Supporters urge legislators to take the deal while skeptics raise doubts as state lawmakers debate whether Nebraska should expand Medicaid under provisions of the federal health care law.
When debate will end and a vote taken is unknown.
Sen. Kathy Campbell of Lincoln sponsors LB 577, which would extend Medicaid to those making up to 138% of the federal poverty level.
“At the end of the discussion of LB 577, the legislature will send a message regarding health care,” Campbell said in her opening statement.
Approximately 240,000 Nebraskans are on Medicaid. Expansion could bring in between 50,000 and 90,000 uninsured Nebraskans.
Supporters say expansion is needed to provide health insurance to the working poor who do not qualify for government assistance, but cannot afford to buy private health insurance.
Under provisions of the Affordable Care Act, the federal government will pay the full cost of expansion the first three years. The law provides for the federal government to pay 90% of the cost thereafter.
Supporters add Nebraska would be foolish to not accept the approximately $2.3 billion being made available by the federal government.
Sen. Jeremy Nordquist of Omaha sought to assure those worried about the cost of expansion that the state will actually save money, because it will be able to eliminate health care programs no longer needed with expansion. He also claimed that Nebraska residents absorb the cost of the uninsured through increase taxes to cover uncompensated care at hospitals and through increased health insurance premiums.
Nordquist told colleagues that with those fiscal concerns settled, Medicaid expansion becomes more of a moral issue than a budgetary one.
“Because with these cost savings and with the federal support, I cannot look a waitress who’s battling cancer or a hair designer who is battling health conditions or the mom who contacted my office with three kids who has MS who can’t work or work very limited amount of time; I can’t look them in the eye and say ‘no’ to this bill,” Nordquist stated during floor debate.
Supporters also contend that expanding Medicaid will improve the health of Nebraskans.
Still, skepticism met the optimistic outlook of supporters.
Sen. Tom Hansen of North Platte cast doubt on whether the federal government, facing its own fiscal problems such as a growing federal debt will be able to fulfill its promise of nearly full funding.
“This is one of the questions I have that if the federal government, with all the problems that they’re facing right now, if they can continue that 90%,” Hansen said.
An amendment has been offered to require the legislature to review Medicaid expansion if the federal government reneges on its promise. That hasn’t satisfied opponents.
Sen. Bill Kintner of Papillion predicted Medicaid costs will keep growing, forcing cuts to other programs and, eventually, forcing legislators to increase taxes.
“And we’re going to have to go to the taxpayers and we’re going to say, ‘We need you to pay more money. We need you to work a couple extra hours this week to not only pay for your health care, but to pay for the health care of others,’” Kintner said.
Debate is expected to continue into tomorrow.
AUDIO: Sen. Campbell opens, plus the first hour of legislative debate on LB 577. [51 min.]