Las Vegas Sun

August 21, 2019

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Ahead of inauguration, Sisolak outlines priorities for Nevada’s future

Health Insurance Deadline Approaching

Steve Marcus

Gov.-elect Steve Sisolak speaks during a news conference on health insurance at the Sawyer State Building Friday, Dec. 14, 2018.

Nevada’s next governor is preparing to take office with the state’s stalled gun background check law as his first priority.

Gov.-elect Steve Sisolak, who will be the first Democrat in the office in 20 years when he is inaugurated Jan. 7, said his first priorities are implementing gun background checks and tackling education funding.

“We got our message out during the campaign that we’re going to focus on education and health care and jobs, and I think the message resonated with the citizens of Nevada,” Sisolak said. “It’s our plan to continue to deliver on the promises and the discussions we had during the campaign.”

The governor-elect spoke to the Sun ahead of his inauguration about his priorities, but declined to provide specifics for certain policies, such as how the state would implement the gun background check law or roll out a weighted funding formula. Sisolak said lawyers and experts are analyzing these issues to come up with solutions.

Sisolak also discussed protecting coverage for residents under Obamacare, which was recently ruled unconstitutional, as well as education and school safety, among other issues. His comments have been edited for grammar and organization.

Guns and background checks

The state has been unable to enforce its narrowly-approved gun background check law from 2016 without FBI support. The law sought to make all private gun sales contingent on a federal gun background check rather than a check through the state’s system, which experts say is more robust.

Sisolak said implementing the law is his most immediate concern, but that he couldn’t share specifics of the options that experts and lawyers are considering. He said he wants to implement the law “as soon as conceivably possible.”

“I have some ideas, but we’re running them by legal now and want to talk to the leadership in both the Senate and the Assembly, and we’ll go from there,” Sisolak said.

As the Legislature looks at gun legislation, Sisolak said he’d support banning bump stocks. Several lawmakers have voiced support for introducing legislation to ban the devices, used in the Oct. 1 mass shooting on the Strip.

Sales of these devices are all but halted as the federal government pursues an administrative ban rather than action from Congress to make bump stocks illegal. Critics say an administrative fix would be easier for gun advocates to challenge in court.

“I’m certainly supportive of banning bump stocks, and anything else coming forward, I would have to look at,” he said.

Health care

A judge recently ruled the ACA unconstitutional without its key provision, the individual mandate, a penalty for not having insurance that was eliminated through GOP tax reform. The mandate helped keep healthy people in the insurance market to stabilize costs associated with preexisting conditions protections, which allowed people with conditions like cancer to obtain insurance without being denied or charged unaffordable premiums.

Heather Korbulic, director of the Silver State Health Insurance Exchange, said in a statement last week after the ruling that the case is still moving through the courts. The ruling Friday came just before Saturday’s open enrollment deadline for 2019 Obamacare plans.

“The Nevada Exchange and all exchanges through the nation are still open for business,” she said.

Sisolak and state Attorney General-elect Aaron Ford plan to join the appeal of the ruling against the Affordable Care Act. Sisolak has repeatedly expressed support for the law and maintaining coverage for people under the state’s Medicaid expansion as part of Obamacare.

The ACA was credited with decreasing Nevada’s uninsured population, though a recent Georgetown University Center for Children and Families report says the uninsured rate dropped in the state from 2016 to 2017. Enrollments on the exchange actually increased during that period, meaning some families with insurance may still be priced out of coverage for their children.

The Trump administration has also threatened funding for the Children’s Health Insurance Program, and spent months in a failed bid to repeal Obamacare through Congress. The Georgetown report said “national political trends” helped make public insurance programs appear to be at risk.

“The increase in the uninsured rate among children is concerning and needs to be addressed,” Sisolak said. “We need to determine if this can be mitigated through education efforts around CHIP or affordable options for families under the Medicaid expansion, or if more steps need to be taken.”

A patient protection commission will look at issues facing the healthcare system in Nevada and make recommendations on a range of issues, Sisolak said. He told reporters at a news conference Friday that a state-level individual mandate law is one of the issues the commission could consider.

“We're in the process of talking to stakeholders interested in being part of the commission,” Sisolak said. “From there we will define the scope of their work and determine an appropriate schedule. We would expect some of the first recommendations to be presented towards the end of the legislative session.”

Korbulic has raised concerns about federal efforts to curb the ACA’s reach, such as expanded short-term health plans that do not cover all of the benefits required by Obamacare. The state is also facing rising costs of Medicaid while hospitals raise awareness about low reimbursement rates.

“If we can expand it, that’s great, but we will dedicate state resources and any available methodology in order ensure that that happens,” Sisolak said of Medicaid and pre existing conditions protections.

Sisolak said he wants to ensure the state safeguards Medicaid for current enrollees, takes steps to bring as many people under Medicaid as possible, and ensures continued protections for patients with preexisting conditions who were able to obtain coverage under the ACA.

“We’re going to appoint a patient protection commission that is going to analyze the health care system from top to bottom and try to understand the efficiencies and the inefficiencies of the system, where we can make changes or compromises in order to make it more available and affordable, and we’ll go from there,” he said.

The state is projecting 7.2 percent more in its revenue in the coming biennium, and Sisolak said he’s looking at where those dollars may go. Along with rising costs of Medicaid and the state’s many other priorities, education experts say it would take millions if not billions of dollars to achieve adequate funding levels in Nevada

“We are spending what I would consider a significant amount of time going over the budget, Gov. Sandoval’s budget, and working with his staff along with my staff to understand,” Sisolak said. “But the budget that we present will reflect a lot of priorities that I spoke about during the campaign and we’re going to make changes where we deem appropriate.”

Education and pot money

Educators have been calling for lawmakers to bring education funding to adequate levels and implement a full weighted funding formula. Weighted funding would allocate more money for students who cost more to educate, such as English learners.

Critics of the state’s decades-old funding formula for the distributive school account say it was built when Nevada was less diverse. Sisolak said he wants his administration to look at all aspects of education funding, including categorical dollars, which provides funds for a variety of uses including the class-size reduction program.

Sisolak said he plans to get marijuana tax revenue into the distributive school account. Marijuana tax money generally goes toward education, but lawmakers want to fix the process to ensure that a 10 percent tax that currently funnels into the in the rainy day fund goes to the distributive school account.

“I have said during the entire campaign that the DSA formula is 50 years old, and it’s something that I want to look at as we get into the session,” Sisolak said. “We’re analyzing our budget options right now, but we’re not planning on raising any taxes.”

School safety

Several reports on school safety have called for supporting student mental health and ensuring availability of school officers and police, among many other recommendations. A report from the Guinn Center for Policy Priorities estimates costs for metal detectors and other safety measures would cost tens of millions of dollars.

Sisolak said it’s still unclear what the state will seek to invest in to support school safety.

“I support additional investments for school safety to harden the targets,” Sisolak said. “There’s an ongoing discussion as to what that should involve, in terms of actual logistics, whether that is mechanics, i.e. locks and cameras and whatnot, or if that’s people, or if that’s counselors. That discussion is ongoing.”

Higher education structure

This year, a man without a college degree ran unopposed for Nevada’s state board of regents. Unlike in some other states where members are appointed, Nevada’s regents are all elected.

Sisolak, who spent 10 years on the board of regents before becoming a Clark County commissioner, said his administration is planning to look into possible changes in the structure of the board during the legislative session. Possible appointed regents could have an area of expertise, Sisolak said, like real estate, finance or law.

“If you look back at my record all along on the board of regents, I thought that the size of the board was too large,” Sisolak said. “I thought that there should be maybe a hybrid board of some elected, some appointed involving certain areas of expertise.”

Economic diversity

Sandoval is leaving office with a legacy of putting economic diversity under his umbrella more so than his lieutenant governor, who historically took the lead on these issues.

Sandoval took an active role in bringing Tesla and the Raiders to the state. Sisolak said he wants to approach economic diversity with an eye toward unintended consequences, and gear the state’s incentive packages toward smaller businesses, not just large corporations.

Sisolak said he wants these smaller companies vetted on their ideas, their business and what jobs, diversification and revenue they can bring to the state. Businesses that “provide high-paying jobs, that are clean … and can get going quickly” would be best for the state, he said, declining to specifically name any particular industries that Nevada may focus on.

”Tesla, it caused an enormous spike in the real estate market that I think was not anticipated,” Sisolak said. “I don’t think that it’s something we want to rush into. I want to focus on continuing to attract businesses to the state using what options we have, but also focusing on some of our smaller businesses, to give them some of the same opportunities to come to Nevada and expand and flourish, not just the big ones.”