LINCOLN, Neb. (AP) — Health care advocates urged Nebraska lawmakers on Thursday to expand Medicaid coverage as part of the federal health care law, while the state's Medicaid chief says the program is too expensive.
Supporters, many of them from the health care industry, testified before the Legislature's Health and Human Services Committee. They argued that expanding Medicaid to an estimated 55,000 newly eligible Nebraskans would allow the federal government to cover long-term health care costs and reduce the financial burden on taxpayers and hospitals.
They also said it would extend coverage to uninsured residents who fall in the gap of medical coverage — those who cannot afford private insurance and currently are not eligible for Medicaid.
The U.S. Supreme Court ruled in June that the Medicaid expansion required under the Affordable Care Act is optional for states. Gov. Dave Heineman opposes the proposal and says he worries about the program's costs.
On Wednesday, he said he will not join several other GOP governors who have decided to support Medicaid expansion.
The federal government has agreed to pay 100 percent of the cost for newly insured Medicaid recipients from 2014 to 2016, and then reduce its contribution to 90 percent by 2020.
Sen. Kathy Campbell, chairwoman of the Health and Human Services Committee, asked lawmakers to expand Medicaid so Nebraska's federal tax dollars don't go to other states.
"We are already paying the expenses related to not covering health care to low-income adults," Campbell said. "All of us are paying the cost."
She said 12 percent of Nebraskans do not have health care coverage.
Campbell then asked, "Do we say to the last group, we the 88 percent have coverage, sorry we can't insure you even though we have the federal dollars?"
Vivianne Chaumont, director of the state Division of Medicaid and Long-Term Care, said she's against the expansion because she thinks it would put a large burden on the state budget.
The state is already trying to find ways to pay for the cost of insuring an estimated 21,000 residents who are already eligible for the program, but are not recipients. Chaumont said these people will likely seek benefits once they are required to obtain insurance under the Affordable Care Act in 2014.
The Legislature's Fiscal Office estimated the expansion would cost $2.5 billion through fiscal year 2019-20, with Nebraska paying about $67 million of the total cost.
Chaumont disputed the overall cost. She said the Department of Health and Human Services calculated the cost to be $2.7 billion.
Sen. Jeremy Nordquist, who supports Medicaid expansion, said several state funding streams that will no longer be needed due to the Affordable Care Act could be diverted to help fund the expansion.
He said more than $68 million of those funds — from the State Disability Program, the AIDS Drug Assistance Program and the Department of Corrections — could be set aside for a health care access fund between now and 2020.
"There is without a doubt in my mind we can capture those savings and have no state general fund impact between now and 2020," he said.
Jim Stimpson, director of the Center for Health Policy at the University of Nebraska Medical Center's College of Public Health, presented his study on Medicaid expansion projections. He said the costs to pay for uninsured patients are shifted to Nebraskans through higher insurance premiums. He said providing health care for the uninsured increases insurance premiums by an average of 8 percent for state residents.
Nebraska Hospital Association President Sharon Lind said uninsured people go to emergency rooms for treatment, which is the most expensive source of medical care and is ultimately paid for with Nebraskans' tax dollars.
Beatty Brasch, executive director of the Lincoln-based anti-poverty organization Center for People in Need, said many working poor make too much to qualify for Medicaid, yet too little to afford health insurance premiums.
"The Affordable Health Care Act gives Nebraska a chance to rectify this problem by paying for expanded Medicaid eligibility," Brasch said.
Omaha hairdresser Monica Sheehan-Martz said she is in the gap and goes without medical insurance while her 8-month-old baby is covered by Medicaid. If expanded, she said she would qualify for Medicaid.
"Expanding Medicaid would change everything for me and give me a peace of mind," she said. "I'm a single mom and I need health care coverage so I can be healthy to take care of my daughter."
Western Nebraska Taxpayers Association representative Mike Groene said expanding Medicaid would make Nebraska a magnet for poor people who need free health services.
"I pay for my family's health care and then you are asking me to pay for somebody else's health care," he said. "I can't do it anymore."
But Kathy Hoell said it's not fair that several of her friends have mental illnesses but don't qualify for Medicaid and cannot afford private health insurance.
"Medicaid expansion is not a partisan issue, it is a moral issue," said Hoell, who uses a wheelchair.
The bill is LB577.