The Board of Examiners was told Tuesday that the new health care legislation will cost Nevada an estimated $575 million between now and 2019 when its provisions are fully implemented.
Health and Human Services Director Mike Willden said the biggest cost he expects will come from changes in Medicaid eligibility rules.
"We will enroll somewhere around 150,000 new people into Medicaid," he said. "We're around 260,000 now."
Willden said the $575 million estimate is "just the new eligibles," and doesn't include those who are currently eligible but haven't signed up for benefits.
Those new eligibles, he said, will be fully federally funded for the first three years. But after that, the state will have to start picking up part of the tab - a bigger percentage each year after that.
In addition, he said it will cost the state some $38 million to upgrade and expand its computer systems to handle the new Medicaid workload and rules, plus more for increased administrative costs.
"All these things will cost the state money," he said.
Willden made the comments as the board, headed by Gov. Jim Gibbons, approved $279,119 to hire consultants and employees to begin planning implementation of the health care law.
Gibbons, who is trying to have Nevada join in the Florida case challenging the constitutionality of parts of that law, said despite his opposition, he would vote for the expenditure.
"I fundamentally and philosophically disagree with this federal legislation," he said. "That being said, the law is the law. I will not put employees of the state of Nevada in the position of violating the law."
That item must still be approved by the Interim Finance Committee.