Potential Medicaid expansion would extend reach of local healthcare services

The Nebraska State Legislature is continuing to go back-and-forth on the potential expansion of Medicaid, including its feasibility and cost, as outlined in President Barack Obama’s signature healthcare reform – the Affordable Care Act.

Under the Affordable Care Act (ACA), the federal government is slated to pay 100 percent of the costs states take on from a Medicaid expansion through the year 2016. From that point on, the federal government will pay 95 percent is 2017, 94 percent in 2018, 93 percent in 2019 and 90 percent from 2020 on. In other words, the portion of the costs delegated to the states would increase over the next six years.

The figures vary, but a generally agreed upon figure is that the expansion would provide healthcare to approximately 54,000 Nebraskans who currently lack healthcare.

“Actually, it would help us. It would expand the number of people--most of the people that would be covered in that program are not covered now. So it should have a positive effect,” said Ken Hunter, CEO of Kimball Health Services. “For instance we particularly see in young couples that they fall just above the financial standards to receive medicaid. I think what it does is it just raises the bar on the financial qualifications so that would help.”

According to an Associated Press story from last week, several conservative Nebraska lawmakers were working to stop progress on the potential expansion to Medicaid. State Senators stalled debate on the expansion last week, and the backers of the legislation were unable to procure the necessary 33 votes to end the debate on the proposal.

The U.S. Supreme Court upheld the expansion last summer, stating that the Medicaid expansion was optional to the states, rather than required as President Obama had previously stated.

According to the UNMC Center for Health Policy, “states that decide not to expand Medicaid eligibility will face a coverage gap or “doughnut hole” of insurance coverage options for the poor and uninsured.”

One of the most vocal supporters of the expansion, Senator Jeremy Nordquist of Omaha, told the Associated Press 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.”

Nebraska Governor Dave Heineman has maintained his position on the expansion over the course of the last year, since the Supreme Court upheld the Constitutionality of the legislation.

“My position is very clear – Nebraska can’t afford an unfunded Medicaid expansion,” Heineman wrote last summer, according to Reuters. He went on to say that the expansion would cost the state hundreds of millions of dollars that would have to come from other critical areas in the state budget, such as education.

In the same July 11, 2012 report from Reuters, Nordquist claimed the governor was unwilling to have “a serious bipartisan policy discussion” with a group that included “pretty much every stakeholder in Nebraska.”

In a news conference on April 15, Heineman again stated his opposition to the expansion, citing reasons of financial feasibility as time goes on. He also said that adding a sunset date to the bill, which would allow the legislation to expire after a certain date, would fail to control costs, because they are often removed after the fact.

“It would help this area. It’s something that we need. I think another reason that maybe some people are against it is that they don’t know how it will play out with the overall Obamacare,” said Hunter.