Author’s note: This blog has been updated with a comment from Gov. Brian Sandoval’s office.
If there was any doubt remaining — after months of critical emails from Democratic groups — that Nevada’s senior senator, Dean Heller, is in for the fight of his political life in 2018, state Democrats on Monday moved to erase it.
In a small news conference at their new headquarters offices, party chairman Assemblyman William McCurdy II, D-Las Vegas, and state Sen. Pat Spearman, D-North Las Vegas, condemned Heller for his comments last week endorsing an end to expanded Medicaid funding for states seven years from now.
“I don’t care what timeline it’s on, getting rid of federal funding for Medicaid expansion will hurt Nevadans and take away health care for hundreds of thousands of people,” McCurdy said. “And it’s unacceptable.” (In fact, 203,900 people are in Medicaid in Nevada thanks to the expansion of the program, according to the Kaiser Family Foundation.)
“Health care should be a right, not a privilege,” Spearman said. “Unfortunately for us, Dean Heller is out of touch. He’s out of touch with the progress that we’re trying to make.”
She added: “Dean Heller, we’re calling you out, because we cannot, and we will not, go back to a time when less Nevadans had access to affordable health care.”
The news conference came in reaction to a story in The Hill newspaper last week in which Heller told a reporter that he was pushing for a seven-year phase out of federal funds for the expanded Medicaid program in the Senate’s version of the health-care repeal bill. That’s a longer period than some Republicans, including Senate Majority Leader Mitch McConnell, want.
Heller spokeswoman Megan Taylor said Heller was working to mitigate the impact of the loss of federal funding for the state.
“Senator Heller has been working to ensure whatever health care bill is drafted in the Senate works for Medicaid expansion states,” she said. “This is just one of many policy options that is being discussed along with additional transition relief (i.e. growth rates) to ensure that the rug is not pulled out from underneath Nevadans and the more than 200,000 Nevadans who received insurance for the first time under Medicaid expansion.”
Taylor added: “Two years [the timeline contemplated in the House legislation] is not what works for the state of Nevada.”
Heller has never wavered from his view that the Affordable Care Act should be repealed. But he has come out against two House versions of the repeal because of their impact on Nevada. He also questioned Health and Human Services Secretary Tom Price about the impacts of repeal in a hearing last week.
But by backing the idea of ending federal funding for Medicaid — even seven years down the road — Heller could be putting himself at odds with Nevada Gov. Brian Sandoval, who has opposed Republican efforts to roll back the program. In a Jan. 5 letter to House leaders, Sandoval stressed the benefits to Nevada of the federally supported expanded Medicaid program.
“I chose to expand the Medicaid program, to require managed care for most enrollees and to implement a state-based health insurance exchange,” Sandoval wrote. “These decisions made health care accessible to many Nevadans who had never had coverage options before.”
The letter noted that Nevada’s uninsured rate had fallen from 23 percent before the Affordable Care Act to 12 percent afterwards. “Going forward, we must ensure 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.”
If federal funding for expanded Medicaid is withdrawn, Nevada may have to decide between continuing care for the more than 200,000 people in that group, or tapping state resources to pay for the additional costs. McCurdy and Spearman suggested the cost of doing that could be staggering, and said they didn’t know where that money could be found.
Sandoval spokeswoman Mari St. Martin said the governor has two priorities when it comes to the Affordable Care Act: preserving coverage for those in the expanded Medicaid program and avoiding a huge cost shift to the state. But if federal funding is cut off — whenever that happens — Nevada would have to confront exactly that dilemma.