Imperfect Medicaid expansion bill a vital first step


Phil Brown

Currently, it’s estimated 77,000 Nebraska citizens languish in the dreaded health care “coverage gap”: people who can’t afford high-priced private health insurance premiums, but don’t meet the requirements for Medicaid coverage. Hospitals around the state, especially rural hospitals, face closing as expenses and unrecoverable debt pile up. But the solution is just within reach, and indeed has already been paid for by Nebraska taxpayers.

The issue at hand is Medicaid expansion, a federal initiative that unfortunately left a large loophole open for state politicians to exploit. Nebraska’s expansion money, which was made available in 2014, has been lying dormant for two years as Nebraska’s leaders have resisted the change.

However, the time has come to move past stubborn political posturing and make the best use of the resources the state has available to it, whether one agrees with its source or not. To do otherwise is to deliberately dangle vital health care coverage just out of reach of 77,000 Nebraskans, and all to make a petty political point.

Omaha’s John McCollister, a state senator who represents Omaha’s District 20, introduced a bill earlier this year that purports to finally make use of the Medicaid expansion dollars provided by the Affordable Care Act of 2010. McCollister’s bill, LB 1032, would take the federal money and create a Transitional Health Insurance Program.

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The THI would enroll eligible Nebraskans into “premium assistance” programs, wherein they would be enrolled in private insurance programs. If they had access to insurance through their jobs, the THI would apply to them as well.

Perhaps the most compelling criticism of McCollister’s bill is that, in the words of Arkansas State Senator Bryan King, testifying against the bill last week on Tuesday, “it’s a boondoggle for insurance companies.” It is a worrying aspect of the bill: the assistance is just funnelling directly into private insurance company pockets. It would be far better to implement a single-payer system like Medicare, and not have to rely on the dubious motives of big insurance business, which is flocking around the bill in support.

It’s easy to foresee a scenario in which private insurance companies gouge the state for the new federal dollars. As such, the only way this bill will truly succeed is if state leaders are diligent and vigilant against such exploitation.

But in the end, the measure is a necessary step to ensuring the health of all Nebraskans, a duty to which legislators pondering the bill would do well to take seriously. At the end of the day, Nebraska taxpayers have already and will already be footing the bill for the Medicaid expansion dollars the federal government provides.

Right now, that tax money is being wasted, and for nothing. Putting it to use to provide life-giving treatment to tens of thousands of Nebraskans is the only logical, moral solution.