The following opinion was published in the February 27, 2014 Lincoln Journal Star.
Sen. Mike Gloor of Grand Island presented a potent argument this week in favor of a legislative bill that would expand Medicaid coverage in Nebraska under the Affordable Care Act.
In explaining his vote to advance LB887 to the full Legislature, Gloor, a former hospital administrator, said that the bill would help transform health care in Nebraska in ways that would have long-term benefit.
Those benefits would stay in place even if the Affordable Care Act does not survive, Gloor said.
Among the benefits listed by Gloor include a focus on primary care, accountability for patient results, control of spending and patient-centered medical homes, which describes a concept in which patients develop a relationship with a doctor and staff at a clinic in a throwback to the days of the small-town family doctor.
“It’s an appropriate focus on where our health care seems to be headed in this country, and we’re building our Medicaid system around it,” Gloor told the Journal Star’s JoAnne Young.
Gloor’s support for the measure is significant. Last year he opposed a different approach to expanding Medicaid in Nebraska under the Affordable Care Act. That bill never came to a vote because of a filibuster.
This year’s bill, introduced by Sen. Kathy Campbell of Lincoln, represents a new approach that would be unique to Nebraska. Among its major provisions are an emphasis on personal responsibility — for example, people who go to the emergency room for non-emergency health care would have to pay a $75 co-payment.
Importantly, the bill would staunch the hemorrhage of federal tax dollars that Nebraskans are now sending to other states which have expanded Medicaid coverage under the ACA.
Under the federal law, 100 percent of the cost of expanding Medicaid in Nebraska would be covered by the federal government through 2016. After that the federal share would fall gradually to 90 percent.
If Nebraska continues to refuse the expansion, about 54,000 Nebraskans, often working poor who earn too much to qualify for regular Medicaid and too little to buy coverage on the federal exchanges, will continue to be without coverage.
If senators and other Nebraskans examine the facts and think rationally, they will reach the same conclusion that Gloor did. Yes, we understand that at the national level Republicans want to use the fight against the ACA to rally the troops to take control of Congress. But refusing state participation is too costly to Nebraska. Passing the bill is the practical thing to do, and it would provide long-term benefit to the state.