Medicaid expansion bill gets rocky start; water plans resisted

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March 18, 2014 - 5:42pm

A new effort to expand Medicaid got off to a rough start, and a proposal to require plans for water sustainability met plenty of opposition Tuesday in the Nebraska Legislature.

Last year, supporters proposed a simple expansion of Medicaid to cover an estimated 54,000 Nebraskans. Opponents blocked that plan with a filibuster. This year, supporters have a different proposal. It would use federal Medicaid dollars to help buy private insurance for some. It would put others in a revised Medicaid plan that would connect them with primary care physicians and take other steps aimed at better care and lower costs.

Grand Island Sen. Mike Gloor, who opposed last year’s proposal, supports this year’s bill. Gloor said it addresses problems that will not go away, such as hospitals shifting costs from people without insurance to people with insurance, relying on emergency rooms for care, or expecting there to be enough physicians. . "Whether this bill passes or not, we can’t just say no," Gloor said. "No is not an option. This is an option."

The bill would expand Medicaid coverage to households with income below 133 percent of the federal poverty line. That would equal an income of about $26,000 for a family of three. Omaha Sen. Jeremy Nordquist said most of the people who would be covered are working. "If 15 or 13 percent of our population is uninsured and 3 percent are unemployed, that means that somewhere between 9, 10 percent of our population is working but is uninsured," he said. "These able-bodied people are working. They’re working low-wage jobs, they’re struggling to make ends meet, put a roof over their head, and they’re struggling to afford health insurance."

Omaha Sen. Pete Pirsch said he is concerned about the effects of the proposal. Supporters claim that it will save money by giving people access to preventive care instead of relying on expensive emergency room visits. But Pirsch said that was not the case after Oregon expanded Medicaid. "In fact they did not see a decrease in emergency room visits. Quite the contrary, they experienced a 40 percent surge," he said.

Sen. Bill Kintner of Papillion criticized the existing Medicaid program, and said it should not be expanded. "If this was a private company administering Medicaid it wouldn’t survive," he said. "There’s unfavorable economics, poor service, broken promises. And we want to enlarge this system that’s given us the Medicaid that we have?" he asked.

The Legislature is not expected to reach a vote on the bill before Wednesday. But the first vote, on a technical amendment, showed supporters have a long way to go. It attracted 24 votes, one short of the number needed for the amendment, and nine short of what supporters will eventually need to cut off a filibuster.

Also on Tuesday, the Natural Resources Committee held a public hearing on a proposal to require every river basin in the state to have a plan to reach water sustainability within 30 years. Jasper Fanning, who manages the Upper Republican Natural Resources District but was testifying as an individual, warned against plans requiring a balance between water users and water supplies. Fanning said that could require shutting down groundwater irrigation to supply less efficient surface water irrigation.

Dale Helms, who farms along the Republican River near Holbrook, objected to the current system of reducing allocations to surface water irrigators in order to comply with an interstate compact with Kansas. "I lost over $130,000 in revenue last year because my surface water was sent to Kansas. I cannot survive two or three years of this," Helms said.

The committee took no immediate action on the proposal.

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