An Omaha senator forced a discussion on Medicaid expansion Wednesday, even though the bill has yet to return to the Legislature's agenda.
Omaha Sen. Steve Lathrop used debate on a bill (LB545) that would change Public Service Commission appeal procedures to talk about the effect on rural communities of not enacting Medicaid expansion.
Small Nebraska towns struggling to keep young people and avoid atrophy need their community hospitals, he said. Medicaid expansion is an important key to helping ensure that about 15 of those hospitals across the state will remain open.
Sen. Paul Schumacher of Columbus thanked Lathrop for steering discussion back to the issue.
"We have got just 20 days to examine one of the greatest and most complicated and most expensive issues of our time, and very well the most important issue this room will face for the next 10 years," he said.
The Legislature failed to reach a first-round vote last month on the Medicaid expansion bill (LB577) after more than 10 hours of discussion. Debate was suspended April 17.
Lincoln Sen. Kathy Campbell, who introduced LB577, said she told Speaker Greg Adams she would not ask for the bill to come back to the agenda until she had 33 senators who would agree to force a vote.
She's still working on it, she said. The number of those who say they would vote for cloture has fluctuated.
"I'm a woman of patience and perseverance," Campbell said Wednesday.
She has heard it questioned many times whether the federal government will keep its promises, she said.
"And I say, 'Will we keep our promise to bring to this floor and discuss public policy?' That's what we promised when we got elected."
Proponents have been up against a pretty strong -- although not impenetrable -- wall of opposition. Gov. Dave Heineman has said many times he adamantly opposes the expansion.
Seventeen of the 49 lawmakers reportedly signed a pledge saying they would not vote for cloture, which would leave Campbell short of the 33 votes needed.
But one of those -- Sen. Jerry Johnson of Wahoo -- said Wednesday he has changed his mind.
"I just feel that I'm wavering and I think it needs to come to a vote," Johnson said.
Several of those who opposed Medicaid expansion said the bill received more than 10 hours of debate and that was enough.
LB577 has several problems, Sen. Jim Smith of Papillion said, including questionable income guidelines for people who would be added, concern about whether the Medicaid system already is stressed enough for those who qualify now, and whether the federal government can deliver on its promises.
Sen. Ken Schilz of Ogallala said he signed the pledge because LB577 in its current form can't move forward.
"We were very clear when we started that it was a nonstarter at the beginning," Schilz said.
It's not just about the money, he said. It's about an ideology that the government should not be first and foremost in caring for people, especially when it pulls them off private insurance and moves them to public insurance.
Schilz said he would be willing to talk about an alternative approach using private insurance rather than Medicaid to meet the needs of uninsured Nebraskans.
"I think everybody does understand that there's an issue and a problem out there," he said. "The question then becomes how best to address it."
Sen. John Murante of Gretna signed the pledge as a demonstration that proponents of Medicaid expansion do not have the votes they need, he said. The Legislature needs to move on.
Omaha Sen. Bob Krist took his name off LB577 as a sponsoring senator in order to work on a compromise, he said.
"Compromise is not possible when 17 people decide, 'I'm going to make legislation by blocking legislation,'" he said. "But you continue to do what you want to do. Godspeed. You'll answer some way in the future."