Nevada Rep. Mark Amodei explains yes vote on Trump's budget bill, Medicaid changes
Trump plans to sign the bill into law at 2 p.m. Pacific time July 4.
After the U.S. House approved the bill July 3, Amodei released a lengthy statement explaining his decision to support what he called historic legislation to address the Biden administration's mismanagement.
'As with any major reform bill, the One Big Beautiful Bill is a balancing act,' he said, referring to its legislative name inspired by Trump's language. 'I have long believed that we can't let perfect be the enemy of good, and our work won't stop here in getting Nevadans the relief they need.'
Amodei disputed claims the bill is only a handout to the wealthy and characterized it as helping everyday working families.
Amodei's bill highlights
Among Amodei's highlights for the bill are that:
'Claims that this bill harms veterans are nothing more than political scare tactics and gaslighting,' he said. 'The legislative text contains no provisions explicitly targeting veterans, and veterans receiving VA benefits will continue to do so without interruption.'
Amodei on Medicaid changes
Amodei, a Republican who represents the top half of Nevada, noted that discussions around the bill have focused on Medicaid.
Sen. Catherine Cortez Masto, a Nevada Democrat, hammered the bill the day before its passage, calling it 'mean and cruel.'
She noted that estimates show 114,500 Nevadans are expected to lose health care coverage. Northern Nevada HOPES, which serves low-income patients, said the bill will force a 30% reduction in the number of people it can serve.Amodei said Medicaid has exploded in size since it started in 1965.
'Since the enactment of the Affordable Care Act,' his news release said, 'Medicaid has shifted away from its original mission of serving the traditional low-income population, evolving instead into a de facto state-run universal healthcare system.'
In fiscal year 2023, he said, Nevada spent 30% of its budget on Medicaid, $5.6 billion.
'The One Big Beautiful Bill addresses and reins in these excessive Medicaid costs by establishing commonsense work requirements for able-bodied adults without young dependents,' Amodei said. 'In addition, the bill strengthens program integrity measures that protect Medicaid resources for the most vulnerable such as children, pregnant women, people with disabilities and low-income families.'
More: 'Cruel' Medicaid cuts in Trump budget bill cuts to hurt Nevada, Sen. Cortez Masto says
Funding for rural hospitals
There's a balancing act, he said, between reining in out-of-control Medicaid spending and protecting Nevada's hospitals and health clinics.
To offset decreases in Medicaid funding for hospitals, Republicans added the Rural Hospital Stabilization Fund to the bill.
This, Amodei said, 'will provide $50 billion in relief from 2028 through 2032 for rural hospitals.'
Pat Kelly of the Nevada Hospital Association said it's unclear how much help it'll bring.
At Cortez Masto's news conference, Kelly said that the federal budget bill's changes to the provider tax rate will decrease hospital funds.
'The total effect by state fiscal year 2029 on Nevada hospitals,' he said, 'will be a loss of $618 million in payments.'
Kelly noted the $50 billion fund mentioned by Amodei in the federal budget bill.
'But that provision,' he said, 'is not just for rural hospitals. It's for all providers in rural areas so we're not sure how much is going to be available for hospitals. If there's a group that truly needs our support, it's our rural hospitals.'
Amodei said the bill gives the state two years to prepare for changes to the Medicaid provider tax supporting hospitals.
'A perfect solution to healthcare costs has eluded us again,' he said, 'but it will be interesting to see what the Centers for Medicare and Medicaid Services do with implementation of these new Medicaid policies and future rules and regulations.
'I look forward to continuing to work with CMS, the Nevada Health Authority, and our local stakeholders on these issues.'
Mark Robison is the state politics reporter for the Reno Gazette Journal, with occasional forays into other topics. Email comments to mrobison@rgj.com or comment on Mark's Greater Reno Facebook page.
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