- Associated Press - Monday, May 22, 2017

Omaha World-Herald. May 19, 2017

Nebraska’s Medicaid system needs stability

Nearly 227,000 low-income or disadvantaged Nebraskans depend on Medicaid funding for health care or mental health services. It’s crucial to process claims efficiently and properly handle authorization of care so that important services can be delivered.

A key example is home health care. Another is mental health counseling. These supports are vital for many Nebraska households.

Nebraska shifted on Jan. 1 to a new system in which companies or nonprofits providing those services can choose among three managed care companies now administering the bulk of the state’s Medicaid program.

The new approach provides a major plus by bringing behavioral health under the same umbrella as physical health. As a result, the system provides incentives to treat patients’ whole range of conditions, mental as well as physical.

But five months into Nebraska’s new system, the claims processing and authorization of care have run into major problems.

World-Herald reporting this week pointed to examples in which claims were left unpaid for some behavioral health and home health providers, and care wasn’t authorized for some individuals.

These misfires have triggered a host of complaints, including from Nebraska lawmakers, who say they will increase their oversight.

The unpaid bills have led CenterPointe, a behavioral health treatment center with programs in Omaha and Lincoln, to take out a line of credit for the first time in 44 years. The new system places increased administrative obligations that can weigh significantly on some small-scale providers.

HHS says processes have improved, pointing to the increased volume of payments to providers in the last six weeks. Most of the complications involve individual cases rather than large-scale processing issues, HHS contends.

Under CEO Courtney Phillips, HHS has commendably achieved efficiencies in some of its operations. The department streamlined the procedure for low-income Nebraskans to apply for federal nutritional assistance. It reduced the waiting times for families seeking state help for loved ones with developmental disabilities.

HHS and the three management companies need to demonstrate similar progress now with Medicaid management.

It’s crucial that they work with providers to resolve the entire range of problems, to ensure the services to clients and to give much-needed reassurance to the public.


The Grand Island Independent. May 18, 2017

Trade talks must not sacrifice gains for agriculture

New U.S. Trade Representative Robert Lighthizer is getting plenty of advice as he begins his new job after being sworn in to the position Monday.

Most of the advice, and concern, is about the North American Free Trade Agreement (NAFTA). Leading the list of those concerned are farmers, ranchers and government officials from farm states.

On Tuesday, Gov. Pete Ricketts and some Nebraska farm groups hosted Mexican officials and had a clear message for them.

“Bilateral trade with Mexico has helped grow agriculture in our state over the years,” Ricketts said. “Mexico is Nebraska’s largest export market for corn, dairy, sugar and sweeteners, and the second largest market for soybeans, wheat, sorghum and distillers grains.

“All of this combined accounts for thousands of Nebraska jobs. I’m encouraged by local and national discussions to expand trade, and am committed to helping grow our trade relationship with Mexico so we can continue to grow Nebraska.”

Kelly Brunkhorst, executive director of the Nebraska Corn Board, said Mexico is Nebraska’s largest export market for corn, which adds $287 million in value to Nebraska’s economy.

Under NAFTA, U.S. agricultural exports to Canada and Mexico have tripled and quintupled, respectively. This is because corn is exported to Mexico without tariffs or duties.

However, farm groups say that trade is threatened because President Donald Trump has indicated he wants to renegotiate the agreement. So farm groups are rightly increasing the heat on Lighthizer.

Sen. Deb Fischer of Nebraska was among a group of 18 Republican lawmakers who sent a letter to Lighthizer saying “modernization” of NAFTA may be appropriate, but warned that going too far could have “devastating economic consequences.”

“Among other benefits, NAFTA has led to tremendous growth in U.S. trade with Mexico and Canada, integrated cross-border supply chains that benefit U.S. employers and more than tripled U.S. exports of goods (including agricultural and manufactured goods) and services,” the senators said. “As senators who represent states that see a significant economic impact from trade, we will maintain a keen interest in the ongoing process surrounding NAFTA and look forward to working with your office.”

Sen. Ben Sasse of Nebraska even voted against Lighthizer’s nomination because of concerns that he would seek to blow up NAFTA. In a letter written with Sen. John McCain of Arizona, Sasse wrote, “Your confirmation process has failed to reassure us that you understand the North American Free Trade Agreement’s (NAFTA) positive economic benefits to our respective states and the nation as a whole. We fear that you do not have an appreciation for the millions of jobs created by this free trade deal, and that you would not champion agriculture during your time as USTR.”

The letter said that “Mexican officials have cited the possible renegotiation of NAFTA as a major reason why they are currently pursuing actions to import less corn from the U.S. and more from other nations, including Argentina and Brazil.”

As trade representative, Lighthizer must be a champion for agriculture. He must not sacrifice the gains that NAFTA and other trade pacts have brought to the ag economy for a protectionist policy that will drive U.S. trade partners elsewhere.

Lighthizer must seek a balance between improving trade agreements, while at the same time not hurting the thriving trade market for American ag products.


Lincoln Journal Star. May 19, 2017

Deafening silence on refugee, DACA votes

Nebraska senators approved a pair of resolutions declaring support for refugees and so-called “Dreamers” on Monday.

The level of support for those who were born elsewhere but are Nebraskans, however, was tepid - and extremely disappointing for a state that has long welcomed the refugee and immigrant.

Neither measure reached a majority: 24 senators supported Sen. Tony Vargas’ resolution on Latino immigrants brought to the U.S. as children and only 21 voted in favor of Sen. Kate Bolz’s resolution supporting refugees. Both also had large contingents - 17 and 14 lawmakers, respectively - listed as present not voting.

“Dreamers” and refugees came to what we affectionately call the “Good Life” in search of a better life. Unlike them, however, we were fortunate enough to be born into it.

Nebraska is home to an estimated 3,000 young Latinos, protected from deportation as Deferred Action Childhood Arrivals if they meet particular requirements, and 11,000 refugees from dozens of nations. Though they combine to make up slightly less than 1 percent of the state’s population, these groups deserve the same support by lawmakers as native-born residents.

“Diversity” may be a loaded, negative word to some, but Nebraska has long been blessed as a melting pot of different cultures and nations. Towns of German, Swedish, Czech and Danish origins dot the state, while larger cities were shaped by enclaves of Russians, Italians, Poles, Lithuanians and others.

Today, this remains true, although the nationalities have changed. Immigrants and refugees endured hardships elsewhere before reaching their promised land and long-awaited safety in Lincoln or Nebraska at large.

Despite their long roads to their new homes, these two groups have been subject to baseless demonization and discrimination by national officials eager to score points with a political base, human cost be damned.

By their silence, too many state lawmakers failed to stand up against the fear and misunderstanding these fellow Nebraskans face.

Though both Bolz and Vargas are Democrats in the officially nonpartisan Legislature, their resolutions weren’t poison pills. Supporting fellow humans trumps any and all party lines.

Republicans and Democrats alike - along with the lone Libertarian and independent senators - took a symbolic stand to support these two groups who have been the target of hateful, divisive words and actions in a toxic political environment at the national level.

“Nebraska is stronger with all of them,” Bolz correctly noted.

This Legislature represents all Nebraskans, regardless of their national origin or country of birth. The failure of so many lawmakers to support them in a manner as mild as a formal legislative reception is truly disappointing.


Kearney Hub. May 18, 2017

Don’t fix NAFTA; it’s not broken, so hands off

Nebraskans who aren’t already sweating bullets over President Trump’s mentions about renegotiating the North American Free Trade Agreement should be gravely concerned. That’s because the United States’ partners in NAFTA - Canada and Mexico - are this nation’s largest customers. As far as Nebraska is concerned, NAFTA isn’t broken and doesn’t need fixing.

Thanks to NAFTA, Mexico is the top importer of U.S.-grown corn. In fact, no other country buys more Nebraska corn than Mexico. In 2015, Nebraska sold $287 million of corn to our southern neighbors, accounting for about one-third of our state’s $987 million in corn exports that year. Similarly, Canada is a huge customer, and its demand has grown even faster than Mexico’s.

It’s for legitimate reasons that we in farm country are nervous about Trump’s renegotiations talk. He’s created an environment of doubt and instability. Merely suggesting that NAFTA should be trashed drove up U.S. grain prices, a situation that harmed Mexican importers who couldn’t afford the spike. Somebody needs to tell the president to bite his lip next time he thinks it would be wise to renegotiate NAFTA. It’s not broken so let’s not try to fix it.

If there is a problem, it’s that some U.S. workers and professionals have been left behind in the new global economy. These Americans have a right to complain if they’ve lost their jobs. The answer to these Americans’ dilemma is clear. They need to be retrained to perform jobs of the future.

If the president believes NAFTA has harmed some Americans, he ought to first look at the U.S. map and understand how far and wide farm country stretches. Most of his base supporters reside in farm country, but they’ll change their tunes if Trump undermines NAFTA with his off-the-cuff comments.

Rather than retooling the trade pact, the president needs to expand training opportunities and provide them for Americans who are under-educated and unprepared to survive in the new global economy.

Trump placed his concerns about NAFTA and the Trans Pacific Partnership front and center during his campaign. He now leads a divided nation in which urban ex-factory workers expect action and ag producers in rural regions like things just as they are, favoring the export of their ag products.


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