Medicaid expansion debate continues

Lawmakers continued debate April 17 on a bill that would require Nebraska to opt in to expanded Medicaid coverage available under federal health care reform.

LB577, introduced by Lincoln Sen. Kathy Campbell, would require the state Department of Health and Human Services (DHHS) to add the adult population newly eligible under the federal Patient Protection and Affordable Care Act (ACA) to the state’s Medicaid state plan amendment.

Under the ACA, low-income adults ages 19 to 65 with incomes of up to $15,856 would be eligible for Medicaid if a state chooses to extend benefits to them, Campbell said.

During debate April 16, Campbell said expanding Medicaid to this group would be a good financial move for the state because it would allow Nebraska to cover the newly eligible adult population with 100 percent federal funding from 2014 to 2016. Federal funding would decrease incrementally, she said, leveling off at 90 percent starting in 2020.

LB577 would direct DHHS to request the secretary-approved benefit plan and to include the mandatory and optional coverage under traditional Nebraska Medicaid. The bill also would specify that the benefit plan comply with the requirements of the Mental Health Parity and Addiction Equity Act and include habilitative services as provided by the ACA.

Campbell offered an amendment, which was divided into two separate amendments, that she said was intended to address concerns regarding the federal government’s commitment to funding Medicaid expansion.

Under the first amendment, if at any time the federal match falls below 90 percent for the newly eligible group, the Legislature would be required to determine whether to affirm, amend or repeal eligibility from that group during the next regular legislative session.

Senators voted 30-12 to adopt the Campbell amendment during debate April 16.

Omaha Sen. Beau McCoy offered a motion to reconsider the vote, saying many senators were waiting to speak on the issue when the vote was taken.

The McCoy motion failed April 17 on a 17-26 vote.

A second Campbell amendment would set a sunset date for LB577 of June 30, 2020, unless extended by the Legislature.

Kearney Sen. Galen Hadley offered an amendment to the Campbell amendment April 17 that would change the sunset date to Dec. 31, 2016.

Hadley said the earlier date would give Nebraska a chance to experiment with Medicaid expansion without requiring a funding commitment on the part of the state.

“I truly believe that this makes the bill better,” he said.

Gloor called the amendment a step in the right direction.

“It puts us in the position of making a decision before that 100 percent federal subsidy disappears,” he said.

Ogallala Sen. Ken Schilz spoke against the amendment, saying LB577 should be killed, not altered to increase the likelihood of its passage. He said lawmakers should not authorize Medicaid expansion if people would have to be removed from the program should the law sunset in three years.

“I don’t think that’s right; I don’t think it’s smart and I don’t think it’s moral to do that,” Schilz said. “Let’s not step into the trap in the first place.”

Senators moved on to another agenda item without voting on either amendment.