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Nebraska lawmakers seek common ground on Medicaid

Published on NewsOK Modified: April 20, 2013 at 9:59 am •  Published: April 20, 2013

LINCOLN, Neb. (AP) — Nebraska lawmakers who support expanding Medicaid to more low-income adults said they are uncertain if the Legislature will get another chance to debate the issue.

Advocates of an expansion bill considered Wednesday thought the bill would get the minimum votes needed to sail to the governor's desk. Instead, a group of conservative lawmakers stalled debate when they refused to vote for cloture, which is a motion to end debate.

Speaker Greg Adams of York said this setback could push the measure off until next year if bill sponsors don't gather 33 votes to reach cloture.

Even if Medicaid expansion were to clear its first hurdle, Republican Gov. Dave Heineman would likely veto it. It is unclear if the bill would receive 30 votes needed to override Heineman.

Since Wednesday, Medicaid advocates have been trying to figure out what went wrong during debate. The bill's sponsor, Sen. Kathy Campbell, said she has taken a step back to review the debate before she figures out her next strategy to advance Medicaid expansion. Campbell and other supporters plan to regroup next week to figure out a plan B.

"I thought we would have the votes to pass the bill, and we did, but 33 votes for cloture is daunting," Campbell, said. "That probably surprised me."

Campbell said she wants to begin chatting one-on-one with senators who are on the fence next week. She said she plans to respond to lawmakers' unanswered questions about the implications of Medicaid expansion and see if there's a way to find common ground.

The expansion measure would offer Medicaid to more low-income adults under the Affordable Care Act. Medicaid expansion was originally required under the health care law, but a U.S. Supreme Court ruling said the federal government couldn't order states to expand the program.

The federal government has agreed to pay 100 percent of the cost for new Medicaid recipients from 2014 to 2016. Aid would gradually decrease until 2020, when the federal government would pay 90 percent of the costs for patients who fall under Medicaid expansion.

Sen. Jeremy Nordquist of Omaha, an avid supporter of Medicaid expansion, said he's willing to do what it takes to convince lawmakers to extend coverage to more than 55,000 Nebraska residents. He has been considering offering an amendment to study an option to allow Nebraska to use Medicaid expansion funds to buy private insurance for low-income residents. Several conservative lawmakers, including Sen. Beau McCoy of Omaha, suggested considering this option as Arkansas is now. Nordquist said he would like to expand Medicaid and do the study at the same time.

"I think we need to reach out to people who are in the middle, who are still undecided, and try to work with them on their concerns and see if we can reach an agreement," he said.

Gridlock began Wednesday when Sen. Galen Hadley of Grand Island offered an amendment to the bill that would require Nebraska lawmakers to approve, amend or repeal Medicaid expansion in December 2016, when the federal government will begin reducing the funding for Medicaid expansion. The amendment was intended to meet concerns of senators who were worried about reduced federal funding.

Adams said putting a three year sunset on the bill gives him some comfort, but he's still not sold on Medicaid expansion.

"If I had to vote today I would probably vote against it," Adams said.

The turning point in the debate happened when Sen. Dan Watermeier of Syracuse said reversing Medicaid expansion three years down the road would be a difficult task. Other senators began to echo Watermeier's sentiments and then refused to end debate.

"It wasn't really a true filibuster," Watermeier said. "I always expected a true filibuster to be filled up completely with opponents talking the entire time. But the proponents actually outtalked the opponents."

Campbell said she agreed with Adams' decision to pull to bill because the votes weren't there.

"It's not gone. It's just on hold," Campbell said. "If it doesn't pass I will feel a sense of failure for the people who need this health care."


The bill is LB577.


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