Nevada

This article is part of the State Status and News series related to the Patient Protection and Affordable Care Act.

On 21-Jul-2010, Senator Harry Reid, Senate Social-Democrat Caucus leader at the time of PPACA passage, wrote a letter to Secretary of Health and Human Services Sebelius detailing PPACA cuts to Nevada health care funding and requesting assistance therewith. Congressional Quarterly published the letter and additional commentary is available on various blogs.

On 31-Mar-2010, reports1) began to surface that Nevada “Attorney General Catherine Cortez Masto, a Democrat, says a lawsuit would be a waste of state money, since more than a dozen other states are already challenging the health care reform law in court. But, [Nevada] Gov. Jim Gibbons, a Republican, wants Nevada to mount a legal challenge to the law. He is even willing to go around the attorney general's office to do it.” Later the same day, the Nevada Governor personally confirmed2) the reports by saying “My obligation under the oath I took, I am required to protect the people of the state of Nevada. I see this lawsuit or this piece of legislation as an abridgement to the rights of Nevadans. I'm obligated to protect those rights, whether it is an incremental encroachment or a vast step backwards in the freedoms of the people of this country. I have to bring that lawsuit. I am obligated to do it. I will do.” By 01-Apr-2010, at least one non-scientific poll3) suggested that 56% of 2,300 Nevadans surveyed “favored a lawsuit without Cortez Masto's consent while 44 percent said Nevada should not sue.” On Friday, 02-Apr-2010, Dan Burns, the Nevada Governor's spokesperson, leaked reports4) that “the Nevada attorney general may have violated rules of professional conduct when she publicly advised the governor not to sue over the recently passed national health care plan,” with the same reports indicating that “the matter will also 'be discussed further on Tuesday,' the day Gibbons is expected to hold a news conference to discuss a possible lawsuit over the law.”

Nevada Gov. Jim Gibbons said Thursday he wants to know very soon whether his state's attorney general will pursue legal action against the health care bill signed this week by President Barack Obama.

In a terse letter from the Republican governor to Attorney General Catherine Cortez Masto, a Democrat, Gibbons expressed frustration that Masto's office is still investigating the constitutionality of the health care overhaul.

[…]

Critics say the law is unconstitutional, mainly because it contains a mandate for individuals to have health insurance coverage or face an annual penalty of $695. The legislation will also add about 16 million people to the states' Medicaid rolls, which will costs the states.

“This law forces all Nevadans to buy health insurance or face the wrath of the Internal Revenue Service,” Gibbons said this week. “That kind of arrogance in Washington DC must be stopped and Nevadan's must be allowed the freedom to choose their own health care options.”

Rizo, Chris. “Nevada AG Pressured Over Possible Health Care Lawsuit”. LegalNesline. March 26, 2010. Available online as of 2010-04-06.

Last week Governor Jim Gibbons gave Attorney General Catherine Cortez Masto until Monday to decide if she would join a lawsuit brought by 14 other states challenging the new health care reform bill.

With that deadline passing and no answer from the attorney general, the governor says he's prepared to circumvent her office with other legal representation.

[…]

The governor said he was for the moment still waiting for the attorney general's decision, but if it was not forthcoming, he was prepared to go elsewhere.

The governor said he felt his own in-house counsel could bring the suit or perhaps one of several private attorneys he says have offered to work pro bono on the state's behalf.

There could be a problem with that. According to state law (NRS 41.0345) the governor does not have independent authority to to hire outside counsel to represent State interests and must be represented either by the Attorney General or by outside counsel hired by the Attorney General.

The governor and his staff apparently see an opening in that word “hire.” If an attorney is working pro bono–for free– is the law satisfied and can they represent the state?

[…]

Pearce, Ed. “Governor: Other Attorneys Could Represent State”. KOLO-TV. March 29, 2010, 5:40 PM. Available online as of 2010-04-06.

Even after a year of seemingly nonstop political wrangling on health care, the enactment of a law in March marks just the opening phase of change.

Many of the provisions that will affect businesses the most won't take effect until 2014. However, some changes mandated by the law, now officially titled the Patient Protection and Affordable Care Act, could start to change insurance premiums within a few months. Many other provisions will mean little in practice until the federal government has gone through the tedious and years-long task of writing regulations.

[…]

Dwight Mazzone of Mazzone & Associates has few concrete answers for the calls he gets from employers.

“I tell people to be patient. Anger isn't going to do anybody any good right now,” he said. “Take a deep breath and have a cup of coffee,” but continue to press lawmakers with your opinion.

An example of a question that has no answers, he said, is language in the law that could alter different levels of coverage, such as one set of benefits for management and another set for hourly workers. This will fall under the rule-writing process, which the National Association of Health Underwriters estimates will take from seven to 10 years.

In some instances, reactions from businesses have come swiftly. Several major corporations, including Deere & Co., Caterpillar and AT&T have announced hits to future earnings running as high as $1 billion due to accounting changes for covering drug costs for retirees. Experts in the sector do not see this affecting Las Vegas because companies did not provide that benefit.

[…]

O'Reiley, Tim. “Health Care Reform's Fallout Needs Sorting Out”. Las Vegas Busines Press. April 5, 2010. Available online as of 2010-04-06.

The recently-passed health insurance reform bill will lead to major changes for Nevada’s Medicaid program.

According to Ben Kieckhefer, a spokesman for the Nevada Department of Health and Human Services, the bill will require Nevada to extend its Medicaid coverage to families with children over the age of six whose income is below 133 percent of the federal poverty level, along with childless adults with an income below 133 percent of the poverty level. Previously, no childless adults qualified for Medicaid, and families with children over the age of six only qualified if their income was below 100 percent of poverty level.

After the Medicaid changes go into effect in 2014, Kieckhefer estimates that 80,950 Nevadans will qualify under the new rules during the first five years. Federal funds will pay the for the total cost of these newly eligible citizens through 2016. The funding will then gradually decrease to reach 90 percent in 2020.

However, Kieckhefer says the newly eligible Nevadans are not the only expense. The federal funding provided in the health care reform bill does not apply to Nevadans who already qualified for Medicaid before the passage of the bill.

In what he calls the “woodwork effect,” Kieckhefer estimates that due to the new federal mandate requiring all citizens to have health insurance, over 72,000 previously-qualified Nevadans will sign up for Medicaid. Nevada will not receive any additional federal coverage for those new insureds beyond the current Medicaid funding of about 50 percent of costs.

Current estimates show that reform bill Medicaid will cost the state about $600 million between 2014 and 2019, an amount Dan Burns, Governor Jim Gibbons’ Communication Director, says will put significant strain on Nevada’s ability to provide other services, such as public safety and education.

Burns said Nevada currently has no plan for how to pay for the projected $3 billion budget hole that will have to be tackled during the next legislative session.

As a result, Burns said, Gibbons is focusing on legal action to try to invalidate the law

[…]

Governor Gibbons, who has been outspoken about future costs to the state in his opposition to the health care bill, is tomorrow scheduled to announce details of actions he plans to take. He is holding a press conference at noon at the Governor’s Office, Grant Sawyer Building, 555 E. Washington, Suite 5100, Las Vegas, NV.

Moyer, Phillip. “What Health Insurance Reform Means For Nevada Medicaid”. Nevada News Bureau. April 5, 2010. Available online as of 2010-04-06.

Nevada Gov. Jim Gibbons has called a noon news conference Tuesday to announce his response to what he calls the “Reid/Pelosi/Obama Nationalized Healthcare Law.”

Gibbons, who failed to convince the state attorney general to sue the federal government over health care reform, is expected to sue through a private attorney who will work pro bono.

The news conference will be held at the governor’s office at the Grant Sawyer Building in Las Vegas.

A majority of respondents to a recent FOX5 Web poll supported Gibbons’ decision to sue without the attorney general’s consent.

[…]

Staff. “Gibbons To Tackle Health Care Tuesday”. Fox-5 News (Las Vegas). April 5, 2010, 2:11 PM PDT. Available online as of 2010-04-06.

Nevada Gov. Jim Gibbons on Tuesday appointed an attorney to represent the state for free and join a federal lawsuit in Florida to block federal health care reform. The Republican governor has been publicly feuding with Democratic Attorney General Catherine Cortez Masto, who refused his request to file the lawsuit. Both are up for reelection. Gibbons said attorney Mark Hutchison, with Hutchison & Steffen, will work for free, and that other fees, which he expects to be less than $5,000, will be paid with private donations.

[…]

Gibbons argues that the laws violates states' rights, and that it will cost already cash-strapped Nevadans $2.4 billion, including $600 million from state taxes and $1.8 billion in federal taxes.

“This health care nationalization plan is illegal because it is unconstitutional,” Gibbons said, “The arrogance of this administration to force all Nevadans to purchase something (health insurance from private companies) or face IRS penalties is outrageous and wrong.”

Meanwhile, the Nevada Department of Health and Human Services is set to ask the legislature's Interim Finance Committee for $500,000 next month to start planning for the anticipated impact of the new law.

[…]

Divito, Nick. “Nevada Governor Sidesteps AG, Hires Private Counsel to Fight Healthcare Reform for Free”. Courthouse News Service. April 6, 2010. Available online as of 2010-04-06.

Gov. Jim Gibbons has signed an executive order for Nevada to join 14 other states suing the federal government over health care reform.

The Republican governor on Tuesday said the state would be represented by Las Vegas lawyer Mark Hutchison.

Democratic Nevada Attorney General Catherine Cortez Masto refused an earlier directive from Gibbons to join the multistate challenge to the health bill passed by Congress and signed by President Obama.

Gibbons says the measure will cost Nevada taxpayers $2.4 billion in additional state and federal taxes.

Hutchison says Nevada's objections to the law will be similar to other states.

But he says the suit will be stronger with Nevada taking part.

[…]

Garcia, Oskar. “Governor Orders Nevada to Join Health Reform Suit”. Associated Press. April 6, 2010. Available online as of 2010-04-06.

The home state of the top Democrat in the Senate filed a lawsuit today against the new pro-abortion health care law. Nevada Gov. Jim Gibbons announced he will rely on outside attorneys to sue the federal government over the health care scheme because the state's attorney general wouldn't file suit.

The lawsuit is a bit of a hit to Sen. Harry Reid, the pro-abortion Nevada Democrat who heads the Senate and refused calls from pro-life groups to pull the abortion funding from the bill.

[…]

“The arrogance of this administration to force all Nevadans to purchase something (health insurance from private companies) or face IRS penalties is outrageous and wrong,” he added.

Gibbons has directed Nevada Attorney General Catherine Cortez Masto to file a lawsuit against the federal government over the constitutionality of the requirement in the new health care plan that every American buy or obtain health insurance. Masto refused.

As a result, Gibbons signed an executive order naming Mark Hutchison from the Las Vegas law firm of Hutchison & Steffen as special legal counsel to the governor to handle the lawsuit.

[…]

The latest Rasmussen Reports telephone survey of likely voters in Nevada shows support for repeal of the health care plan is stronger in Nevada than it is nationally, and 54% of the state’s voters would like Nevada to join the 14 other states that are suing the federal government over the health plan.

Ertelt, Steven. “Home State of Top Senate Democrat Files Suit Against Pro-Abortion Health Care”. Lifenews.com Available online as of 2010-04-06.

Gov. Jim Gibbons on Tuesday appointed a private attorney to represent Nevada and join a Florida lawsuit seeking to overturn the federal health care law that was passed last month. The governor’s move comes after Attorney General Catherine Cortez Masto defied Gibbons’ demand that she join the lawsuit.

[…]

In this case, Gibbons points to a state law that mandates the attorney general sue “whenever the governor directs” and cites her failure to do that as the reason for his action. Some of Gibbons’ supporters have attacked Cortez Masto. One of his aides said she violated the attorney-client privilege by releasing a letter outlining her reasons for declining to join the lawsuit, and someone has since filed a bar complaint. Other supporters have suggested that Cortez Masto has committed a misdemeanor by not obeying the governor.

[…]

State law and the Nevada Constitution clearly set up a tension between the attorney general and the governor, which prevents abuses like this.

[…]

Editor. “A constitutional crisis”. Las Vegas Sun. April 8, 2010. Available online as of 2010-04-08.

Former New York Governor George Pataki joined top Nevada Republicans today in calling for repeal of the newly passed healthcare reform law.

Pataki, Governor Jim Gibbons, Congressman Dean Heller and Attorney General candidate Jacob Hafter spoke to an audience of about 100 at a Reno rally.

Healthcare reform was the theme of the gathering. It wasn't the only target.

Each took shots at Attorney General Catherine Cortez Masto for her refusal to join other states in a lawsuit challenging the law on constitutional grounds.

“I was very disappointed when we asked her to stand up for Nevadans,” said Governor Gibbons, “and she said no.”

The governor is attempting to join the lawsuit anyway with private attorneys, including Hafter, representing the state–an effort applauded by Pataki

“If the AG won't do it, you should do it,” he told Gibbons. “I wish you success.”

But Pataki says voters can force repeal of the law by pressuring Congress. He's campaigning for a nationwide petition drive to gather a million signatures calling for repeal.

“We need your help,” he told the crowd.

And it was no accident the former New York governor was standing Reno as he made that pitch.

“he [sic] corrupt deals I've never seen in my lifetime,” he said, “and I wound who it was that put those deals together so that Obamacare that the people didn't want could get through the United States Senate. I think you know the answer to that.”

The crowd answered “Harry Reid.”

Earlier he was in Nebraska noting the deal made before final passage giving that state extra Medicaid funding to corral the vote of Senator Ben Nelson and, following the Reno rally he headed for San Francisco for a similar event in House Speaker Nancy Pelosi's congressional district.

We should note the special treatment of Nebraska was taken out of the bill before its final passage. Those negotiated with Florida and Louisiana remained in the measure.

Pearce, Ed. “Pataki Plugs Health Care Repeal in Reno”. KOLO-TV. April 19, 2010, 6:59 PM. Available online as of 2010-04-20.

Nevada has opted out of a health insurance pool to cover people with high-risk pre-existing conditions. Governor Jim Gibbons has notified the Department of Health of Human Services of the decision. He claims the new healthcare reform law provides just a fraction of the funding needed to properly run the insurance pool. Gibbons says the 61-million dollars would only cover about 29-hundred high-risk patients in Nevada. State officials project about 100-thousand people would qualify. The move means the federal government will run the high-risk pools for Nevada and other states that decline federal funding. By the year 2014, all insurance companies will be legally barred from denying coverage to people with pre-existing conditions.

“Nevada Opts Out Of Health Insurance Pool”. April 29, 2010, 5:17 AM PDT. KXNT Radio (Nevada). Available online as of 2010-04-29.

It’s interesting to note that much of the media, who told the public that the health care reform package would be deficit-reducing, failed to report the new cost adjustment made by the Congressional Budget Office in the past few days. The CBO has added $115 billion to the 10-year cost of the bill. Guess you can kiss the $140 billion in deficit reductions goodbye.

Of course anyone who followed the passage of this bill knew much larger costs were tagged onto other bills to disguise the true cost of the political lunacy. Keep voting for the career politicians and one day you will have to pay for the funded and unfunded debts rapidly approaching $150 trillion.

And please don’t forget the billions that will be our part of the International Monetary Fund’s bailout of Greece, with Spain and Portugal soon to follow. As P.T. Barnum knew, there’s a sucker born every minute. Who knew it was the American public?

Donnelly, Michael A. “True cost of health care is already emerging”. Las Vegas Sun (editorial). May 14, 2010. Available online as of 2010-05-14.

1) “Nevada Governor Considers Options on Health Care Reform Fight”. CBS 8 News Las Vegas. March 31, 2010 10:47 PM EST. Available online as of 2010-04-04.
2) VanSusteren, Greta. “Health Care Civil Wars”. On The Record (Fox News). March 31, 2010. Available online as of 2010-04-04.
3) “Poll: Sue Over Health Care Despite AG's Refusal”. Fox 5 News Las Vegas. April 1, 2010 8:47 PDT. Available online as of 2010-04-04.
4) Rizo, Chris. “Nevada AG Suspected of Violating Confidentiality Rules”. Legal Newsline. April 4, 2010. Available online as of 2010-04-04.