LINCOLN, Neb. (AP) — Nebraska Gov. Dave Heineman held firm Wednesday in his opposition to a proposed Medicaid expansion, saying the state shouldn't rush into the program when the potential costs are unclear.
The Republican governor said in an interview that he remains adamantly opposed to the expansion, even as a growing number of GOP governors have decided to back the proposal.
The Legislature's Health and Human Services Committee will hear testimony Thursday on the proposed expansion, which is now optional under the federal Affordable Care Act.
Heineman argued Wednesday that lawmakers should delay the proposal until they get a better sense of the costs of insuring more people. State officials are projecting that more residents who are currently eligible for Medicaid will seek coverage even without the expansion.
"You're going to have more people coming into the Medicaid system, and that's going to drive down the number of uninsured in this state," Heineman said. "We just can't afford the Medicaid expansion. It's unsustainable, unless you're prepared to acknowledge that you're going to cut education."
Sen. Jeremy Nordquist of Omaha, a supporter of the health care law, said delaying the expansion would cost Nebraska the 100 percent payment promised by the federal government for newly insured residents during the expansion's first three years. The federal government has promised to pay 100 percent of the state's costs from 2014 through 2016.
Nordquist said many of the uninsured are already receiving care, which health providers pass along through higher premiums to those who are insured.
"These people are getting care, but it's the most costly care possible, and it's the inefficient care," Nordquist said. "But they're getting care, they're in the system, and they're using our emergency rooms. The governor should acknowledge that. We know we're spending money this way, but how do we make it more efficient."
Heineman's comments came in the wake of several GOP governors have who reversed course in their opposition to the Medicaid expansion. Govs. Rick Scott of Florida and Chris Christie of New Jersey have backed the program within the last week, joining the governors of Arizona, New Mexico and Nevada.
Some of the governors have argued that the federal government will spend the money regardless, and rejecting the expansion would effectively send their residents' tax dollars to other states.
"I really don't buy into that," Heineman said. "There are a lot of federal dollars, particularly in the Medicaid program, that are going to continue to flow into our state no matter what. (The expansion) provides additional dollars, no question about it. But what I'm worried about is whether the federal government will fulfill its promise."
The governor's Medicaid chief said Wednesday that her agency plans to oppose the bill, which would extend coverage to an estimated 54,000 new residents. Nebraska agency officials plan to argue that the proposed expansion is unaffordable and unsustainable, and the health care law will stretch the division's budget even without the expansion.
"We feel that's going to be a strain on our budget," said Vivianne Chaumont, director of the state Division of Medicaid and Long-Term Care. "And that's before we even start talking about the expansion."
Supporters argued that the measure would reduce long-term health care costs for county taxpayers and hospitals, and ease the financial pressure on the state by shifting many expenses to the federal government.
Lawmakers said the bill would extend coverage to more than 54,000 uninsured Nebraskans, and state officials predict that some insured Nebraskans would switch from their current plans. The proposal would cover 117,000 to 159,000 residents in all by fiscal year 2016, when the program is in full swing, according to a January report commissioned by the state Department of Health and Human Services.
The bill was introduced in the wake of a U.S. Supreme Court decision that struck down part of the federal health care law, one of President Barack Obama's top domestic achievements in his first term. The court upheld most of the law, but ruled that the federal government cannot withhold funding from states that choose not to expand their Medicaid programs.
The bill is LB577