Nevada’s health care leaders sounded the alarm on pending Medicaid cuts during a legislative hearing Wednesday, but uncertainty over the scope of changes left them unwilling to predict just how drastically health care in the state could be affected.
Lawmakers questioned state Medicaid and public health officials during a joint Health and Human Services Committee hearing in a two-and-a-half hour session in Carson City. Tracy Brown-May, chair of the Assembly committee, called the meeting one of “information gathering” to better understand how Nevada – where one in three residents are on Medicaid, according to the state — could be affected by a Congressional budget proposal that drastically downsizes the joint state-and-federal health care system for low-income earners.
It came about a week after Whitley told lawmakers Nevada could lose almost $1.9 billion in federal funding for a Medicaid expansion program covering roughly 300,000 Nevadans as well as for supplemental payment programs if Congress moves forward with cuts.
Still, Nevada Department of Health and Human Services Director Richard Whitley cautioned lawmakers against drawing conclusions about who could lose care and what services could be cut before any decisions are made at the federal level.
“We have a fragile health care system,” Whitley told lawmakers. “We have to work through this all the time when changes occur at a federal level. It doesn’t benefit us to have people be fearful when we don’t have a known. We’ve done some iterations of what ifs, but we haven’t played out every scenario, and we don’t know yet what those scenarios are.”
Stacie Weeks, administrator of Nevada’s Medicaid program, said the reduction could have a coverage impact for Nevadans who are part of the Medicaid expansion program.
“If you can’t fill that hole or we don’t find ways to make cuts to address it, it would impact coverage and our ability to pay for medical services for that 300,000 people,” she said.
Weeks also said if work requirements are expanded — as is being considered in Congress — coverage for between 70,400 and 112,600 people could be affected. That would be a spending reduction of up to $705.6 million over the upcoming biennium.
Lombardo shares concerns
In a Wednesday letter ahead of the joint hearing, Republican Gov. Joe Lombardo told lawmakers he shared their concerns “regarding any changes to the program that may negatively impact Nevadans” — perhaps his strongest rebuttal to the Congressional Republicans’ budget plans.
Lombardo told lawmakers in the letter he’s actively working with the White House and others in the federal government to “relay our state’s concerns,” which include the impacts of rolling back critical expansion population funding, limiting federal funding with a per capita model and lowering the safe harbor for provider taxes for hospitals.
“An abrupt reduction in federal funding would not only disrupt care for those who rely on Medicaid, but would also destabilize public and private health care providers, leading to workforce reductions, service limitations, and financial strain on already overburdened health care facilities,” he wrote. “My hope is that by engaging in constructive dialogue with the federal government and other policymakers, we can work together to protect Nevadans, protect health care providers from shouldering the burden of these cuts, and protect our hospitals who play a vital role in all communities across Nevada.”
Health officials respond
Brett Salmon, president and CEO of Nevada Health Care Association, said his group representing assisted living and skilled nursing facilities could become squeezed financially, which could lead to providers cutting services or staff and ultimately leading to more patients going to hospitals instead.
“You might squeeze the balloon to solve one problem, but then you might inflate many other problems as a result of that,” Salmon said.
Pat Kelly, president and CEO of the Nevada Hospital Association, said significant Medicaid cuts could result in rising costs in unreimbursed hospital care. That’s because people who do not have insurance will still go to hospitals for care. It could lead to longer wait times and put a strain on emergency departments, he said. Cuts could also reduce bed capacity and reduce or eliminate services so the hospitals can stay financially stable.
“This is tough when areas of the state are just exploding, and we’re not going to have the money to keep our infrastructure, keep building it,” Kelly said.
Nevada Primary Care Association CEO Nancy Bowen said they can expect to see 29,000 fewer patients compared with 2023, depending on the level of Medicaid cuts.
Representatives of United Way of Southern Nevada also said Medicaid cuts could affect the nonprofit sector because about a third of the sector’s funding comes from government grants and contracts. Meanwhile, Nevada is 49th in the nation for philanthropic giving, meaning donor giving would not make up for the loss.
Contact McKenna Ross at mross@reviewjournal.com. Follow @mckenna_ross_ on X.
