State Government Profile
Governor: Brian Sandoval (R)
Lt. Governor: Brian Krolicki (R)
Attorney General: Catherine Cortez Masto (D)
Legislature: Senate (Democratic control 11-10), House (Democratic control 26-16)
Legislative Leaders: Senate President/Lt. Governor Brian Krolicki; Senate President Pro-Tem Michael A. Schneider (D); Speaker of the House John Oceguera (D)
2012 Legislative Session: No regular session in 2012; next session will begin Feb. 4, 2013 (biennial legislature)
Key Health Officials: Insurance Commissioner Scott J. Kipper; Mike Willden, Director of the Department of Health and Human Services; Charles Duarte, Administrator, Division of Health Care Financing and Policy
- Department of Health and Human Services (DHHS)
- Division of Health Care Financing and Policy (DHCFP)
- Division of Insurance (DOI)
- Governor’s Office
- State Legislature
State Population: 2,700,551 (2010 US Census data)
Medicaid Enrollment: 265,019 (July 2010, CMS)
Percent Enrolled in Managed Care: 85.07% (July 2010, CMS)
Uninsured Rate: 20.3% (three-year average, 2008-10, US Census Bureau)
Health Reform Projections: 136,563 – 196,168 (total new Medicaid enrollees, low and high participation scenarios, Kaiser Commission on Medicaid and the Uninsured)
2.9 – 5.2% (change in state Medicaid spending, low and high participation scenarios, Kaiser Commission on Medicaid and the Uninsured)
State Fiscal Year (SFY) 2011 Budget Appropriations: $3.372 billion (state general funds)
SFY2012 Projected Budget Shortfall: $1.3 billion (state general funds)
SFY2008 Medicaid Expenditures: $455 million (state general funds)
Federal Medical Assistance Percentage (FMAP) Rates:
54.81% (January – March 2011)
52.81% (April – June 2011)
51.61% (July – September 2011)
56.20% (October 2011 – September 2012)
Health Reform Implementation Activities and Developments
Health Reform Implementation Structure:
Nevada has begun planning for health care reform by creating two separate teams to review the legislation, ensure coordinated planning and implementation efforts are conducted throughout state government and provide high-level policy advice to the Governor:
Led by DHHS Director Mike Willden, this is a policy-level panel tasked with monitoring major health reform issues and decision points, providing the Governor with regular updates, and developing comprehensive recommendations.
Overseen by Medicaid Administrator Charles Duarte, this work group is responsible for conducting in-depth analyses of the new Health Reform legislation, focusing on how it will affect state Medicaid policies and procedures. The work group has established several Subcommittees around specific subject areas.
- The state has drafted a policy paper that, along with an overview of the American Health Benefits Exchanges to be established under the ACA, provides some initial policy recommendations for Nevada.
The state applied for and was awarded an Exchange Planning and Establishment Grant.
Amount Awarded: $1,000,000
Administrator: Nevada Department of Health and Human Services
Initial Planning Activities:
- Assemble information, identify priorities, assess resource needs, and lay the foundation for the development of a fully functioning health insurance Exchange that best meets the needs of Nevadans.
- Conduct background research to better quantify the populations covered by existing and future health insurance programs and to better understand the potential impact on the market with introduction of the Exchange.
- Establish a streamlined eligibility process to serve all applicants for all medical assistance programs.
- Define a governance structure and administrator for the Exchange.
- Catalogue existing resources that may be used to support an Exchange.
- Identify services that will need to be developed and contracted to operate the Exchange
High Risk Pool:
- Federal-Run. Governor Gibbons submitted a letter to Secretary Sebelius declining state participation in the high risk pool program.
- The DOI issued a press release informing consumers of the availability of the federally operated temporary high risk insurance pool program in Nevada as of July 1, 2010.
Additional Grants and Funding:
- According to a DHHS paper outlining grants awarded and future funding opportunities, as of October 12, 2010 Nevada had received nearly $7 million in federal grants under the ACA.
- The state applied for and was awarded a $1 million rate review grant. The DOI’s grant application included a project narrative outlining how the state intends to use the potential grant funding and what goals it hopes to achieve.
- The state received a consumer assistance program grant
Other State Actions, Indicators, and Health Reform Resources:
- DHHS Health Care Reform Web Site
- DOI Health Reform Web Page
- DHCFP Summary of Key ACA Provisions
- Nevada Health Care Reform Policy Papers
- DHHS Health Care Reform Cost Estimate
- DHHS Presentation to Legislative Committee on Health Care
Anti-Reform Actions and Developments:
- Nevada is participating in the multi-state lawsuit challenging the constitutionality of the ACA. Governor Gibbons appointed a Special Counsel to lead the state’s legal efforts and utilized citizen donations to set up a “Constitutional Defense Fund” to pay the filing fees and other costs associated with the lawsuit.
- Governor Gibbons posted a running tally of the cost of federal reform on the state website that also advertises Nevada’s participation in the multi-state lawsuit and provides a link to a website operated by the Attorney General of Florida promoting the plaintiff’s case.