Senators debate medicaid expansion

LINCOLN – Nebraska lawmakers debated Tuesday about expanding Medicaid to a particular group of low-income adults and adopted an amendment allowing lawmakers to review the policy if federal funds decrease.

The bill (LB577), introduced by Sen. Kathy Campbell of Lincoln, would allow adults between the ages of 19 and 64 who fall between 0 and 138 percent of the federal poverty level to qualify for Medicaid, which provides health care for certain low income people.  Expanding access to Medicaid was authorized under the federal Affordable Care Act, commonly known as “Obamacare.”

For example, Nebraska residents who make less than $16,000 annually and have no family to support would be eligible for Medicaid, according to Medicaid.gov, which reported that families of one making about $15,500 annually would be considered at 135 percent of the federal poverty level.

“The bill provides for expanded eligibility to low-income, childless adults,” Campbell said.

It would increase Medicaid eligibility for another 54,000 Nebraskans, Sen. Bob Krist of Omaha said.

Campbell also said that for the first three years, the federal government would pay 100 percent of the costs of the Medicaid expansion. This federal assistance would gradually decrease each year, until it covered 90 percent of the additional cost from 2020 and beyond.

Campbell’s amendment (AM1028) would allow the Nebraska Legislature to affirm, amend or repeal the new Medicaid policy if the federal assistance were to ever drop below 90 percent.

The amendment passed with a 30-12 vote. But Sen. Beau McCoy of Omaha moved to reconsider the vote, which is a motion still pending on the floor.

“I don’t think we’ve had full and fair debate,” McCoy said. “We’re talking about something that is vitally important to our state budget.”

Some supporters of the bill said it would not raise taxes because funds from other health care programs for uninsured residents could be repurposed.

Some programs currently using taxpayers’ money, such as one for AIDS drug assistance, would be covered by the expanded Medicaid policy, allowing those funds to be transferred somewhere else, Sen. Jeremy Nordquist of Omaha said.

Sen. Sara Howard of Omaha added that expanding Medicaid could also create more health care jobs in Nebraska.

Other proponents said expanding Medicaid coverage would help these individuals receive preventative care rather than forcing them to wait until they needed the emergency room. This would ensure that emergency rooms would be more readily available for actual emergencies, Krist said.

Senators also mentioned that many veterans would be able to utilize Medicaid if it were expanded to include this new income range.

“There are a number of low-income veterans who fall through the cracks,” Nordquist said. “These are not government dependents. These are people the government depended on.”

Opposing senators expressed concern about what the policy may end up costing Nebraskans, especially if the federal government does not fulfill the promise to offer at least 90 percent of the funds and whether the policy were sustainable.

“I am a skeptic when it comes to expanding Medicaid, in this state or in any state, when institutional dysfunctions, which always trump good intentions, place at risk already scarce tax dollars,” Sen. Mike Gloor of Grand Island said.

Sen. Jim Scheer of Norfolk said that, even if the federal government upheld its promise to fund 90 percent of the expanded Medicaid, Nebraska residents would still pay for it through federal taxes.

“Regardless of where those dollars come from, they are our dollars,” Scheer said.

Sen. Charlie Janssen of Fremont also said that many Nebraskans would not support this expansion.

“I feel confident that my constituents by a majority, a large majority, are in opposition to LB577,” Janssen said.