in  Nevada

* Fiscal
* Budgets
* Nevada state budget and finances
* Tax policy in Nevada
* Finance
* Financial regulation in Nevada
* Pensions
* Public pensions in Nevada
* Pension health in Nevada
* Civil liberties
* Affirmative action in Nevada
* Campaign finance requirements in Nevada
* Campaign finance requirements for Nevada ballot measures
* Nonprofit regulation in Nevada
* Education
* Charter schools in Nevada
* Higher education in Nevada
* Public education in Nevada
* School choice in Nevada
* Elections
* Ballot access
* Ballot access requirements for political candidates in Nevada
* Ballot access requirements for political parties in Nevada
* Political parties in Nevada
* Ballot access requirements for presidential candidates in Nevada
* Redistricting in Nevada
* Voting in Nevada
* Energy and Environment
* Energy policy in Nevada
* Fracking in Nevada
* Oil and gas extraction on federal land in Nevada
* Endangered species in Nevada
* Environmental policy in Nevada
* Healthcare
* Healthcare policy in Nevada
* Medicaid spending in Nevada
* Effect of the Affordable Care Act in Nevada
* Immigration
* Immigration in Nevada

* * *

This article does not contain the most recently published data on this subject. If you would like to help our coverage grow, consider donating to Ballotpedia.

* * *

* * *

* * *

Healthcare policy in the U.S.
Obamacare overview
Obamacare lawsuits
Medicare and Medicaid
Healthcare statistics

Obamacare glossary • Effect of Obamacare • Centers for Medicare and Medicaid Services

Nevada's Medicaid program provides medical insurance to groups of low-income people and individuals with disabilities. Medicaid is a nationwide program jointly funded by the federal government and the states. Medicaid eligibility, benefits, and administration are managed by the states within federal guidelines. A program related to Medicaid is the Children's Health Insurance Program (CHIP), which covers low-income children above the poverty line and is sometimes operated in conjunction with a state's Medicaid program. Medicaid is a separate program from Medicare, which provides health coverage for the elderly.

This page provides historical information about Medicaid spending in Nevada, including benefits covered, total spending figures, and spending details, as well as information related to CHIP. The sections below display information as it was published on Ballotpedia in 2015. For more current information regarding Medicaid spending in Nevada, click here.

## Contents

* 1 Background
* 2 Benefits
* 3 State and federal spending
* 4 Enrollment
* 5 Dual eligibility
* 5.1 Enrollment
* 5.2 Spending
* 6 Children's Health Insurance Program (CHIP)
* 7 See also
* 7.1 Medicaid in the 50 states
* 8 Footnotes

## Background[edit]

Established in 1965, Medicaid is the primary source of coverage for low-income and disabled individuals and the largest source of financing for the healthcare services they need. In 2014, about 80 million individuals were enrolled in Medicaid, or 25.9 percent of the total United States population. According to the Kaiser Family Foundation, Medicaid accounted for one-sixth of healthcare spending in the United States during that year.[1][2][3]

The federal Centers for Medicare and Medicaid Services (CMS) monitors state Medicaid programs and establishes requirements for service delivery, quality, funding, and eligibility standards. Medicaid does not provide healthcare directly. Instead, it pays hospitals, physicians, nursing homes, health plans, and other healthcare providers for covered services that they deliver to eligible patients.[3][4]

The Patient Protection and Affordable Care Act of 2010, also known as Obamacare, provided for the expansion of Medicaid to cover all individuals earning incomes up to 138 percent of the federal poverty level, which amounted to $16,643 for individuals and $33,948 for a family of four in 2017. A 2012 United States Supreme Court decision made the Medicaid expansion voluntary on the part of the states.[5][6]

## Benefits[edit]

In large part, the states "determine the type, amount, duration, and scope" of benefits offered to individuals enrolled in Medicaid, according to the Centers for Medicare and Medicaid Services. However, benefits are subject to federal minimum standards. The federal government has outlined 16 benefits that are required of all Medicaid programs:[7][8][9]

* Hospital services for inpatients
* Hospital services for outpatients
* Health screenings for individuals and children under age 21
* Nursing facility care
* Home healthcare
* Physician checkups and other services
* Rural health clinic visits
* Visits to federally qualified health centers
* Laboratory tests and X-rays
* Family planning
* Nurse midwife care
* Maternity and newborn care
* Visits to pediatric and family nurse practitioners
* Visits to licensed freestanding birth centers
* Emergency and non-emergency medical transportation
* Tobacco cessation programs for pregnant women

Optional benefits offered in Nevada

In addition to the above required benefits, as of 2012, the optional benefits included in the bulleted list below were offered in Nevada, according to the Henry J. Kaiser Family Foundation. Note that other, less common specialized practitioner services may also have been offered, such as nutritionists and acupuncturists.[9][10]

Number of benefits offered

Nevada | 42
Arizona | 40
California | 45
Utah | 44

* Freestanding ambulatory surgery centers
* Public and mental health clinics
* Certified registered nurse anesthetists
* Chiropractic care
* Dental care
* Dental surgery
* Optometrists
* Podiatrists
* Psychologists
* Occupational therapy
* Physical therapy
* Speech/hearing/language therapy
* Dentures
* Eyeglasses
* Hearing aids
* Home medical equipment
* Prosthetics
* Adult health screenings
* Case management
* Home and community-based services
* Hospice care
* Personal care
* Private duty nurse
* Inpatient psychiatric care for individuals under age 21
* Inpatient care for mental diseases for individuals age 65+
* Intermediate care for intellectual disabilities

## State and federal spending[edit]

During fiscal year 2012, combined federal and state spending for Medicaid was lower in Nevada than in its neighboring states, totaling about $1.7 billion. Spending per enrollee amounted to about $5,410, above only that in California. Nevada dedicated the largest portion of its 2012 budget to Medicaid among its neighboring states, 25.4 percent.[11][12][13][14][15]

Medicaid spending, fiscal year 2012

State  | Total spending*† | Per enrollee*† | Total growth‡ | Compound annual growth rate‡ | Federal share* | State share* | Percent of state budget
Nevada | $1,738,903,012 | $5,410 | 124% | 6.9% | 57% | 43% | 25.4%
Arizona | $7,904,776,123 | $5,429 | 169% | 8.6% | 69% | 31% | 23.7%
California | $50,165,335,340 | $4,803 | 83% | 5.2% | 51% | 49% | 21.4%
Utah | $1,903,197,459 | $6,657 | 80% | 5% | 71% | 29% | 17.5%
United States | $415,154,234,831 | $6,833 | 63% | 4.1% | 57% | 43% | N/A
* "Expenditures do not include administrative costs, accounting adjustments, or the U.S. Territories."
† Includes both state and federal expenditures.
‡ 2000-2012\. Includes payments for services, administrative expenses, and DSH payments.

Acute care services are those that are typically provided within a short time frame, such as inpatient hospital stays, lab tests and prescription drugs. Long-term care services, on the other hand, are those provided over a long period of time, such as home care and mental health treatment. Disproportionate Share Hospital (DSH) payments are funds given to hospitals that tend to serve more low-income and uninsured patients than other hospitals. The bulk of Medicaid spending in Nevada was on acute care, at a similar portion to that in California and Utah. However, a higher portion was spent on DSH payments in Nevada than in neighboring states, 4.9 percent. The remaining 23.9 percent was on long-term care services.[16]

Back to top↑

## Enrollment[edit]

According to a July 2014 report from the Pew Charitable Trusts, in 2010 there were 340,520 Nevada residents enrolled in Medicaid. By 2013, Medicaid covered 10 percent of Nevada residents; between 2000 and 2012, this figure had increased by 4.7 percentage points.[17][18]

In 2010 the majority of spending, 56 percent, was on the elderly and disabled, who made up 21 percent of Medicaid enrollees. This was typical of most states, since this group of enrollees is "more likely to have complex health care needs that require costly acute and long-term care services," according to the Pew Charitable Trusts. The portion of Medicaid enrollees who are elderly and disabled is a factor taken under significant consideration when state lawmakers make appropriations for the program each year.[19]

Distribution of Medicaid enrollment and payments, 2010

State  | Enrollment rates  | Payment for services
Total  | Elderly and disabled individuals  | Parents and children  | Total (in billions)  | Elderly and disabled individuals  | Parents and children
Nevada | 340,520 | 21% | 79% | $1.4 | 56% | 44%
Arizona | 1,531,122 | 16% | 84% | $9.2 | 42% | 58%
California | 11,428,811 | 18% | 82% | $39.3 | 68% | 32%
Utah | 349,595 | 16% | 84% | $1.7 | 58% | 42%
United States | 66,390,642 | 24% | 76% | $369.3 | 64% | 36%
Source: The Pew Charitable Trusts, "State Health Care Spending on Medicaid"

## Dual eligibility[edit]

See also: Medicaid and Medicare dual eligibility

### Enrollment[edit]

Some individuals, such as low-income seniors, are eligible for both Medicare and Medicaid; these individuals are known as dual-eligible beneficiaries. For those enrolled in Medicare who are eligible, enrolling in Medicaid may provide some benefits not covered by Medicare, such as stays longer than 100 days at nursing facilities, prescription drugs, eyeglasses, and hearing aids. Medicaid may also be used to help pay for Medicare premiums. According to the Henry J. Kaiser Family Foundation, in 2011 there were 50,500 dual eligibles in Nevada, or 13 percent of Medicaid enrollees. While average Medicaid spending per enrollee was $3,728, spending per dual eligible was $10,398.[20][21][22][23][24]

Dual eligible enrollment, fiscal year 2011

State  | Total Medicaid enrollment  | Medicaid spending per enrollee  | Number of dual eligibles  | Dual eligibles as a percent of Medicaid enrollees  | Medicaid spending per dual eligible
Nevada | 297,200 | $3,728 | 50,500 | 13% | $10,398
Arizona | 1,350,700 | $7,022 | 146,400 | 12% | $14,824
California | 7,633,100 | $4,468 | 1,294,400 | 11% | $16,053
Utah | 273,900 | $4,890 | 30,200 | 9% | $17,765
United States | 53,535,000 | $5,790 | 9,972,300 | 15% | $16,904
Source: The Henry J. Kaiser Family Foundation, "State Health Facts"

### Spending[edit]

Total Medicaid spending for dual eligibles in Nevada amounted to $434 million. Most payments were made toward long-term care services.[25]

Medicaid spending for dual eligibles by service, fiscal year 2011 (in millions)

State  | Medicare premiums  | Acute care  | Prescribed drugs  | Long-term care  | Total
Nevada | $72 | $110 | $5 | $247 | $434
Arizona | $203 | $1,757 | $0 | $31 | $1,990
California | $2,248 | $7,235 | $245 | $8,949 | $18,677
Utah | $33 | $165 | $8 | $259 | $465
United States | $13,489 | $40,190 | $1,462 | $91,765 | $146,906
Source: The Henry J. Kaiser Family Foundation, "State Health Facts"
Back to top↑

## Children's Health Insurance Program (CHIP)[edit]

In 2015, Nevada served CHIP enrollees through a combination of Medicaid and a separate program. Its upper eligibility limit was 205 percent of the FPL, meaning a family of four had to make less than $48,892 per year to qualify. The state imposed monthly premiums beginning at 133 percent of the FPL. Below is a table with some general information about CHIP in Nevada, including spending figures, the state's federal match percentage, and enrollment in the program. These data points are compared with those of its neighboring states.[26][27][28][29][30][31]

General CHIP information for Alabama

State  | Total CHIP expenditures, 2015 (millions)  | Enhanced FMAP, 2017* | CHIP enrollment, 2014  | Program type
Federal  | State  | Total
Nevada | $45.90 | $15.30 | $61.20 | 98.27% | 45,870 | Combination
Arizona | $92.10 | $26.20 | $118.30 | 100.00% | 54,361 | Separate CHIP
California | $1,440.60 | $775.70 | $2,216.30 | 88.00% | 1,874,939 | Combination
Utah | $117.00 | $30.40 | $147.50 | 100.00% | 76,533 | Separate CHIP
United States | $9,528.00 | $3,933.40 | $13,461.40 | 88.00% | 8,129,426 | N/A
* FMAP stands for Federal Medical Assistance Percentage and reflects the percentage of state dollars spent on CHIP that are eligible for matching funds from the federal government.
Sources: The Henry J. Kaiser Family Foundation, "State Health Facts"
MACPAC, "CHIP Spending by State"

## See also[edit]

* Medicaid spending in Nevada

* Healthcare policy in Nevada

* Effect of the Affordable Care Act in Nevada

### Medicaid in the 50 states[edit]

Click on a state below to read more about the Medicaid program in that state.

Choose your state...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington, D.C.West VirginiaWisconsinWyoming

http://ballotpedia.org/Medicaid spending_in_STATE

## Footnotes[edit]

1. ↑ The Kaiser Commission on Medicaid and the Uninsured, "Medicaid Enrollment in 50 States," February 2010 (Note 1)
2. ↑ Center on Budget and Policy Priorities, "Policy Basics: Introduction to Medicaid," June 19, 2015
3. ↑ 3.0 3.1 The Henry J. Kaiser Family Foundation, "Medicaid Financing: How Does it Work and What are the Implications?" May 20, 2015
4. ↑ Centers for Medicare and Medicaid Services
5. ↑ Kaiser Health News, "Consumer’s Guide to Health Reform," April 13, 2010
6. ↑ Office of The Assistant Secretary for Planning and Evaluation, "Poverty Guidelines," accessed June 9, 2017
7. ↑ Medicaid.gov, "Benefits," accessed June 8, 2017
8. ↑ The Commonwealth Fund, "Medicaid Benefit Designs for Newly Eligible Adults: State Approaches," May 11, 2015
9. ↑ 9.0 9.1 The Henry J. Kaiser Family Foundation, "KCMU Medicaid Benefits Database: General Benefits and Cost-Sharing Notes," January 2014
10. ↑ The Henry J. Kaiser Family Foundation, "Medicaid Benefits Data Collection," accessed September 24, 2015
11. ↑ The Henry J. Kaiser Family Foundation, "Total Medicaid Spending," accessed July 17, 2015
12. ↑ Cite error: Invalid `<ref>` tag; no text was provided for refs named `perenrollee`
13. ↑ The Pew Charitable Trusts, "State Health Care Spending on Medicaid" Table B.1, accessed July 17, 2015
14. ↑ The Henry J. Kaiser Family Foundation, "Federal and State Share of Medicaid Spending," accessed July 17, 2015
15. ↑ National Association of State Budget Officers, "State Expenditure Report: Examining Fiscal 2011-2013 State Spending: Table 5," accessed July 17, 2015
16. ↑ The Henry J. Kaiser Family Foundation, "Distribution of Medicaid Spending by Service," accessed July 17, 2015
17. ↑ Data on Medicaid enrollment figures may differ depending on the source of data and the computational methods used, such as "point-in-time" figures versus "ever-enrolled" figures.
18. ↑ Centers for Medicare and Medicaid Services, "Total Medicaid Enrollees - VIII Group Break Out Report," accessed September 14, 2015
19. ↑ The Pew Charitable Trusts, "State Health Care Spending on Medicaid," July 2014
20. ↑ The Henry J. Kaiser Family Foundation, "Monthly Medicaid Enrollment (in thousands)," accessed September 4, 2015
21. ↑ The Henry J. Kaiser Family Foundation, "Medicaid Spending per Enrollee (Full or Partial Benefit)," accessed September 4, 2015
22. ↑ The Henry J. Kaiser Family Foundation, "Number of Dual Eligible Beneficiaries," accessed September 4, 2015
23. ↑ The Henry J. Kaiser Family Foundation, "Dual Eligibles as a Percent of Total Medicaid Beneficiaries," accessed September 4, 2015
24. ↑ The Henry J. Kaiser Family Foundation, "Medicaid Spending per Dual Eligible per Year," accessed September 4, 2015
25. ↑ The Henry J. Kaiser Family Foundation, "Distribution of Medicaid Spending for Dual Eligibles by Service (in Millions)," accessed July 17, 2015
26. ↑ The Henry J. Kaiser Family Foundation, "Medicaid and CHIP Income Eligibility Limits for Children as a Percent of the Federal Poverty Level," accessed May 25, 2016
27. ↑ The Henry J. Kaiser Family Foundations, "Premiums, Enrollment Fees, and Cost-Sharing Requirements for Children," accessed May 26, 2016
28. ↑ Medicaid and CHIP Payment and Access Commission, "CHIP Spending by State," accessed May 26, 2016
29. ↑ The Henry J. Kaiser Family Foundation, "Enhanced Federal Medical Assistance Percentage (FMAP) for CHIP," accessed May 26, 2016
30. ↑ The Henry J. Kaiser Family Foundation, "CHIP Program Name and Type," accessed May 26, 2016
31. ↑ The Henry J. Kaiser Family Foundation, "Total Number of Children Ever Enrolled in CHIP Annually," accessed May 26, 2016

v • e

Ballotpedia

About|

Overview • What people are saying • Support Ballotpedia • Contact • Contribute • Job opportunities

* * *

Executive: Leslie Graves, President • Gwen Beattie, Chief Operating Officer • Ken Carbullido, Vice President of Election Product and Technology Strategy

Communications: Kayla Harris • Megan Brown • Sarah Groat • Lauren Nemerovski
External Relations: Alison Prange • Sara Key • Kari Berger • Hannah Nelson
Operations: Meghann Olshefski • Lauren Dixon • Kelly Rindfleisch
Policy: Christopher Nelson • Caitlin Styrsky • Molly Byrne • Katharine Frey • Jimmy McAllister
Tech: Matt Latourelle, Tech Manager • Nathan Bingham • Ryan Burch • Michael Cella • Kirsten Corrao • Margaret Kearney

Contributors: Scott Rasmussen

* * *

Editorial|

Geoff Pallay, Editor-in-Chief • Daniel Anderson, Managing Editor • Josh Altic, Managing Editor • Ryan Byrne, Managing Editor • Cory Eucalitto, Managing Editor • Mandy Gillip, Managing Editor • Jerrick Adams • Victoria Antram • Dave Beaudoin • Jaclyn Beran • Marielle Bricker • Kate Carsella • Kelly Coyle • Megan Feeney • Juan García de Paredes • Sara Horton • Tyler King • Doug Kronaizl • Amee LaTour • David Luchs • Brittony Maag • Andrew McNair • Jackie Mitchell • Elisabeth Moore • Ellen Morrissey • Mackenzie Murphy • Samantha Post • Paul Rader • Ethan Rice • Myj Saintyl • Maddie Sinclair Johnson • Abbey Smith • Janie Valentine • Caitlin Vanden Boom • Joel Williams • Samuel Wonacott • Mercedes Yanora