Medicaid Myth Buster #1

By Jon Bailey, Guest Writer

During debates over expanding Medicaid to uninsured, low-income families, expansion opponents argued it doesn’t provide quality healthcare coverage, and low-income residents would be better off uninsured.
Reports of organizations such as The Buckeye Institute (from Ohio, which has expanded its Medicaid program) make such claims. They have been repeated across the nation by anti-Affordable Care Act and anti-Medicaid expansion politicians and groups.
These arguments are nonsensical. Myriad economic and health benefits accompany health insurance. These are well documented in Center for Rural Affairs’ reports. To deny people those benefits and the security and well-being they bring and then tell them they are better off is absurd and immoral.
It’s also dishonest, as the Commonwealth Fund Biennial Health Insurance Survey shows. The 2014 survey found that Medicaid outperforms private health insurance in many respects. All measures show those receiving Medicaid are significantly better off than those without health insurance.
Medicaid is not a perfect source of healthcare coverage. Provider reimbursements are low, which makes many providers less likely to accept Medicaid patients. Physicians in rural areas, however, are more likely to participate in the Medicaid program and accept all or new Medicaid patients. Research shows practicing in a rural area is one of the factors associated with higher physician Medicaid participation.
Medicaid services are also susceptible to state budget cuts, private insurance is not. But to say Medicaid is not worthy health insurance and that low-income individuals and families and people with disabilities are better off being uninsured is simply false.
Jon M. Bailey is a rural policy and research expert and former Center for Rural Affairs Policy and Research Director. Contact him at

Medicaid Redesign Won’t Bust Budget

By Jon Bailey,, Center for Rural Affairs 


Other states have found their initiatives to expand Medicaid similar to Nebraska’s LB 472, the Medicaid Redesign Act, have produced significant budget savings. Providing health insurance for low-income, working Nebraskans will result in state budget savings and economic growth.


Kentucky estimates their expanded Medicaid program will result in net state budget savings of $820 million from state fiscal year 2014 to state fiscal year 2021. And Arkansas estimates savings of $370 million during that time.


The savings Kentucky and Arkansas realized are available to all states. Providing health insurance coverage in LB 472 through private premiums and federal contributions will result in less need for state-funded mental and behavioral health programs. Other current specialized Medicaid programs would be to initiatives where the federal government is providing a greater contribution. Nebraska’s corrections program would achieve savings from released inmates receiving needed mental health and substance abuse treatment resulting in fewer reoffenders.


Research found that Connecticut, New Mexico, and Washington also realized budget savings in the first year of expanded Medicaid programs.


A recent University of Nebraska-Kearney study finds that over the next 10 years LB 472 would result in $1.5 billion savings in state spending (a conservative estimate; the experiences of other states argues it may be more) while bringing in more than $2 billion in federal Medicaid funding to Nebraska. LB 472 is estimated to result in $5 billion in economic activity to Nebraska.


LB 472 is not a budget buster and will result in economic growth to Nebraska.

Redesigning Medicaid in Nebraska

By John Crabtree,, Center for Rural Affairs 

Nebraska’s failure to participate in the new Medicaid program under the Affordable Care Act has, for two years, allowed low-income, working Nebraskans to fall into a health care coverage gap that has left them economically and medically vulnerable. At least 54,000 of our friends, family members and neighbors do not qualify for Medicaid, cannot afford private insurance, and have incomes too low to qualify for tax credits in the new health insurance marketplace. Yes, you read that right… with incomes too low to qualify for coverage in the healthcare exchange.


The Medicaid Redesign Act, LB 472, would help redesign Nebraska’s Medicaid program, creating a Nebraska-specific plan for better, more cost-effective health coverage while also closing the coverage gap and providing coverage to working Nebraskans with low incomes who cannot afford insurance under the current system.


LB 472 sets out a framework to redesign Medicaid and close the coverage gap, providing the Governor and Department of Health and Human Services broad latitude to design and implement a plan for Nebraska.


Moreover, through 2016, 100% of the cost will be covered by the federal government. The federal share will then gradually settle to 90% in 2020 where it will then remain. And most enrollees would be required to contribute up to two percent of their income to the cost of their coverage.


The Medicaid Redesign Act – LB 472 – is a responsible, commonsense Nebraska solution to closing the health care coverage gap. Let’s get this done.

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