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Experts: Heller’s bill completely nixes Medicaid expansion in 2019, “much more radical” than previous bills

Republican Senator Dean Heller’s health care bill isn’t just a stunning reversal from his commitment to protecting Medicaid coverage for Nevadans. As health care experts are now pointing out, this legislation’s devastating rollback of Medicaid expansion is more reckless and more radical than previous GOP repeal bills that Heller opposed. 

Under Graham-Cassidy-Heller-Johnson, more than 200,000 Nevadans who have health care through the Medicaid expansion would lose coverage in 2020, and Nevada’s governor would be blocked from using the state’s own money to continue the Medicaid expansion program.

The Hill: GOP ObamaCare repeal takes new step in nixing Medicaid expansion



  • The Senate GOP’s last-ditch effort to repeal ObamaCare goes farther than past bids to rein in the law’s Medicaid expansion, barring states from extending the expansion past 2019 even if they use their own money.
  • “The expansion group is gone even as an option,” Sara Rosenbaum, a professor at George Washington University and Medicaid expert, wrote in an email. “This is why it is so much more radical.”
  • The effect of the provision would be that states would face hurdles in providing a new form of coverage to people currently on the Medicaid expansion.
  • Even using funding under new block grants in the bill, states would have to set up an entirely new program, with new staff, computer systems and more, to provide coverage, experts say. States would have just two years to make that happen, before changes took effect in 2020.
  • “To start afresh would mean creating a whole new infrastructure to cover people, which would really tax states administratively,” said Barbara Lyons, a Medicaid expert at the Kaiser Family Foundation.
  • Aside from the logistical challenges, there simply could not be enough money to recreate Medicaid expansion under the block grants. The proposal shifts money away from states that expanded Medicaid and towards those that did not. “The block grants are going to have less money because the funding is reduced, and they’re redistributing the money from expansion states to non-expansion,” Lyons said.
  • Republican governors from states that expanded the state-federal health program for the needy – including from Nevada, Ohio, Massachusetts and Vermont – are pushing back on the proposal… Nevada would get $2 billion less, according to a study from the consulting firm Avalere.
  • Lyons said that people currently on Medicaid expansion would face difficulty affording other coverage once that went away. “It’s highly likely that they would become uninsured,” she said.