An effort to renew the GOP’s controversial plan to replace the Affordable Care Act seems to be gaining little traction. Yet, Nevada officials are still worried that any changes to the nation's current health care laws could result in thousands of Nevadans losing their coverage.
Some state lawmakers are even trying to place protections within state law.
U.S. Speaker of the House Paul Ryan told reporters last week that Republicans are still looking for a way to reform federal health care laws.
“If Obamacare stays as is, that’s unacceptable for the American people,” Ryan said. “That’s not what we said we would do. So we’re going to go figure out how we get this done.”
Ryan’s remarks came days after he pulled a vote on a controversial measure to replace the Affordable Care Act.
Some have speculated that Ryan's bill failed to gain support was due in part to a provision cutting federal Medicaid funding by 880 billion dollars over the next ten years. A cut that large could help reduce the national deficit, however, it could also result in a loss of coverage for as many as 200,000 Nevadans.
"With that, there’s going to be a lot of pressure on the entire health system in Northern Nevada, in our hospitals and emergency departments, on city resources, on county resources and the state,” said Chuck Duarte, the Director of Community Health Alliance – a federally qualified health center. He was also the head of Nevada’s Medicaid program for 12 years.
“It really just shifts the cost of care to the state and creates hundreds of thousands more vulnerable Nevadans."
And that’s something, Nevada’s Democratic lawmakers are trying to prevent. In recent weeks, lawmakers have presented bills looking to protect certain aspects of the Affordable Care Act by placing them in state law.
One measure, Assembly Bill 408, would include a provision allowing children to stay on their parent’s insurance until they turned 26. It also requires insurers to provide coverage for people with pre-existing conditions in addition to maternity and newborn care.
“Regardless of what happens at the federal level, there are things that we can do here at the state level to make sure that the insurance that people have continues to cover them,” said bill sponsor Assemblywoman Amber Joiner (D-Reno). “I’m just trying to maintain that status quo that we have. It’s a protection in case something at the federal level changes.”
Another bill, introduced by Assemblyman Michael Sprinkle (D-Sparks), would allow any Nevadan to buy into the state’s Medicaid program. Regardless of their income level, AB374 would allow a resident to purchase the coverage for an annual premium.
“This opens up options,” he said. “This allows people to potentially have another way to get affordable and accessible healthcare. On top of that, it will bolster our current Medicaid system. This is one of the things that we heard from the Trump administration is that they wanted states to take on [a] more active role in their own healthcare. Well, this plan will do that.”
But Republican lawmakers like Assembly Minority Leader Paul Anderson of Clark County argue the strategy won’t work on a state level.
“Taking the ACA and making them state statutes simply don’t work,” said Anderson. “There’s not a budget for them, there are no reimbursements for them. There’s no practical way that actually can be put into place. Sure, you can put it in a statute, but there’s no funding mechanism for them, so it’s not going to solve anybody’s problems by trying to put the ACA into a state plan.”
And Community Health Alliance Director Chuck Duarte agrees.
“Continuing to provide coverage to the 200,000 to 250,000 Nevadans that now have coverage as a result of the ACA would require hundreds of millions of dollars in federal funds and would probably crowd out others types of spending on the state level things like: K-12 education, higher education, public safety, all the things that we count on in government. I don’t thin Nevada can afford that frankly.”
Members of the state’s Congressional Delegation, Democrat and Republican alike, have stated they will not back any measure that would strip Nevadans of their healthcare. However, the Trump administration and Republican leaders in Congress have spent the past seven years running on a platform calling for an end to the Affordable Care Act.