Will expanded healthcare in Nebraska finally see light of day?

For seven years, lawmakers have failed to expand health care coverage for an estimated 90,000 Nebraskans who can’t afford to purchase insurance on their own.
Governor Pete Ricketts and Gov. Dave Heineman before him successfully thwarted the attempts in what has become one of the largest, most divisive partisan struggles in the officially nonpartisan Legislature.
In case you forgot, there are way more Republicans than Democrats in the Legislature, well, in Nebraska for that matter. And the oft-suggested vehicle for providing the insurance—Medicaid expansion—apparently sounded too much like Obamacare.
Supporters such as Sen. Adam Morfeld of Lincoln have argued that the infusion of federal funding would spur economic development and help secure the future of rural hospitals in Nebraska while treating health conditions before they spiral into serious health challenges that may result in far more expensive and uncompensated care.
The vast majority of current Medicaid recipients are children and the elderly. The stories abound and are heart-wrenching. Life is not good for the working poor.
Nationwide, 32 states have approved Medicaid expansion. Meanwhile, in Nebraska, Morfeld and others must have felt like the mythological Sisyphus during years of a mostly uphill struggle. That changed last session when Morfeld and company decided to support an initiative petition measure instead.
Working with the same zeal that Ricketts-backed petitioners used a couple years ago to get a death penalty reinstatement on the ballot after lawmakers repealed the death penalty over his veto, the pro-expansion supporters turned in more than 133,000 petition signatures to place the expansion on the November ballot. They needed 84,268 valid signatures after a review by county election officials and a decision by Secretary of State John Gale.
But, don’t get too excited. The Republicans found another way to try to derail the proposal.
State Senator Lydia Brasch of Bancroft, Nebraska’s National Republican Committeewoman, and former Sen. Mark Christensen of Imperial have filed a lawsuit to block the initiative. They are being represented by Nebraska’s National Republican Committeeman J.L. Spray, a Lincoln attorney.
The term-limited Brasch, who will be gone in January, is identified as a plaintiff who is “opposed to the Medicaid expansion petition because of the negative impact it will have on property taxes in Nebraska.”
Christensen is described as “concerned that if the Medicaid expansion petition proceeds, his son’s existing benefits will be reduced or altered.”
Medicaid expansion campaign manager Meg Mandy has called the lawsuit “a desperate attempt to block the people’s ability to voice their opinion on this issue and ensure affordable health care for 90,000 Nebraskans.” She characterizes the plaintiffs as “two politicians who have failed to find solutions for working Nebraskans to access health care.”
The expansion proposal would provide health coverage to single adults and couples without minor children who cannot qualify for Medicaid now, as well as parents and disabled people, with incomes up to 138 percent of the poverty level—$16,753 for a single person or $34,638 for a family of four.
The proposal would bring an estimated $1 billion in federal funding flowing into the state while requiring a state match that officials in the Ricketts’ administration have said would eventually accumulate to some $800 million over a 10-year period.
Federal law has allowed states to expand their Medicaid coverage since 2014 as part of the Affordable Care Act. The ACA requires the federal government to pay 94 percent of the cost of Medicaid expansion programs in 2018, with the federal share declining year by year until plateauing at 90 percent by 2020. The state pays the rest.
The lawsuit suggests a number of procedural, statutory and constitutional flaws that would render the initiative petition “invalid and legally insufficient,” including a claim that language in the initiative seeks to “exercise legislative power specifically reserved to the executive branch.”
If the election proceeds and voters approve the initiative, there remains an implementation debate in the next session of the Unicameral. Remember, the current mix of that body is 31 Republicans, 16 Democrats, one Independent and one Libertarian. The November elections will change that number some.
But one can still expect a partisan battle. Stay tuned.