Medicaid Debate Day 1 Recap

April 17, 2013

We want to provide you a daily update on the contentious debate on LB 577, the Medicaid expansion bill.

Sen. Kathy Campbell introduced the bill arguing that Medicaid expansion provides incentives for working Nebraskans and health coverage that will save the lives of those who otherwise would not be able to afford access to care.

Senators Krist, Chambers, Nordquist, McGill, Mello, Lathrop, Howard, Bolz, Conrad, Cook, Crawford, Haar and Wallman also spoke in favor of Sen. Campbell’s bill and argued LB 577 was a ‘great deal’ for Nebraska because for the first three years the federal government has offered to pick up the tab and no less than 90% of the costs thereafter.

These state senators forget why we’re having this debate in the first place.

Medicaid expansion is not a tool the states have been asking for.

Medicaid expansion is a budget gimmick pushed by President Obama early in his first term to help ram his health care law through Congress.  Remember, President Obama wanted the CBO (non-partisan Congressional Budget Office) to estimate the cost of the Affordable Care Act under $1 trillion.

The CBO scored the bill at $940 billion, and with much jubilation Administration officials and Congressional Democrats trumpeted the CBO cost estimate and even claimed that long-term the health care law would create ‘cost-savings’.

Crucial to keeping costs ‘low’ for the President’s health care law was Medicaid expansion, a provision the law originally mandated for all 50 states.  Critical to understanding how expansion would keeps costs low is the fact states contribute a portion of the cost to administer the Medicaid program as well as the substantial cost of providing health coverage.

In Nebraska, our state contribution to fund Medicaid spending is $1.7 billion annually.

President Obama originally wanted Medicaid expansion to be mandatory because he could then rely on state budgets to help ‘pitch in’ to fund his health care reforms; thus keeping the federal costs low.

The Supreme Court upended Obama’s budget gimmick.  The Court made Medicaid expansion optional.  The states now had the option to either voluntarily participate in the President’s health care law and agree to contribute to paying for those reforms with state tax dollars.  Or states could reject this costly expansion of government spending.

That the Nebraska Legislature is now engaged in a thorough debate of Medicaid expansion is not of our choosing, it is due to the ACA being rammed through Congress and thrust upon the American people over our objections.

Medicaid expansion is not a Nebraska idea, it is not an organic policy alternative nor the best thought-out health reform.  It is a budget gimmick that failed the scrutiny of the Supreme Court and is now being pushed by members of the Legislature who apparently do not believe government spending has yet hit a tipping point.

During Day 1 debate a number of amendments and motions were filed.  Sen. Campbell offered AM 1011 which made two revisions to LB 577.  First, the amendment allows for the Legislature to revisit participation in Medicaid expansion should the Federal funding commitment drop below the promised floor of 90%.  The amendment also terminated the right of the Unicameral to review the 90% funding commitment after 2020, unless the 90% threshold ‘trigger’ was extended.

Sen. McCoy was successful in a motion to divide AM 1011 into two amendments.  AM 1011 became AM 1028 and AM 1029.  AM 1028 contained the 90% threshold trigger while AM 1029 contained the 2020 extension deadline.

Late in the afternoon on Day 1 of the Medicaid expansion debate Sen. Wallman successfully called the question on AM 1028, effectively ending debate and forcing a vote on the amendment.  The amendment was successfully adopted by machine vote.  Quickly thereafter, Sen. McCoy motioned to reconsider the vote on AM 1028, arguing that concerning a bill the magnitude of LB 577 the Legislature should commit more time to debate.

Debate on Sen. McCoy’s MO 44 continued until the Legislature adjourned for the day after 5:00pm to reconvene on Wednesday, April 17th at 9:00am.

To watch the Unicameral debate LB 577 live, click here.

To take action to oppose LB 577, click here.

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