Bills seek to capture Medicaid savings

The Health and Human Services Committee introduced two bills during a Feb. 9 hearing that would require the state Department of Health and Human Services to seek amendments or waivers to Nebraska’s Medicaid state plans regarding emergency room visits and family planning services.

Lincoln Sen. Kathy Campbell, chairperson of the committee, said the proposals are an attempt to address the state’s looming budget deficit.

“We came up with some ideas that had not been put on the table by other folks, but that we might want to take a look at,” she said.

Under LB540, HHS would be required to submit a state plan amendment or waiver to the Centers for Medicare and Medicaid Services (CMS), no later than July 1, 2011, to provide medical assistance for family planning services to individuals with a family earned income at or below 185 percent of the federal poverty level.

Kay Oestmann, president of the Public Health Association of Nebraska, testified in support of the bill.

The state match for family planning services is 10 percent, Oestmann said, with federal funds covering 90 percent of the cost. Furthermore, she said, several states that have expanded family planning services in ways similar to the proposal have saved more than $15 million per year.

“LB540 provides an opportunity for improvement in access to women’s health care services at a demonstrated cost savings to the state,” Oestmann said.

Laura Urbanec, executive director of the Central Health Center in Grand Island, also testified in support, saying the bill’s fiscal note projects a savings of approximately $5.5 million in general funds per year.

“No other Medicaid program has a higher federal match,” Urbanec said. “Medicaid family planning waivers have proven to be successful.”

Greg Schleppenbach of the Nebraska Catholic Conference testified in opposition to LB540.

The bill’s cost saving potential is overstated by proponents, he said, and is based on a “questionable” study which assumes that greater access to contraception leads to a decrease in unplanned pregnancies and abortions.

“It’s pure speculation,” he said.

In addition, Schleppenbach said, Nebraska would have to spend tax dollars to implement the measure’s provisions, which is counter to the bill’s stated intent.

“This bill will cost the state more than $100,000 in this biennium,” he said.

Under LB539, HHS would be required to submit a state plan amendment or waiver to CMS, no later than July 1, 2011, that would limit Medicaid payments for emergency room visits to 12 per year for adults. An emergency room visit resulting in inpatient admission would not be counted toward the limit.

According to LB539’s fiscal note, the bill would save the state’s Medicaid program $948,000 in general fund expenditures annually.

Vivianne Chaumont, director of Medicaid and long-term care for HHS, testified in a neutral capacity.

“We are very supportive of the intent behind this bill,” she said. “We would be happy to work with you in the future to make sure that it meets the goals you intended.”

No proponent or opposition testimony was given on LB539.

The committee took no immediate action on either proposal.