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Sprinklecare Dies; Would Have Made Medicaid Buy-In Available To All Nevadans


Updated at 7:00 p.m. on June 16, 2017:

Governor Brian Sandoval vetoed Assembly Bill 374.  In response to the veto, Assemblyman Mike Sprinkle, who sponsored the bill posted this statement on his Facebook page:

"I will continue to believe that health care is a right and not a privilege and to make sure your government provides you with that right. Though today's veto is highly disappointing my job as your legislator is to make sure you have access to affordable and quality health care. As an elected representative I take that responsibility very seriously and will work hard in the future to protect all people's right to health care, not just the privileged."

Governor Brian Sandoval has until the stroke of midnight Friday to veto or sign the bills recently passed by the Nevada Legislature. One, in particular, could have sweeping impacts on healthcare by providing nearly 3 million Nevadans the option to purchase Medicaid.

Reno Public Radio’s Anh Gray sat down with the bill's sponsor.

Medicaid is a federal and state-funded program that provides low-income Americans with health insurance. During the recent legislative session, Democratic Assemblyman Mike Sprinkle introduced Assembly Bill 374.  Officially known as the Nevada Care Plan, it has been dubbed “SprinkleCare.” If it becomes law, Nevada’s Medicaid program will be available to anyone who wants to buy-in to the program. Assemblyman Sprinkle joins us to break down how this bill could affect Nevadans.

There’s been ongoing national debate about healthcare and we’re waiting to see how federal lawmakers will make changes to Obamacare. How did this uncertainty motivate you and your colleagues at the legislature to act on this bill?

Once we started our legislative session, and even before that, we started hearing a lot of the conversations, the rhetoric, and a lot of the uncertainty that was coming out of the federal government, as far as what healthcare is going to look like in the future. So we started to take it upon ourselves to look out for the people of Nevada and what we could do at the state level as a state legislature to provide certainty for them.

Why do you think this Medicaid-for-all type of approach is the way to go for Nevada?

Each state kind of does their Medicaid differently, but in Nevada, we have a really good program, and the benefit structure is really comprehensive, and it’s what people have told us they like. So it made perfect sense, that while we were trying to look at what was best for Nevada—not for other states—but what was best for Nevada, we would also want to mirror it to a program that has already proven itself.

Traditionally, Medicaid is for low-income Americans and is subsidized by the state and federal governments. The bill focuses on a buy-in option. Can you explain that?

People assume that what we’re doing here is allowing people into the Medicaid program, which is not true.

First off, that would be illegal, because we can’t use federal dollars for something like this. So what would happen is an individual would be able to pay a monthly premium cost for the benefit package that is currently associated with Medicaid. Medicaid recipients receive these benefits. Now any other individual that is not eligible for Medicaid could purchase them at a cost. That premium cost is what pays for the program. So we’re not using any tax dollars; we’re not using state tax dollars; we’re not using federal tax dollars for this, which is why it’s legal for us to do it.

Assemblyman Mike Sprinkle

Some healthcare providers have criticized the low reimbursement rates of Medicaid. How would expanding Medicaid affect reimbursement rates?

I think reimbursements rates are a very legitimate concern and a very legitimate question, but it transcends more than what I’m trying to do here with the Nevada Care Plan. This is something that we have recognized for years that needs to improve and increase because that’s how we’re going to get more providers into the state.

I think that that’s a much broader and larger topic of discussion as we go into our next legislative session and beyond. We really need to look at how we can raise those rates even further and that it is essential to providing quality healthcare providers in the state of Nevada. I do not discount those concerns; however, the flip side of that is if we start seeing a decrease in the number of people actually receiving insurance, one of the biggest concerns we’ve heard recently is that the Medicaid expansion that we have had for the last several years may go away in the next two to five years. Well, if that happens, these people could very well become uninsured. With my plan, at least these providers would be getting some sort of reimbursement for the services that they provide.

Before the end of the day on Friday, you’ll know whether the bill passes. Do you have a sense of how Governor Sandoval will decide?

I was very fortunate to have members of his staff work with me on the final piece of legislation that made it through the legislature. So I think that the governor has all the information he needs to make the decision that he’s going to make, so at this point we’re just waiting to see what that decision is.

Anh is a contributing editor for the KUNR news team and has been with the station since 2014. She is an alumna of the Boston University School of Public Health and Teachers College, Columbia University.