State’s future Medicaid costs: hundreds of millions

When the federal government reduces funding for the “newly eligible” Medicaid recipients, it will cost the state of Nevada an estimated $300- to $400-million to cover the cost.

Health and Human Services Director Mike Willden told the Economic Forum on Tuesday the state already has nearly 500,000 Medicaid enrollees, some 50,000 more than the 2013 Legislature budgeted for. He said the state has added some 200,000 Medicaid enrollees because of the Affordable Care Act — Obamacare — and that half of them are the newly eligibles.

Willden said the federal government is currently covering 100 percent of the costs for those recipients — many of whom are young, single and low-income adults.

But, he said, beginning in fiscal year 2017, the federal government will start reducing what it provides and the state will have to pick up 10 percent of the cost for those people.

Forum member Marv Leavitt said that means the 2015 Legislature will have to budget for the start of the expense since it will be approving the 2016-2017 biennial budget.

“Starting in 2017, it’s going to have a big impact,” he said.

Willden said that increase isn’t the whole increase he expects in Medicaid. He said his department’s total budget — more than half of which is Medicaid, went from $6.2- to $7.4-billion this budget cycle and he expects a similar increase in the 2016-2017 cycle.

“We jump in billions each biennium,” he said. “The forecast is we will be jumping in total spending a couple of billion again.”

But he said he can’t actually predict the cost of covering the newly eligible since that depends on how much they generate in medical claims.

“The question is how healthy or unhealthy these newly eligible are,” he said. “We don’t have claims data yet.”

But he said $300- to $400-million is probably a good estimate.

Willden said overall, those costs are largely — about two-thirds — federal dollars, “but it does have a General Fund impact.”

The Medicaid budget for regular enrollees is covered 63 percent by the federal government and, for those in Nevada Check-Up, 74 percent.