We’ve taken a forward step with health care

While Republican lieutenant governor candidates Sue Lowden and Mark Hutchison have been busy hurling insults and taunting each other about who did the most to unsuccessfully defeat Obamacare, something extraordinary happened: Some 183,000 uninsured Nevadans got health care.

Instead of going to the emergency room for strep throat, leaving behind an astronomical bill they’re never going to be able to pay, they can go to urgent care or see their primary care physician just like those of us with health insurance do.

They are now able to address chronic medical problems and get preventive care. They won’t constantly worry that a medical crisis will bankrupt them for life. And Nevada will have a more productive workforce as health care costs go down.

According to a new report from the Silver State Health Insurance Exchange, 148,000 of the newly insured are eligible for Medicaid, and the rest entered the private insurance market.

Nevada, long ranked among the worst states for uninsured residents, might not be in the bottom 10 much longer.

Gov. Brian Sandoval and the Legislature deserve credit for implementing the federally financed Medicaid expansion component of the Affordable Care Act despite the garbled criticism from Lowden and Hutchison. Nineteen other states, dominated by Republicans, have refused the federal dollars, leaving hundreds of thousands of eligible people without access to health insurance.

Despite the Feds’ offer to cover 100 percent of the cost now, and then gradually reduce their contribution to 90 percent by 2020, these states refuse to act, leaving their constituents adrift and saddling their taxpayers with the bill for uninsured care in emergency rooms.

It’s elected malfeasance, really. Taking a cue from Nevada’s historically bad habits, these states still refuse to accept Medicaid expansion, thereby ensuring their tax dollars are passed along to states that do want to insure their families. And worse, while it’s morally wrong to allow people to die or get sick for lack of medical care, it rises to a new level of outrage when the funding is available to prevent it.

While the federal health exchange, Healthcare.gov, which matches consumers with the private insurance market, had an abysmal start, enrollment is now exceeding projections, premiums are lower than expected, and the risk pool has improved. But Nevada’s health exchange is struggling to stay afloat. Sandoval even hired Deloitte Consulting, to figure out how to improve the performance of the Exchange contractor, Xerox.

Deloitte was given $1.5 million last March to evaluate what went wrong with the $75 million contract and recommend a path going forward. Three options were presented: spend more money to fix what doesn’t work in the existing system, copy a successful exchange from another state, or move to the federal exchange.

Hutchison insists we stick with the state exchange, despite its robust failure. In last week’s debate on Nevada Newsmakers, he chided Lowden for not backing up the governor: “It’s unfortunate my opponent would rather have the federal government come in and do that rather than support the governor and rather than support Republicans” who voted to implement Sandoval’s plan.

Imagine for a moment if we had a Democratic governor as our chief executive right now. The failure of the state exchange would be an albatross around her neck, with smug Republicans saying, “This is why we need a governor who knows how to run a business and enforce a contract.” (As it happens, as we go to press, the Exchange board voted to dump Xerox and move partly to the national exchange.)

Meanwhile, Lowden has a scary TV ad using the scarcity of doctors in Nevada as a reason we shouldn’t have expanded Medicaid, claiming seniors might have to wait longer to see their doctor.

As for those uninsured families who have been waiting for years for health insurance? Maybe they should take Lowden’s advice on bartering for their health care and start raising some chickens.