Nebraska lawmakers won't expand Medicaid this year

LINCOLN, Neb. (AP) -- A proposal to expand health care coverage to low-income Nebraskans won't make it out of the Legislature this year.

Lawmakers fell six votes short of stopping the filibuster on the bill Wednesday after debating the measure for eight hours. It will not be taken up again in this legislative session.

The "Wellness in Nebraska Act," laid out a plan to help cover health care costs for about 54,000 residents by mid-2015 through a combination of Medicaid and subsidized private health insurance. It would cost an estimated $62 million between July of this year and June 2020.

Sen. Jeremy Nordquist, a supporter of the bill, said Tuesday the projected expenses will amount to less than a quarter of 1 percent of Nebraska's general-fund spending between now and 2020. Supporters of the bill also argued that it would benefit the state's rural hospitals and low-income workers.

"Uninsured Nebraskans are more likely to seek care when their disease is more advanced and less treatable," the bill's lead sponsor, Sen. Kathy Campbell of Lincoln, said Tuesday. "Uninsured Nebraskans are six times more likely to go without health care, due to the cost. Even those uninsured with cancer are five times more likely — five times more likely — to delay care than those who have insurance."

Sen. Tommy Garrett of Bellevue, who did not vote to end the filibuster, said he was concerned about the federal debt.

"We have got to do our part and our part is to be responsible to taxpayers and say no to this," he said.

Sen. John Murante of Gretna, who also did not support the expansion, said opponents are just not convinced the bill would do the most good for the most people. The federal government is already making a lot of decisions in the health care field, he said.

"At some point I think we have to examine how well that is working for us," he said.

In his weekly newspaper column, Gov. Dave Heineman argued that state Medicaid expenses would rapidly grow under the bill and pull money away from other priorities, such as education.

The new measure would have offered traditional Medicaid coverage to residents who make less than 100 percent of the federal poverty level, which is $19,530 for a family of three. Participants who make between 50 percent and 100 percent would have to pay as much as 2 percent of their income for premiums, which could be waived if they participate in a wellness program that would initially include a medical checkup and health assessment.

Residents who make between 100 and 133 percent of the federal poverty level would still qualify for subsidies offered under the federal health care law, but the proposal would have Medicaid dollars cover most of what they're now paying in premiums and copays. Those participants would have to pay up to 2 percent of their incomes.

Residents with employer-sponsored health insurance would be allowed to keep their plans, but Medicaid would cover a worker's contribution if that employee makes up to 133 percent of the federal poverty limit. Campbell said the provision was added to address some senators' concerns that the expansion might pull business away from the private market.

The federal government would have paid 100 percent of the cost until 2016, and then gradually decrease its contribution to 90 percent by 2020.

Supporters of the bill said the issue was not going away.

Campbell said she intends to sit down with Nebraska's next governor and 17 new members of the Legislature, who will be elected in November, before deciding how to proceed.

"These 54,000 people are still going to be in the state of Nebraska," she said.

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The bill is LB887