Initiative 427, the Medicaid expansion issue on the ballot, received 335,424 votes, or about 53% of the total vote. Slightly more than 295,000 voted against the measure, a split of roughly 53-47%.
Medicaid expansion is estimated to cover 90,000 low-income Nebraskans now without health insurance. Under the ACA, the federal government pays 90% of the cost of Medicaid expansion, an estimated $600 million a year. The state will have to come up with at least $50 million for its match.
It is estimated Medicaid expansion would cost $148.3 million over a three-year period. Nebraska is expected to receive $1.359 billion in federal funding over that three-year period.
Legislators opposed to the issue consistently gathered enough opposition to block the issue from coming to a vote in the Unicameral.