Medicaid amendment may force a special session

Last-minute amendments to legislation approved by the U.S. House of Represen-

tatives last Friday will create a nearly $100 million hole in Nevada's budget - a hole that could force a special session of the Legislature this summer.

State Director of Administration Andrew Clinger and Lynn Hettrick, deputy chief of staff to Gov. Jim Gibbons, said on Tuesday the gap can't be fixed by simply cutting back the programs involved because of other federal laws.

Hettrick said the state is on hold "until we see what they are actually going to do."

The issue is the House's last-minute decision to eliminate renewal of the increased Medicaid match rate - which cuts a total of $88.5 million lawmakers and the governor included in the budget during February's special session.

In addition, Clinger said, the Temporary Assistance to Needy Families emergency contingency funding was amended out of the bill - costing Nevada an additional $9.3 million.

Unless those funds are put back in the legislation, the state budget is $97.8 million out of balance.

Nevada Reps. Shelley Berkley and Dina Titus, both Democrats, voted for the stimulus extension bill. Republican Dean Heller of Carson City voted against the measure because of the taxes it contains to help pay for programs and what he referred to as "propped-up stimulus programs."

Heller's office did not respond to specific requests on whether Heller supported the Medicaid extension or its removal from the bill.

A spokesman for Sen. Harry Reid, D-Nev., said the majority leader is aware of the problem and how important it is to Nevada.

"That's why he fought to make sure an extension of (Medicaid) funds was included in the original package we negotiated with the House," said Tom Brede of Reid's staff.

He said Reid will now fight to add the money back when the Senate takes up the bill this week but that, "it will take help from Republicans who are willing to help their states avoid even deeper program cuts or job losses."

Clinger and Charles Duarte, administrator of Nevada's Medicaid program, said federal maintenance of effort requirements don't allow the state to cut back welfare or Medicaid benefits and provider payment rates.

Hettrick said the same rules would prohibit the state from taking money out of other programs to fill the hole - particularly in education.

He said the changes to the American Workers, State and Business Relief Act of 2010 make no sense to him - especially since that legislation, the original American Recovery and Reinvestment Act and the health care package approved by Congress fund so many things he doesn't believe should get federal money.

"It's amazing," he said. "They throw money at some things and then turn around with mandated Medicaid and cut."

Hettrick said the timing of the cut was especially bad because the funding had been in the proposed legislation for months, convincing 30 states to count on the money in their budgets.

"It was clearly anticipated by more states than just Nevada that the (Medicaid) renewal would take place," he said.

Cutting the funding would reduce the federal Medicaid match from nearly 64 percent to just 50 percent.

Hettrick said cutting that much money from other programs to keep Medicaid whole with just six months left in the fiscal year would be "devastating" to whatever programs it was taken from.