Democrats on legislative money panels added back $88 million to Medicaid programs that assist Nevada's poor, elderly and disabled, saying some cuts in Republican Gov. Brian Sandoval's budget are too painful and would hurt health care and services for all.
One party-line vote after another, members of the Senate Finance and Assembly Ways and Means committees rejected Sandoval's rate cuts for hospitals, skilled nursing homes and other health care providers.
In an emotional appeal to committee members, Senate Majority Leader Steven Horsford, D-Las Vegas, spoke of how his grandmother was in a nursing home for 25 years after suffering a debilitating stroke.
"My entire time growing up as a child, we would visit my grandmother in a nursing home," he said, his voice shaking. He and others said cutting rates would jeopardize quality of care.
"There's a reason behind why these rates have to be maintained at a certain level," he said. "Once you drop below, the adequacy of care gets compromised. It does."
"These are our grandmothers, our grandfathers, our parents," Horsford said. "Nevada has a very high percentage of seniors ... many without family members in the state. For some, this is how they live."
Democrats also argued that reducing the state portion paid to providers to care for the poor would end up costing everyone, and amounts to a tax increase for people who buy insurance because their rates would likely increase.
Sandoval's original budget proposed cutting rates paid to nursing homes by $20 a day, but he restored $5 a day after more federal matching funds were forecast. The money committees, however, said the resulting $15 cut was too much.
Lawmakers also rejected the governor's recommendation to reduce rates paid to hospitals by 5 percent and rates by physicians by 10 percent.
"I think we are at the tipping point," said Sen. Sheila Leslie, D-Reno. "If we go forward and we accept another 5 percent hit on the hospitals ... we're going to see services closed in the hospitals."
"We are jeopardizing the health care system for everybody, not just Medicaid patients," she added.
The governor's recommendation "imposes a tax on anyone who purchases health insurance for themselves or their families," said Assemblyman Marcus Conklin, D-Las Vegas.
Conklin said when hospitals aren't reimbursed for services to the poor, they don't write it off. "You collect if from someone else," he said.
The committees also rejected shifting the cost of services for the aged, blind and disabled to counties, a move Sandoval said would have saved the state general fund $37 million over the biennium.
"We cannot push this down to the counties," Leslie said. "It's stitched together so thinly, it's going to fall apart. I cannot support this."
Committee members, however, did agree to continue diverting to the general fund a slice of county property taxes that had gone to pay the medical bills for indigent accident victims.
Republicans on the committees remained firm behind the governor's platform of no new taxes, which was reflected in his proposed $6.1 billion two-year spending plan.