Las Vegas Sun

July 23, 2018

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A move to boost our quality of life

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Gov. Brian Sandoval is the first Republican governor to announce that he will accept the expansion of Medicaid — the shared state-federal program that provides health care coverage to low-income Americans — under the Affordable Care Act.

There appears to be bipartisan support for this decision, a recognition that 78,000 poor Nevadans will now have health care coverage and that Nevada will save some $16 billion due to federal support for this program. The total estimated cost of the Medicaid expansion from 2013-22 — if all states take part — would be $1.03 trillion, with states paying $76 billion, an increase of 2.9 percent.

The federal government will cover all costs from 2014-16 and fund at least 90 percent in future years. Nevada ranks among the top three states with the most uninsured, along with Texas and Florida, according to the Kaiser Foundation. For 2014-19, federal spending would cover 94.8 percent of Nevada’s costs.

Critics of Medicaid expansion assume a zero-sum game in terms of physicians and health service professionals’ participation, but health services in Southern Nevada are significantly below the required capacity to maintain a population of its size. A recent economic development study by Brookings-Brookings Mountain West-SRI noted that our region is missing almost a third of expected medical services. The expansion of Medicaid will be a magnet for health care professionals and related service industries and will begin to address both unemployment and our need for serious economic diversification.

Accepting the Medicaid expansion is a step toward revitalizing and creating healthy communities. By providing access to timely health care, deficit spending in health facilities will be reduced and a broader, more balanced economic infrastructure for the state will be created.

Nevada sits at the bottom of the rankings, 51st out of the 50 states and Washington, D.C., for receiving formula-based aid from the federal government. Medicaid expansion will provide Nevada with an increased federal match to defray the cost of expanding coverage to newly eligible individuals. Many uninsured residents of Nevada receive medical care only in critical situations, utilizing public hospitals and emergency room facilities.

Nevada taxpayers bear the cost of this service.

Now, with the Medicaid expansion, Nevada can better control health care expenditures and relieve the burden on public hospitals by increasing the number of insured patients who obtain services in primary care facilities, not emergency rooms. The Medicaid expansion will cultivate healthy communities where citizens receive competent health care in a timely manner and build a robust health care infrastructure that will support economic and regional growth.

Accepting the Medicaid expansion is a win-win. It addresses Sandoval’s call to create 50,000 new jobs in the state. The federal funds will help improve a struggling health care system and create a pipeline to educate, employ and retain more health care providers in Nevada. New health care service providers will occupy vacant commercial space; hire newly trained technicians, nurses, and health educators; and buy homes and cars and contribute to our broader economy.

In addition, the expansion of Medicaid will provide additional revenues, generated by those now employed in health care services and by our healthier residents, to improve the state’s public education system, allowing Nevada to produce more health care professionals at all levels, from doctors to technicians.

The next step to fully capitalize on the Medicaid expansion is to invite state licensing boards to examine and revise archaic policies that frustrate health care professionals who wish to move to Nevada. By creating new, reasonable licensure practices that allow medical service providers to come to the state, the revenue lost in medical tourism to our neighbors in California, Texas and Arizona will discontinue and further enrich Southern Nevada.

Medicaid expansion is an opportunity for Nevada to improve the quality of life for all its residents. Expanding Medicaid will diversify the state’s economic base and create a robust health care system that supports a sustainable economy for Nevada. This is a great decision for the state.

Marya Shegog is the director of health programs at The Lincy Institute in Las Vegas.

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