LINCOLN, Neb. (AP) — Nebraska lawmakers unveiled a proposal Wednesday to expand Medicaid coverage as part of the federal health care law, saying the state needs to seize millions of dollars in federal aid while giving more residents access to preventative care.
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.
The bill also sets up a likely showdown with Gov. Dave Heineman, a Republican who repeatedly has voiced opposition to expanding the program under a now-optional piece of the federal law.
Lawmakers said the bill would extend coverage to more than 54,000 uninsured Nebraskans, and a new state report predicts 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.
"If we don't bridge this gap, people will continue to go without primary care, will continue to use emergency rooms and will continue to need more and more expensive care that drives up costs for everybody," said state Sen. Kathy Campbell of Lincoln. "Without it, tens of thousands of Nebraskans will continue to fall in a coverage gap with no affordable means of accessing health care."
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.
Heineman has argued that the federal government has a history of reducing its contributions to other programs, such as special education, forcing states to make up the difference. Campbell said the federal government has shown a strong commitment to make expanded Medicaid work. Sen. Jeremy Nordquist of Omaha said federal matching rates fluctuate each year, but the federal government has never backed out of its contributions.
Nordquist said Nebraskans are already paying for the uninsured through the so-called "silent tax" of higher premiums.
"We already pay for health care for the uninsured, but we do so in a way that guarantees the most expensive care, often sought in the emergency room," Nordquist said. "When a person seeks care in the E.R. and can't pay, the cost of that care is passed on to the provider, who passes the cost of care on the insurer, who passes the cost of that care on to all Nebraskans with private insurance."