State legislators have effectively killed Medicaid expansion, once again.
The latest proposal to expand Medicaid under provisions of the Affordable Care Act has been shelved for the remainder of the session after senators approved a “bracket” motion 28-20.
Sen. John McCollister of Omaha told colleagues during legislative debate his bill, LB 1032, addressed many of the concerns expressed in past debates about Medicaid expansion.
“In a wider application of the Golden Rule, how can we turn our backs on 97,000 fellow Nebraskans? More simply put, how can we turn our backs on our neighbors when the remedy is so easy?” McCollister asked.
It was the fourth year in a row the Unicameral addressed the issue.
“It’s like Deja vu all over again,” Sen. Kathy Campbell said in addressing the legislature.
Campbell, who has unsuccessfully sponsored similar measures in the past, told fellow senators the latest proposal addressed concerns expressed during past debates. It proposed a three-year pilot program, funded not through General Revenue funds, but through money from the tobacco settlement. It also proposed using private insurance and requiring minor co-pays.
Campbell asked opponents to give the latest proposal a chance.
“That is why we said, let’s do a pilot. Let’s do an 1115 waiver and give us three years to prove that this can work,” Campbell stated.
Yet, Sen. Beau McCoy of Omaha said the Congressional Budget Office recently released a report stating the cost of implementation of the Affordable Care Act has risen dramatically, mostly due to the expansion of Medicaid.
“It talked about that this new evidence proves the point, which many of us have been saying, now the fourth time as it’s been said that we’ve dealt with this issue, that the costs aren’t controllable and that they aren’t even predictable,” according to McCoy.
Sen. Heath Mello of Omaha told colleagues they cannot ignore the problem.
“Colleagues, the issue will not go away,” Mello said. “Not moving forward on the most conservative policy option to address the uninsured in the country colleagues does not make 97,000 Nebraskans leave our state to go find health insurance somewhere else.”
But, Sen. Merv Riepe of Ralston said the debate boils down to one question: is health care a right?
“If we contend health care is a right, to how much health care is each citizen entitled?” Riepe asked. “Is each of us entitled to health insurance if we have led a life of bad habits and addictions?”
Sen. Bill Kintner of Papillion argued expansion is unsustainable even if the federal government foots 90% of the bill.
“A couple of things we do know, Mr. President,” Kintner said. “We do know that whenever you expand Medicaid, no matter what form, there is always a lot more people than you think, they are sicker than you think, and cost more than you think.”
Opponents of Medicaid expansion have successfully used the filibuster the past three years to block a vote on expansion. This year, the bracket motion came before the filibuster had run its course.