Expanding Medicaid Makes Sense for Nebraska

By Dr. Amanda McKinney, MD, Beatrice Community Hospital

I support the new Medicaid initiative in Nebraska under the Affordable Care Act. At a minimum, 78,000 uninsured adult Nebraskans would obtain health insurance coverage. Up to 108,000 would be eligible for the benefit. This would cover nearly half of uninsured adults in Nebraska.

There are multiple benefits to expanding Medicaid in Nebraska, but I will focus on an economic one. It is estimated that during 2014-2019, $1.06 billion will be provided in uncompensated care. The way this is handled now is to shift costs for uncompensated care to individuals and businesses that are participating in private insurance plans. Many have called this a “hidden tax.” By expanding Medicaid, uncompensated care would be reduced by $659 million.

In our hospital alone, for fiscal year 2011, we provided $1,956,485 in uncompensated care. This is not sustainable for any small hospital in the long-term without continuing to raise the rates for services that are provided. Uncompensated care in this country is one of the primary drivers of rising, exorbitant health care costs.

By providing coverage for uninsured individuals, Nebraska’s taxpayers would see significant savings as patients shift from uncompensated, expensive emergency room visits to outpatient, coordinated medical facilities. As many as 35,000 emergency room visits could be prevented each year.

Lastly, for every Nebraska tax dollar spent for this expansion, the federal government will return $35 - an economic win-win. The only reason not to expand Medicaid is a political one, which, in my mind, is not valid.

Amanda McKinney, MD, is a physician at the Women's Health Center of Beatrice.

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