Delaying expansion will cost Nebraska hundreds of millions

Rural Health

When Nebraska voters expanded Medicaid coverage last November, they recognized not only the health benefits of expanded insurance coverage, but also the economic impact of it. Expansion is estimated to stimulate nearly $1.3 billion in economic activity in the first three years of implementation. Yet, Nebraska remains nearly a year and a half away from realizing these benefits.

Enrollment for the 90,000 Nebraskans in the insurance coverage gap is not scheduled to begin until August 2020, with coverage set to begin in October 2020.

State senators, too, recognized the economic value of expansion by appropriating $49 million in the recently-approved biennial budget, to be matched by more than $380 million in federal dollars. However, even with full funding, the delayed implementation timeline will leave hundreds of millions of federal dollars on the table. Open Sky Policy Institute recently estimated the delayed implementation of Medicaid expansion would cause Nebraska to lose about $460 million in federal funds—foregoing dollars that could be making an immediate difference in our health care system.

For many of our rural hospitals, health coverage for 90,000 Nebraskans in the coverage gap will result in a significant decrease in uncompensated care costs. Of 64 critical access hospitals which provide care in the state’s most rural areas, at least 28 are under financial stress.

As Nebraska’s voters wait for implementation to begin, hospitals will be forced to divert dollars from services that benefit all members of the community. Implementing Medicaid expansion quickly is an investment in the health of our communities, and simply makes economic sense.