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LINCOLN, Neb. (AP) — The newest attempt to expand health care coverage with Medicaid dollars reopened an old divide Wednesday before a Nebraska legislative committee.
A coalition of doctors, hospitals, local governments and uninsured residents urged lawmakers to advance the bill. Conservative groups and members of Gov. Pete Ricketts' administration argued before the Health and Human Services Committee that the proposal is unsustainable.
The bill by Sen. John McCollister of Omaha would cover childless adults whose incomes are too high to qualify for regular Medicaid but too low to receive tax subsidies available through the federal health care exchange. Attempts to expand Medicaid in Nebraska have stalled three times in as many years, and the newest bill is expected to face strong resistance once again.
Unlike previous versions that would expand Medicaid, the bill would use federal and state Medicaid dollars to buy private insurance for some low-income residents and subsidize coverage for others who have access to employer-sponsored plans. It also would cover people who are deemed medically frail with existing Medicaid dollars.
The bill "has its critics to be sure, but thus far they have only offered critiques without viable alternatives," McCollister said. "Criticism without solutions rings hollow, and doesn't do anything to deal with the situation that needs to be resolved."
McCollister said the bill seeks to make people healthier and more productive, with job-training programs that seek to wean them off of public benefits.
A consultant's report released Tuesday said the state would pay $978 million over a 10-year period under the newest Medicaid bill introduced in the Legislature. The federal government would pay an estimated $13.8 billion over that period for its share.
The legislation would cover more than 74,000 uninsured, low-income residents; provide premium assistance to nearly 35,000 with employer-sponsored insurance; and offer traditional Medicaid coverage to more than 15,000 who are deemed medically frail, according to the report by Optumas, a health care strategy firm that contracted with the state.
Parts of the bill borrow from a hybrid plan enacted in Arkansas, which covers 200,000 residents.
Patricia Boozang, a consultant who worked on Arkansas' hybrid Medicaid plan, said that state has seen a nearly 50 percent decline in uninsured hospital visits since its plan went into effect, and hospitals have seen a 55 percent decrease in uncompensated care losses.
Arkansas Republican Sen. Bryan King, an outspoken critic of his state's plan, told the committee that the plan has hurt Arkansas' economy and created incentives not to work, because beneficiaries risk losing the entitlement if their incomes rise too high. King said the federal government's share of the cost contributes to the federal deficit.
"As state legislators, we're seeing now that the federal deficit is not just a congressman's and a senator's problem," he said. "It's our problem, too, because we're voting to do this."
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The bill is LB1032
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