The Nebraska Legislature adjourned their 2013 session without so much as taking a vote on one of the most significant issues before them - a bill to expand health coverage to 54,000 low-income working Nebraskans.
Senator Kathy Campbell, a Republican, advanced a bill that won the support of a clear majority of senators - Republicans, Democrats and Independents alike. Polling shows that a majority of Nebraskans support the policy. An AARP poll during the legislative session found that 55% of Nebraskans favor extending Medicaid to low-income, working adults who aren’t eligible now (as provided for in LB 577). A recent Center for Rural Affairs poll found that 65% of rural Americans, including rural Nebraskans, favor assisting the working poor with affording the necessities of life with Medicaid coverage for healthcare.
Senator Campbell’s proposal allows the state to accept funds available under the Affordable Care Act to enroll low-income working Nebraskans in the Medicaid program. The proposal is especially important to rural Nebraskans, who are more likely to be uninsured than their urban counterparts.
The proposal is fiscally smart for Nebraska too. The cost is fully paid for with federal funds for the first three years, gradually decreasing to 90% after that. The legislature’s fiscal office found that the proposal saves the state money over the next two fiscal years and eliminates several state programs.
Business-friendly groups agree. Bloomberg News and Moody’s Investor Service wrote that the policy is good for businesses and good for hospitals. The new program will return up to $3.5 billion to Nebraska through 2020 and create tens of thousands of good jobs in health services, not to mention over $1 billion that currently insured Nebraskans will save because less uncompensated healthcare for the uninsured would no longer be shifted to those with insurance.
At the same time, Moody’s warns that hospitals in states that do not expand Medicaid could have credit rating problems and face higher interest rates.
But commonsense and bipartisan support was not enough to overcome politically crass opposition to the bill. Debate on the bill stalled after 17 members in the 49 member body filibustered the bill. Aware that the bill had strong majority support, opponents took the unusual step of demanding a 2:1 super-majority to cut off debate. They refused to even allow a vote on the bill.
That is unfortunate in Nebraska where the nonpartisan unicameral is usually a refreshing relief from the partisan trickery and gridlock in Washington. For generations, Nebraskans have put good governance ahead of party loyalty.
Without this bill, low-income working Nebraskans in poverty will fall into a health care gap. Most don’t qualify for the current Medicaid program, and they also won’t qualify for federal credits that will make health insurance affordable for middle-income Americans.
This health care gap is real. The jobs that the Medicaid expansion would create are real.
A handful of legislators should not stand between bipartisan majorities to block health care coverage for tens of thousands of our low-income, working friends, neighbors, and family members.
You and I elect legislators to make decisions, not just when it is easy, not just when it is popular, but when the stakes are high and the outcome controversial. Nebraskans deserve legislators who finish the job.
Luckily for us, as the political dust-up clears, the legislature can take Campbell’s proposal up as their first order of business next January. With 54,000 working Nebraskans without healthcare coverage until they act, we will be working hard to bring the issue to a vote.
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