Conservatives Stall Nebraska Medicaid Expansion

April
17

Conservatives Stall Nebraska Medicaid Expansion

Lincoln

By Alissa Skelton, Associated Press

LINCOLN, NE — A group of conservative Nebraska lawmakers is trying to derail a proposal to expand Medicaid to more low-income adults.

State senators successfully stalled debate on the issue Wednesday when bill supporters weren't able to secure the 33 votes required to end debate on the measure.

Speaker Greg Adams of York moved the Legislature to discuss a different bill after more than 10 hours of debate on Medicaid. It has not been determined when Medicaid expansion will be discussed again.

Bill supporters say expanding Medicaid is needed to help working Nebraska adults who can't afford private health care but make too much money to qualify for Medicaid. They argue that Nebraska should expand the program because the federal government is willing to fully pay for the expansion for three years.

Opponents are worried that expanding Medicaid won't be fiscally sustainable long-term and fear the state doesn't have enough doctors to see more Medicaid patients.

Conservatives Sens. Ken Schilz of Ogallala, Charlie Janssen of Fremont and others stood opposed to voting for cloture, which is a motion to end debate.

Sen. Jeremy Nordquist of Omaha said he thinks the legislature has at least 25 votes to pass Medicaid expansion onto the next round of debate but acknowledge there might not be enough votes for cloture.

"The opponents' strategy is simple," Nordquist said. "They're mudding the waters and raising doubts and questions to make people uncomfortable to vote for it."

Gridlock ensued after Medicaid expansion supporters offered an amendment to the bill in an attempt to reassure senators who are worried about the future cost and sustainability of Medicaid expansion. Sen. Galen Hadley proposed the amendment that would require Nebraska lawmakers to approve, amend or repeal Medicaid expansion in December 2016 rather than 2020, which is the year the original amendment had specified. The bill's sponsor, Sen. Kathy Campbell, said she fully supports Hadley's amendment.

The federal government has vowed to pay 100 percent of the cost for newly insured Medicaid recipients from 2014 to 2016. After that, the federal government would reduce funding to 90 percent by 2020. Nordquist said the Affordable Care Act provides cost offsets that show Medicaid expansion in Nebraska could be fully paid for through 2020 without making cuts to other budget priorities or raising revenue.

Nordquist said it's possible the conservative block of senators who would not vote for cloture could be powerful enough to sway votes and derail the passing of the Medicaid expansion.

"It comes down to two votes one way or another," Nordquist said. "If we don't pass this bill, we are leaving people of our population with no support to gain coverage."

Sen. Steve Lathrop of Omaha said Nebraska can't wait until the Medicaid system is perfect to provide Medicaid to the working poor.

"This is for working Nebraskans who can't afford health coverage," Lathrop said. "... It is silly for us to pay for every other state's expansion of this program and turn our back on the 55,000 Nebraskans that would be covered."

Sen. Dan Watermeier of Syracuse was a lead opponent against Hadley's amendment. He said it would not change the bill because lawmaker would still be voting to expand an entitlement program. He said he was concerned lawmakers felt they could support the bill after Hadley proposed the amendment.

He said it would be difficult for the Legislature to not continue Medicaid expansion after 2016 since people would already be receiving care.

"I can imagine how this building is going to be filled up with people the day we have to cut this thing," he said.

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The bill is LB577.

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