Medicaid Redesign Act - No-risk Solution for Nebraska

LB 472 is a no risk way to provide health insurance to those in the Coverage Gap.

One of the major arguments against LB 472, the Medicaid Redesign Act, is that the federal government cannot be trusted to maintain the funding to states for an expanded Medicaid program. The argument goes that since the federal government cannot be trusted to maintain funding, LB 472 would cause the state to pick up the tab for this initiative.

Distrust of the federal government to maintain the contribution to state initiatives to expand Medicaid has been a consistent theme of opponents in Nebraska and throughout the nation. However, federal participation rates to states for Medicaid have varied little since Medicaid’s inception in 1964.

This argument also involves a fundamental misunderstanding or misreading of LB 472. According to the Affordable Care Act, from 2020 onward the federal government will provide 90 percent of funding for the LB 472 initiative. Specific language in LB 472 states that if federal funding ever drops below 90 percent, Medicaid coverage for those eligible under LB 472 will terminate and the LB 472 initiative will automatically cease.

This provision in LB 472 is a no risk proposition for the state. The Medicaid provision in the Affordable Care Act is essentially a pilot program for the state. Future trust of the federal government is irrelevant – it is the implementation by the state and the performance of the initiative created by LB 472 that is most important.