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Medicaid expansion legislation has been renewed again this year with Senator McCollister’s LB1032, the Transitional Health Insurance Program Act. While I appreciate the continued efforts to ensure health benefits for Nebraska’s underserved populations, I believe our efforts are best spent on other forms of health care reform. Unfortunately, expanding Medicaid to additional portions of the population is simply unsustainable, and this would only be a detriment to everyone in the future.
The number of individuals covered by Medicaid has increased substantially since the program’s inception in 1965, with the greatest increase happening in the most recent decades. If Nebraska were to expand the eligibility pool even further, the already burdened program will simply not have enough funds to sustain itself for long. We should remember as well that Medicaid was originally created to benefit the country’s most vulnerable citizens, including children in low-income families, caretaker relatives, the elderly, and people with disabilities. According to the Platte Institute for Economic Research, “Creating a new entitlement for able-bodied adults under the Affordable Care Act’s Medicaid expansion will not only hurt the most vulnerable, but undermine Nebraska’s long term reform efforts.”
Furthermore, LB1032 would be funded by the Nebraska Health Care Cash Fund, which is funded solely by the Nebraska Medicaid Intergovernmental Trust Fund and the Nebraska Tobacco Settlement Trust Fund and was created to be perpetually funded. Even without further obligations from Medicaid expansion, the Health Care Cash Fund is itself unsustainable. The Nebraska Investment Council, in 2014, indicated in its letter to the Legislature, “At the current pace of spending the projections suggest that there is a high probability that the [Health Care Cash] Fund transfers are not sustainable indefinitely. The Fund earning cannot keep pace because a significant portion of the earnings are being used to cover a growing negative distribution amount and not reinvested.”
Legislative Bill 1032 would be funded by monies that are already unsustainable. I understand the challenges we face as lawmakers to protect our society’s most vulnerable citizens, but I cannot support LB1032 because, in the end, it will only be a detriment.
This is not a simple issue. Rather, it is very complex. I applaud Senator McCollister and others for their efforts in health care reform, and I hope that we can all work together to find a solution that protects our citizens and can be funded indefinitely.
As always, if we can be of assistance to you in any way, please do not hesitate to contact my office. My door is open and I have made it a goal to be accessible to the constituents of our district. Please stop by any time. My e-mail address is firstname.lastname@example.org, and the office phone number is 402-471-2756. Joe and Katie are always available to assist you with your needs. If I am not immediately available, please do not hesitate to work with them to address your concerns, thoughts, and needs. Please continue to follow me on Facebook at Kolterman for Legislature and on Twitter at @KoltermanforLegislature.
 See Jessica Herrmann, Medicaid’s Midlife Crisis, Aug. 6, 2015 (available at
http://www.platteinstitute.org/research/detail/medicaids-midlife-crisis) (last visited Mar. 11, 2016).
 See Neb. Rev. Stat. § 71-7611(1).
 See letter from Jeffrey W. States to Patrick J. O’Donnell Re: Sustainability of Health Care Transfer, Sept. 30, 2014 (available at http://www.nebraskalegislature.gov/FloorDocs/103/PDF/Agencies/Investment_Council/139_20140930-131617.pdf) (last visited Mar. 11, 2016).