- Associated Press - Wednesday, April 8, 2015

LINCOLN, Neb. (AP) - A third attempt to expand Nebraska Medicaid coverage under the federal health care law was defeated Wednesday by conservative lawmakers who cast it as an unaffordable expansion of government.

Lawmakers voted 28-16 to send the bill to the bottom of the Legislature’s agenda, effectively killing it for the rest of this year.

Had it passed, Nebraska would have joined 28 other states and the District of Columbia in offering coverage to more low-income, childless adults. Two previous efforts to pass the bill have stalled in the officially nonpartisan Legislature, where Republicans outnumber Democrats.

Sen. Kathy Campbell of Lincoln said her bill would have helped prepare the state for its future health care needs, but an early test vote showed the measure didn’t have enough support to advance.

“We all have visions for where Nebraska can go,” Campbell said. “Health care is one of those infrastructure pieces that need to be in place.”

Supporters have suggested placing the issue on the statewide ballot, as they did last year with a minimum wage increase, but Campbell said she didn’t know whether doing so with Medicaid is feasible because of its complexity.

Expanding Medicaid would have helped cover roughly 79,600 people in Nebraska by 2020, according to the latest estimates by the Legislature’s Fiscal Office. The federal government has promised to cover 100 percent of the program’s costs through 2016 and then ratchet its share of the payments down to 90 percent by 2020.

With cost savings included, Nebraska would have saved $3.5 million in the next fiscal year by expanding Medicaid. The state would have paid an increasing amount in future years, from $4.4 million in fiscal 2017 to $26.6 million by 2020. Payments by the federal governments would increase as well, to nearly $447 million by 2020.

Conservative lawmakers railed against the bill. Gov. Pete Ricketts also opposed the measure. In his latest weekly column, the Republican governor said expanding Medicaid would become an expensive burden for the state. Ricketts said Nebraska’s Medicaid program consumes $1.8 billion of the state’s total budget and serves about 238,000 people annually.

“We shouldn’t be putting people on Medicaid. We should be getting people off of Medicaid,” said Sen. Bill Kintner of Papillion. “That’s what I came here to do, and I’m going to stand with the taxpayer.”

Supportive lawmakers argued that many of the uninsured are working but unable to afford insurance.

Sen. Adam Morfeld of Lincoln said his parents will work the rest of their lives because of medical bills that came after his father suffered a heart attack at age 45. He said his father, who was not insured, was forced to sell their family’s home and liquidate his retirement savings to cover the expense. Opponents who criticized the bill haven’t offered any alternatives, he said.

“Their silence is deafening, and in many cases their silence is deadly for families and financially catastrophic,” he said.

Sen. Al Davis of Hyannis said rural senators have the most to lose if Medicaid isn’t expanded, because their districts generally have higher percentages of uninsured residents.

A December report by the advocacy group Nebraska Appleseed concluded that a lack of health coverage was driving many of Nebraska’s personal bankruptcies and shifting more costs onto hospitals and businesses. Davis initiated a similar study in the Legislature to show how the bankruptcies damage rural economies.

“We’re going to bear the brunt of not expanding Medicaid, and that’s going to hurt our communities,” Davis said.

A study released last week by two University of Nebraska at Kearney professors said Nebraska would see at least $1 billion in economic benefits if Medicaid was expanded. The savings included so-called “silent taxes” paid through higher premiums to cover the cost of the uninsured, medical related bankruptcies and reduced consumer spending due to financial hardship.


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