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October 1, 2014

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Nevada Medicaid enrollments soar under health care reform

Updated Wednesday, March 19, 2014 | 2:48 p.m.

CARSON CITY — Nevada Medicaid enrollments under federal health care reform have surpassed initial projections and are on pace to reach 500,000 by summer, a mark initially not expected to be reached until the end of the 2015 fiscal year, a state official said.

Mike Willden, director of the Department of Health and Human Services, said his agency has a 60,000 backlog of pending Medicaid applications and he may need to speed up hiring to keep up with the demand.

"We've doubled capacity. We really need to triple capacity," Willden told the Board of Examiners on Tuesday.

The budget approved by state lawmakers last year funded 400 new positions for the agency, and about 250 have been hired so far in anticipation of Medicaid expansion demands. But the new positions were staggered over the two-year budget cycle, with some funding not authorized until the next fiscal year.

Willden and Gov. Brian Sandoval said action may be necessary to expedite those additional hires.

The Division of Welfare and Supportive Services began receiving electronic enrollments through Nevada's health insurance exchanged called Nevada Health Link in October. At the start, the agency was receiving about 121 applications per day electronically, representing about 40 percent of all Medicaid applications, Willden said.

By December "the floodgates opened" and enrollments jumped dramatically, sometimes reaching 3,000 per day, Willden said.

"Since mid-December, the pipeline is wide open and we are getting thousands of Medicaid applications each and every day," he said.

Under President Obama's health care law, states were given the option to expand Medicaid eligibility to include people up to 138 percent of the federal poverty level. For a single adult, that's about $16,000 a year.

Sandoval, a Republican, agreed to expand eligibility requirements to help more people gain access to health care in Nevada, where the number of uninsured was 642,000 before the federal law took effect.

Since Jan. 1, Nevada for the first time allows adults without children who meet the income threshold to be covered under Medicaid, and the number of newly eligible participants has so far outpaced projections by 8,500, Willden said.

When the current fiscal year began July 1, Nevada had 320,000 enrolled in Medicaid. By February that number spiked to 402,000.

"We're about 14,000 Medicaid recipients over projections with 60,000 in the queue," Willden said.

Under health reform, the federal government is paying 100 percent of the cost to cover newly eligible Medicaid recipients for the first three years. After that reimbursement levels will gradually fall to 90 percent.

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