Governor Ricketts Statement on Blue Cross Blue Shield Exit from ACA Marketplace

Governor Pete Ricketts issued a statement following an announcement by Blue Cross Blue Shield that the company would exit the Affordable Care Act marketplace in Nebraska.


“This is further evidence that the Affordable Care Act was bad policy.  When solid companies like Blue Cross Blue Shield pull out of the market, something is structurally wrong with the system.”

Medicaid Myth Buster #2: Source and Quality of Care

By Jon M. Bailey, Guest Writer

A constant complaint about Medicaid is that fewer healthcare providers take patients on public insurance programs, and the resulting quality of care suffers.
The facts, however, tell a different story. According to the Commonwealth Fund Biennial Health Insurance Survey nearly all Medicaid (95%) and private coverage patients (94%) have a regular source of health care. The quality of care (rated excellent or very good) is higher for Medicaid patients (55%) than for those with private insurance (53%).
Unfortunately, uninsured people are severely disadvantaged in both respects. Only 77% of those without insurance have a regular source of health care. And only 40% of uninsured rate their care as excellent or very good, compared to 55% of those with Medicaid.
Those with private insurance are slightly better able to schedule a same day or next day medical appointment (58%) compared to those on Medicaid (53%) or uninsured (43%). But those on Medicaid have physicians and physician staff who know their medical history; 86% for those on Medicaid compared to 84% for those with private insurance and 77% of the uninsured.
Those who oppose expanding Medicaid, as provided in the Affordable Care Act, use these myths to support their arguments. But the facts tell us that the right choice, the only moral choice, is to extend Medicaid coverage to the hundreds of thousands who fall into the Coverage Gap, where working Americans who don’t currently qualify for Medicaid and whose income is too low to participate in the new health insurance marketplace.

Jon M. Bailey is a rural policy and research expert and former Center for Rural Affairs Policy and Research Director. Contact him at

Supreme Court Preserves Health Insurance Marketplaces

By John Crabtree,, Center for Rural Affairs

The Supreme Court recently announced their decision upholding tax subsidies to help people purchase individual health insurance plans through a federal health insurance marketplace.
The Supreme Court made the right decision, preserving provisions of the Affordable Care Act that have been so crucial in providing access to more affordable health care coverage to millions of Americans. The court focused on interpreting the intent of Congress to create a health insurance marketplace for every eligible American, either through state exchanges or a federal exchange. Incentives for low- and moderate-income families to help make their insurance coverage more affordable was part of that intent.
The decision protects the progress we have made as a nation in providing affordable health insurance coverage for the millions of Americans who were uninsured prior to passage of the Affordable Care Act – 6.5 million Americans received tax credits to make their health coverage more affordable as of this year.
Clearly the ACA’s health insurance marketplaces are working, making health insurance more affordable for families that use the marketplace. Those individuals would have seen their premiums increase by nearly 500% in the federal exchange states if the Supreme Court decision had gone the other way.
Now it’s time to get on with providing affordable healthcare coverage for everyone and finishing the job of expanding Medicaid for the nearly 4 million low-income uninsured adults who fall into the “coverage gap” resulting from state decisions not to expand Medicaid.

Medicaid Redesign Act-No-Risk Solution for Nebraska

By Jon Bailey,, Center for Rural Affairs 

LB 472 is a no risk way to provide health insurance to those in the Coverage Gap.


One of the major arguments against LB 472, the Medicaid Redesign Act, is that the federal government cannot be trusted to maintain the funding to states for an expanded Medicaid program. The argument goes that since the federal government cannot be trusted to maintain funding, LB 472 would cause the state to pick up the tab for this initiative.


Distrust of the federal government to maintain the contribution to state initiatives to expand Medicaid has been a consistent theme of opponents in Nebraska and throughout the nation. However, federal participation rates to states for Medicaid have varied little since Medicaid’s inception in 1964.


This argument also involves a fundamental misunderstanding or misreading of LB 472. According to the Affordable Care Act, from 2020 onward the federal government will provide 90 percent of funding for the LB 472 initiative. Specific language in LB 472 states that if federal funding ever drops below 90 percent, Medicaid coverage for those eligible under LB 472 will terminate and the LB 472 initiative will automatically cease.


This provision in LB 472 is a no risk proposition for the state. The Medicaid provision in the Affordable Care Act is essentially a pilot program for the state. Future trust of the federal government is irrelevant – it is the implementation by the state and the performance of the initiative created by LB 472 that is most important.

Protecting Nebraska Policyholders

Governor Pete Ricketts

Governor Pete Ricketts

Thousands of Nebraskans are being encouraged to quickly change their health care coverage due to the collapse of CoOportunity Health (CoOportunity).


The Affordable Care Act, also known as Obamacare, created CoOportunity as a consumer operated and oriented plan, or co-op. Co-ops are non-profit health insurers intended to create competition in the health insurance marketplace. CoOportunity, based in Iowa, was approved as a co-op to sell health insurance in Iowa and Nebraska.


High enrollment numbers exceeded expectations in both states. This led to more claims, and, in a matter of months, the company had outgrown its resources. On December 16, 2014, President Obama’s administration refused CoOportunity’s request for additional loans, and a week later, an Iowa court determined that CoOportunity was in financially hazardous condition. On February 28, 2015, the company was liquidated.


This Obamacare failure has left many insured Nebraskans wondering what to do next. My administration is working with the Nebraska Department of Insurance (NDOI) to help CoOportunity policyholders decide what is best for their families and businesses. NDOI encourages those still covered by CoOportunity to obtain coverage with a new carrier during a Special Enrollment Period, which runs from March 1st through April 29th. Enrolling during this time is essential because CoOportunity policies will be cancelled before the next open enrollment period begins. NDOI reports that individual policies will be canceled 180 days after liquidation, and group policies canceled within 30-45 days after liquidation.


During the Special Enrollment Period, individuals insured by CoOportunity and any of their enrolled dependents may choose a different health plan offered by a different company. Doing so now may give those individuals more options for individual plans, since an insurer is not required to sell individual policies outside of a special enrollment period.


CoOportunity policyholders can follow the company’s regular process for claims while it is in liquidation. To avoid a gap in coverage, keep paying CoOportunity premiums until you have purchased a policy to replace CoOportunity.


Policyholders still covered by CoOportunity will no longer receive Advanced Premium Tax Credits (APTC) or Cost Sharing Reductions (CSR) because these plans lose Qualified Health Plan status upon liquidation. That means that those who stay on this plan may be forced to pay hundreds of more dollars per month in policy fees and co-pays.


Today, I am joining the NDOI to encourage those affected by CoOportunity’s collapse to find new health insurance coverage. This is yet another unintended and unfortunate result of the Affordable Care Act, and my administration is committed to helping Nebraskans who have been negatively impacted by this issue.


Policyholders with individual plans who are in the Special Enrollment Period (beginning March 1st) should call 1-800-318-2596.


For policyholders with a small business plan through the SHOP exchange, call 1-800-706-7893.


Insurance agents and brokers can assist employers who are moving to a new plan.


Hearing from you is an important part of helping my administration assess your needs.  I look forward to input from people all across our state.  As always, you are welcome to contact my office at (402) 471-2244, or by email, at


Elkhorn Logan Valley Public Health Department Affordable Care Act

The 2015 Affordable Care Act (ACA) open enrollment period starts on November 15, 2014 and ends on February 15, 2015. Coverage ends for 2014 Marketplace plans on December 31, 2014. Coverage for 2015 can begin on January 1, 2015. If you have questions please call ELVPHD at 402-529-2233.

West Point to Host Affordable Care Act Presentation

Lyons, NE – The Center for Rural Affairs will host an Affordable Care Act presentation to help provide information about the new healthcare law and how it will affect people on the local level.
The presentation will be held on Thursday, January 30, 2014 at the Cuming County Courthouse at 7:00 pm and is sponsored by the Elkhorn Logan Valley Public Health Department.


October 1 marked an historic day for health care access in the United States, the day the health insurance marketplaces created by the Affordable Care Act opened for business.
Many people have questions or concerns about health insurance and the Affordable Care Act, especially those who may purchase insurance on the new marketplaces (those who buy insurance for themselves, their family, small businesses, and those without health insurance), health care providers and social service providers.
Jon Bailey, director of research and analysis at the Center for Rural Affairs, will discuss the basics of the Affordable Care Act and in particular the new health insurance marketplaces. He’ll discuss how the marketplaces work, how they will help people, and what assistance is available to help people navigate the new health insurance system.
“There are a lot of questions out there, mostly about how people will be covered based on their personal circumstances,” Bailey said. “I expect there will be a lot of questions for people who are buying insurance on the new marketplace, and we’ll be talking about some of the basics with what’s in the law and what the new health insurance exchanges mean. They opened up on Oct. 1, so we’ll talk about what people can expect on how they work and what they need to have when they go online.”
Bailey said that public information about the new health care act has been lacking, which has led to a lot of confusion.
“I think there are so many sources of information and different spins on the information, that it seems to create more questions and confusion,” he said. “A lot of it depends on where people get their information and what they take in, and we’re trying to give a fact-based presentation, with no politics and no spin on the law at all, and talk about what’s in it and how it will affect people.”
What: A presentation on the Affordable Care Act in rural America
When and Where:
Thursday, January 30, 2014
7:00 p.m.
Cuming County Courthouse (lower level/basement meeting room)
West Point, NE


The meeting is free and open to the public.

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