The House-passed GOP health care bill faces an uncertain future in the Senate, with Nevada legislators among its critics.

One aspect of the American Health Care Act (AHCA) that is getting Nevada officials talking is the future of Medicaid. Nevada was one of the states that opted into expanding Medicaid under the Affordable Care Act, and under this new legislation, the way that expansion is funded could change. 

The expansion took effect January 1, 2015. The legislation broadened Medicaid eligibility to nearly all adults under the age of 65 with an income at, or below 138% of the poverty line. At the end of that year, there were 125,989 new enrollees in the state of Nevada, which the federal government paid for fully. To date, closer to 300,000 Nevadans have been added under the expansion.

Under the new AHCA, as currently proposed, beginning in 2020, the federal government would establish a limit on the amount it would pay to reimburse states for Medicaid coverage. So, if the state can't shoulder those additional costs, some Medicaid patients could lose their benefits.

Support for the AHCA is mixed among Nevada's members of Congress. All Democrats, as well as Republican Dean Heller (joined by Governor Brian Sandoval) remain opposed to the bill. Heller said in a statement: “We cannot pull the rug out from under states like Nevada that expanded Medicaid and, we need assurances that people with pre-existing conditions will be protected.”

Congressman Mark Amodei was initially against the AHCA, stating that he was concerned the changes to Medicaid could leave some Nevadans without insurance and at the same time put a bigger cost burden on the state. However, Amodei ended up changing his mind and voting for the bill. Channel 2 spoke with him over the phone about that decision.

"Is this bill perfect? No," Amodei said. "But when you look back to 'Do we need healthcare reform?' Yeah. We are a long way from the finish but we've got to start so that we get moving on this."

When asked why he thinks Republican Senator Dean Heller was still opposed despite Amodei's 'yes' vote, Amodei responded, "If Dean's got other ideas for Medicaid beyond this, then, you know, more power to him."

Amodei said that after taking a closer look at the provisions in the bill, he is confident that traditional Medicaid enrollees would not see any changes to their coverage. For those who became covered after the expansion, he doesn’t see their care costing the state the additional $245 million he originally thought they would. You can read his full statement here.

Democratic Senator Catherine Cortez Masto has also come out against the AHCA. She released this statement:

“Millions of Americans depend on Medicaid to ensure their healthcare needs are met. The ACA allowed states to expand Medicaid, and Nevada accepted the expansion due to the overwhelming benefits it would bring to our state’s most vulnerable residents. The expansion has proven to be successful, and almost 300,000 people have benefited from it in Nevada. The AHCA would directly impact the ability of states to sustain the Medicaid expansions allowed under the ACA, which has even led some Nevada Republicans, such as Governor Sandoval, to oppose the legislation.This, among many other reasons, is why I vehemently oppose the AHCA. I refuse to sacrifice hundreds of thousands of Nevadans’ well-being to satisfy the demands of special interests.”