Sandoval made the right choice

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Once in a while, Nevada gets it right. In this case, we can’t afford not to.

Ignoring the national partisan rancor over the Patient Protection and Affordable Care Act (ACA), our governor and Legislature methodically moved forward with creating a health insurance exchange so our citizens would have access to competitive policies by the time insurance coverage is required of everyone. Nevada’s willingness to jump into the planning process early garnered almost $84 million in grant funding from the federal government, giving us an unheard-of ranking (for Nevada) of ninth in the country in per capita funding for this purpose.

You might be rightly wondering how Nevada avoided the usual deadlock caused by a Republican governor and a Democratic Legislature and got its act together to become a national leader in the much-maligned and poorly understood “Obamacare.” After all, since its passage Congress has voted 40 times to repeal it, unsuccessfully.

It might have something to do with our dismal statistics in health insurance coverage. About 25 percent of Nevadans are uninsured, the third highest rate in the nation. Only Texas and Louisiana are worse.

Estimates of the number of uninsured Nevadans who could be insured through the Silver State Health Insurance Exchange run from 100,000 to more than 300,000. Nevada also opted-in to expansion of Medicaid. There are at least 163,000 Nevadans who will become eligible under this initiative, along with 41,000 more who currently are eligible but aren’t enrolled. Nevada should receive over $700 million in federal funding for the Medicaid expansion during the first three years.

Gov. Sandoval was actually the first Republican governor to embrace Medicaid expansion. In a statement to the Associated Press, he explained his position: “Though I have never liked the Affordable Care Act because of the individual mandate it places on citizens, the increased burden on businesses and concerns about access to health care, the law has been upheld by the Supreme Court. As such, I am forced to accept it as today’s reality, and I have decided to expand Nevada’s Medicaid coverage.”

While denouncing the ACA, as nearly every Republican does seemingly by reflex, Sandoval nevertheless got on board early, no doubt pressured heavily by the hospital industry that bears the brunt of the cost of emergency care for the uninsured, passing those costs onto the rest of us through increased rates and insurance premiums. Business trumps partisan politics sometimes.

Contrast this realistic and pragmatic position with that of Nevada’s other ranking Republican official, U.S. Sen. Dean Heller, who is shamefully participating in an extremely misleading characterization that Congress is “exempting” itself from Obamacare. (For a succinct account of this maneuver to obscure the truth and create a right-wing talking point, read “The Latest Obamacare Lie That Just Won’t Die” on the New Republic website).

In Heller’s reality, the president and congressional Democrats want to exempt themselves from Obamacare. What really happened is they called GOP Sen. Chuck Grassley’s bluff and agreed to give up their federal health care plan and use the exchange to purchase health coverage instead, something no other worker in the country has to do. The “exemption” being touted by the Republicans and right-wing media is simply a mechanism allowing for employer-paid premiums to continue for these positions.

The irony is as a state legislator and Nevada’s Secretary of State, Heller was known for being rational, reasonable and affable. He seemed sincere about solving problems for his constituents. But like so many others, after a few years in Congress, he has become unrecognizable, more interested in scorning the president’s efforts than trying to connect citizens with affordable health care.

Sen. Heller is an intelligent man. His involvement in this mockery of the truth is not just annoying, it’s beneath him.