For Pete’s Sake


By Jon Bailey, jonb@cfra.org, Center for Rural Affairs 

The Legislature recently voted to delay LB 472, the Medicaid Redesign Act, until the 2016 session. While the bill is still alive, this means another year without access to health insurance for up to 77,000 Nebraskans, another year of health consequences that inaction will demand of them, and another year our rural hospitals are in financial jeopardy.

 

What’s more discouraging is the absolute lack of a reasonable alternative plan to provide access to health insurance for these Nebraskans.

 

Governor Ricketts has suggested two alternatives to the health care access issue facing thousands of modest income, hardworking Nebraskans. First, we should rely on “community health clinics” (we assume he’s referring to Nebraska’s seven Federally Qualified Health Centers). Unfortunately, this is placing a small bandage on a major wound. These clinics exist in Omaha, Lincoln, Norfolk, Columbus, Grand Island, and Gering. A look at a map shows there are vast areas of Nebraska where these services are unavailable. A Valentine resident without insurance would live 200 to 300 miles away from these clinics, for example.
Second, the Governor says we should just create better jobs with health insurance. Unfortunately, no plan is offered on how to accomplish this. In recent years, in fact, Nebraska has one of the lowest rates of employer-sponsored health insurance in the nation. The health insurance access challenges facing thousands of Nebraskans still exists, no matter what a majority of the Legislature and Governor say. We challenge them to work with us on a reasonable, practical solution.

Legislature Enters Final 30 Days of Session


By Senator Lydia Brasch

With the end of the week, Friday, April 10, the legislature entered our final thirty days of session. This week also marked the third full week of all-day floor debate and, when not stalled, things are beginning to move in full force. We discussed a number of key concerns in debate this week such as tax relief, foster parenting, economic development, and Medicaid expansion.

 

The Medicaid Redesign Act (LB472) was debated on Wednesday afternoon. While the intention of LB472 to “increase economic efficiencies and better serve all Nebraskans in the medical assistance program” seems ideal, the floor debate exposed crucial bill flaws. LB472 would have added approximately 54,000 additional Nebraskans to Medicaid at a cost to the state of nearly half a billion dollars beyond the limited Federal funding. While I support the need to provide effective medical services at lower costs, LB472 is simply economically unsustainable. After it was clear LB472 had insufficient support, the bill was bracketed which means the issue can no longer be debated during this session.

 

LB414 also received significant attention. LB414 exempts fraternal benefit societies from property taxes. Discussion on this bill revolved around two issues. First, LB414 was criticized as special interest legislation to satisfy a fraternal benefit organization from Omaha, Woodmen of the World. Second, there was considerable conversation regarding the Legislature’s priority efforts on property tax relief. Many Senators, including myself, expressed the need to address property tax relief for our farmers and ranchers.

 

LB449 was also discussed and easily advanced to second round of debate. LB449 changes provisions of the Business Innovation Act and the Nebraska Visitors Development Act. LB449 was prioritized by the Appropriations Committee. It was also amended to include LB569 which is a bill I introduced. LB569 modifies certain provisions of the Business Innovation Act and gives the Department of Economic Development greater flexibility to fund several programs supporting development of Nebraska-based technology and innovation in both rural and urban communities.

 

Finally, LB623 was considered by the Transportation and Telecommunications Committee in an executive session. I serve as vice-chair of the committee. LB623 addresses granting a drivers license to those brought here by illegal immigrant parents as a child. These children are now teenagers and young adults and have been granted deferred action by an executive agency. LB623 would grant them ‘lawful status’ for the purposes of operators licenses and ID cards. Every other state has already extended some form of drivers license or state ID benefit. LB623 received the five votes necessary to advance to the whole legislature. I was present but did not vote because of my strong belief and support of legal immigration. However, due to sincere compassion for those in this situation I withheld strict opposition to the bill. I cannot fully support LB623 because I believe we have an obligation to pass state laws that uphold legal paths of immigration which many others lawfully and patiently follow.

 

As always, please contact me, administrative aide, Katie Wattermann, or legislative aide, Tom Venzor, with questions or thoughts at (402)471-2728 or e-mail at lbrasch@leg.ne.gov.

 

Keeping the Good Life Growing in Nebraska,

Senator Lydia Brasch, District 16

Senator Lydia Brasch

Senator Lydia Brasch

Medicaid Redesign Won’t Bust Budget


By Jon Bailey, jonb@cfra.org, 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.

Medicaid Redesign Act-No-Risk Solution for Nebraska


By Jon Bailey, jonb@cfra.org, 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.

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