News - May 31, 2018 - by Ray Hagar

By Ray Hagar
Nevada Newsmakers

Democratic gubernatorial candidate Steve Sisolak said Thursday on Nevada Newsmakers that one of his top priorities is to get more senior citizens covered by Medicaid.

"We need to get to covering more of our seniors with Medicaid," Sisolak said. "I am a big believer that health care is only health care if there are two things involved: It's affordable and it is accessible."

Sisolak, the current chairman of the Clark County Commission, said the best way to get more seniors covered is to boost reimbursement payouts to doctors and other health professionals. Currently, many doctors in Nevada do not treat patients covered by Medicaid because the payout rates from the state are too low.
Medicaid, the nationwide social healthcare program funded by federal and state taxes, provides healthcare for those with limited resources, including seniors, single mothers and their children.

"We have to negotiate better contracts with our providers in terms of prescription services and services that are rendered," Sisolak said. "I think we need to increase the reimbursement rates on Medicaid and Medicare. Otherwise, too many professionals now are not taking it because reimbursement is so low."

Boosting reimbursement rates seem to be the only logical solution, Sisolak said.

"I don't know what other means you can use," he said. "You can't drag someone kicking and screaming to the table to participate. The only method that is effective that I can see is to make the reimbursement rates a little bit more reasonable."

In Nevada, households with annual incomes of up to 138% of the federal poverty level may qualify for Medicaid, according to state guidelines. This is $16,394 per year for an individual, or $33,534 per year for a family of four.

"It is a safety net that captures a lot of folks," Sisolak said. "Health care care should not be dictated, in my opinion, by your bank balance or your zip code. Unfortunately that is what is happening right now. Most of our most vulnerable seniors are in areas that don't have access to quality health care. It is particularly true in some of my age-restricted communities where I go and speak regularly."

Sisolak shared this anecdote about the struggles of senior citizens:

"I had a couple (in an age-restricted housing community) who were both on the same medication, for example, a blood thinner or a high blood-pressure medication," he said. "And they were absolutely cutting the prescription pills in half, so that both parties could take half of a pill because they figured that is better than one taking the whole pill and the other taking nothing.

"It is not something that we should be proud of that in our state and our country, seniors are being put into these difficult situations," Sisolak said.

Although Sisolak offered no plan to pay for the boost in Medicaid payouts to doctors, he was adamant that the Commerce Tax would not expand to include more businesses to pay for it.

Republican gubernatorial candidate Adam Laxalt has proposed eliminating the Commerce Tax, which currently only applies to Nevada's largest businesses. Yet his campaign consultant, Robert Uithoven, said that with the expected majority of Democrats in the 2019 Legislature, that probably won't be possible.

"I am not willing right now to look at increasing the Commerce Tax," Sisolak said. "Adam Laxalt wants to take it away but you've got to come up with a way to fill that hole. You can't just have this gaping hole in the budget and have no way to fill it."

State officials said repeal of the Commerce Tax could result in a $350 million to $400 million hole in the budget.

"I am not in favor of increasing anything that is going to affect small businesses in the state of Nevada," Sisolak said. "I would not lower the threshold (of Commerce Tax eligibility) to capture more people because small businesses are still struggling and they need to be protected."

When asked what sector of the economy is struggling, Sisolak said:

"We are in a boon time. You are absolutely right," he said. "The construction industry is going like gangbusters, I guess you would say, and a rising tide lifts all boats. But when you are talking about smaller businesses that have a dozen or 15 or fewer employees and are really trying to expand -- getting to that second location or that third location -- I would not want to burden them with an additional tax increase at this time."