LINCOLN, Neb. (AP) - Nebraska’s latest attempt to expand Medicaid may have died in the Legislature this year, but the issue is certain survive through the November elections and beyond.
Opponents succeeded last week in blocking the measure, which would have extended government-funded health coverage to an estimated 54,000 Nebraskans in 2015 as part of the federal health care law.
Supporters plan to regroup and look at other options, including what other states have done and how their programs have worked, said Sen. Kathy Campbell of Lincoln, the bill’s lead sponsor.
Campbell said she plans to talk with Nebraska’s next governor about Medicaid proposals, as well as the new state senators who will replace 17 term-limited lawmakers in January. Gov. Dave Heineman, a Republican who fervently opposed the bill, is also leaving office because of term limits. Heineman has argued that state Medicaid expenses would rapidly grow under the bill and pull money away from other priorities, such as education.
This year’s proposal “would have set a pretty bold course for health care in Nebraska,” Campbell said. “But the health care issues that we face as a state certainly are not going away. At some point, we’re going to have to address it.”
Sen. Jeremy Nordquist of Omaha said he believes pressure on lawmakers will increase once the state starts to experience the consequences of its decision.
Supporters have argued that the decision not to expand Medicaid will force some rural Nebraska hospitals to close, because too few of their patients can afford treatment.
Without the expansion, Nebraska small businesses could also face between $11 million and $16 million annually in new federal tax penalties that begin in January, according to a study by Jackson Hewitt, a tax preparation service. The health care law was written with the assumption that all states would expand Medicaid, but the U.S. Supreme Court deemed it optional.
Nordquist said Nebraska hospitals will also struggle to hire and keep workers, especially since bordering Iowa and Colorado have both consented to expansion programs. More residents will also realize that they’ve fallen into the so-called coverage gap because their incomes are too high to qualify for Medicaid but too low to qualify for subsidies under the new federal insurance marketplace.
“I think the culmination of those pressures will help push the policy forward - hopefully next year,” Nordquist said.
The issue will also surface as a campaign issue in the 2014 elections. Nebraska’s six Republican candidates for governor all oppose the expansion, while Democratic hopeful Chuck Hassebrook supports it.
Sen. Beau McCoy of Omaha, a Republican candidate for governor, said all of the requirements proposed in the bill would have been subject to negotiation with the federal government, which could have denied them.
McCoy said more people could receive coverage through additional federal reforms, such as allowing insurance to be sold across state lines, helping small businesses pool together to buy insurance and easing restrictions on health savings accounts.
The health care law “is a house of cards, and the Medicaid expansion component is no different,” McCoy said. “It’s not the way we do things in Nebraska. We don’t spend money we don’t have, and we take our time before we make big decisions. This is one instance where I’m very thankful this was our approach.”
Nordquist and McCoy said they expect the issue will also surface in many of the state’s 21 contested legislative races. Of the 17 senators who are leaving in January because of term limits, 10 supported the bill and seven opposed it.
“Nebraskans understand the common sense behind it,” Nordquist said. “Hopefully, we can come back next year with a Legislature that’s supportive.”
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