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CARSON CITY, Nev. (AP) — Nevada Gov. Brian Sandoval said he's concerned about Medicaid costs under the federal health care law upheld Thursday by the U.S. Supreme Court but that the state would prepare to meet the mandates as officials decipher the ramifications.
The first-term Republican, who was critical of the law, said he may not agree with the decision, but he respects the process.
"The implications for Medicaid costs are still unclear, but Nevada will prepare to meet the serious financial implications of this decision," Sandoval said in a statement. "I believe the Congress should act to reform this law and ease the serious burdens it places on the states and the nation's businesses.
Officials estimate 563,000 Nevadans lack health insurance, roughly 21 percent of the population.
Part of the Patient Protection and Affordable Care Act to take effect in 2014 would expand eligibility for more people to be covered under Medicaid, a safety net for the poor. State officials previously estimated that provision would cost Nevada $575 million over the first five years.
While the high court's decision upheld the individual mandate that people could be required to purchase health insurance or pay a tax, it also said states cannot lose existing Medicaid funding if they don't increase their Medicaid coverage levels for adults. Under the law, the federal government picks up the tab for expansion in the first few years, but state portions will gradually rise up to 10 percent.
Mark Hutchison, a private lawyer who championed Nevada's case against the health care law by joining the lawsuit filed by 26 other states and a business group, said the court's position on the Medicaid provision puts the issue of whether to expand coverage for the poor in the lap of the state and the Legislature "where it belongs."
Hutchison, a state Senate candidate, said he was surprised the court upheld the constitutionality of the law.
"I don't think anybody expected it to go this way," he said.
Around the state, reaction to the long anticipated ruling was mixed along party lines, guaranteeing it will remain a hot issue in the November election.
"No one thinks this law is perfect," Senate Majority Leader Harry Reid, D-Nev., said on the Senate floor, calling on Republicans to "stop refighting yesterday's battles" and declaring that the health care debate "is settled."
But his Republican colleague, Sen. Dean Heller, R-Nev., took aim and pledged to fight for its repeal.
"This law has now been affirmed as a colossal tax increase on the middle class, and its excessive regulations are stripping businesses of the certainty they need to hire at a time when Nevadans and the rest of the country are desperate for jobs," he said.
"This onerous law needs to be repealed and replaced with market-based reforms that will provide greater access, affordability and economy certainty to our nation," he said.
Repeal was the mantra of Republican officials and candidates.
"This 2,700-page monster offends seniors, veterans, middle class families and employers," said Rep. Mark Amodei, R-Nev. "I will continue to take every opportunity to repeal and address this mess for Nevadans in a practical way without picking political winners and losers."
Fellow Republican Rep. Joe Heck, a physician, said "just because a law is deemed constitutional does not mean it is a good law."
His Democratic challenger for Nevada's 3rd Congressional District, John Oceguera, said Congress should now move on.
"One thing we know for sure, if Washington politicians don't stop the bickering and finger pointing and focus on what matters .... nothing will get done," said Oceguera, outgoing Nevada Assembly speaker.