the Republican-led Congress are eyeing a repeal of the Affordable Care Act, which could alter the way states and the public buy health care through private exchanges.

In some cases, states such as Nevada have expanded Medicaid to take advantage of federal funding to provide health care to people who otherwise would not be unable to afford insurance.

“No one is better equipped to understand and respond to the unique and complex needs of our citizens than governors,” Sandoval told the NGA during a speech at Newseum.

Sandoval, the NGA vice chairman, and Virginia Gov. Terry McAuliffe, the NGA chairman and a Democrat, met with House Speaker Paul Ryan on Wednesday about GOP plans to repeal Obamacare.

The governors said Ryan suggested Congress could replace the system with block-grant funding to states to help them continue insurance programs to those without access to employer-sponsored plans.

But in a letter to congressional leaders Wednesday, McAuliffe and Sandoval warned that states must be given ample time to review proposed changes “to minimize budgetary impacts to states.”

And they warned that “support for vulnerable populations is a shared responsibility between the federal government and the states.”

Sandoval said that while he is open to changes, “I hope decisions are not made in a vacuum.”

“Until we get into specifics, I’m not going to get into an adversarial relationship,” Sandoval added.

All states who expanded Medicaid and are participating in the program since 2014 have received more federal money.

The federal government is paying for 100 percent of expansion for the first three years. The federal government will pay 90 percent in following years. To date, about $72.6 billion has been paid out to states because of expansion.

Nevada expanded Medicaid, and gets $1.14 for every dollar it contributes, Mike Walden, Sandoval’s chief of staff, told state lawmakers earlier this week.

Meanwhile, Sandoval said governors were ready to work with the Trump administration and Congress to repair and build infrastructure in the states.

Sandoval said a priority for Nevada would be completion of proposed Interstate 11, which would connect Phoenix to Las Vegas and run north to Reno. Other projects important for Nevada would include water delivery, rail lines and improvement of the electrical grid to accommodate new industrial parks important to economic growth in the state, Sandoval said.

Contract Gary Martin at gmartin@reviewjournal.com or 202-662-7390. Follow @garymartindc on Twitter.