Nebraska voters could get the chance to decide whether to expand Medicaid coverage as part of the federal health care law after Maine voters defied conservative opponents and overwhelmingly approved a similar measure.
State Sen. Adam Morfeld of Lincoln has said he will propose a resolution next year to have lawmakers place the issue on the November 2018 general election ballot. Tuesday, Maine became the first state to expand coverage through a statewide referendum.
The measure's prospects are far from certain in Nebraska's conservative, one-house Legislature, but Morfeld said he's hopeful that some senators who oppose an expansion of Medicaid would be open to letting voters decide the matter.
"I think Nebraska voters are infinitely more reasonable than the Legislature and the governor," said Morfeld.
Nebraska lawmakers have rejected five previous attempts to expand Medicaid under the Affordable Care Act. Gov. Pete Ricketts and former Gov. Dave Heineman also opposed the efforts, but a legislatively referred ballot measure would only need approval from 30 of the Legislature's 49 senators to appear on the ballot.
Expanding Medicaid would provide coverage to an estimated 90,000 low-income adults between the ages of 19 and 64 who have no dependents. Ricketts and opponents in the Legislature have said the program would create long-term budget problems and draw resources from other vulnerable groups.
Groups that have pushed for the expansion said they will work on any effort to cover the affected population, which consists largely of residents in service jobs with no benefits, such as hotel and construction workers.
"We've seen over the last five years that the need for these folks to get coverage has not gone away," said Molly McCleery, deputy director for health care programs with Nebraska Appleseed. "They've been waiting, and our Legislature has not taken action on it."
Roughly 11 million people nationally have gotten coverage through the expansion of Medicaid. The health care law appeared to be in jeopardy earlier this year, but President Donald Trump and congressional Republicans have repeatedly failed to repeal it.
With Maine's vote Tuesday, 32 states and the District of Columbia have now expanded Medicaid under the Affordable Care Act. The 18 that have not done so are mostly conservative states in the Midwest and South and mountain states.
Supporters of Medicaid expansion in Idaho and Utah have started similar efforts to get the question on the 2018 ballots in their own states. In Maine, voters expanded Medicaid even though Gov. Paul LePage had vetoed five different expansion measures approved by that state's Legislature.
There isn't enough polling to guess whether Nebraska voters might do the same thing as Maine, said John Hibbing, a University of Nebraska-Lincoln political science professor. Unlike GOP-dominated Nebraska, Maine's congressional delegation is divided between the parties and Democrats control both houses of its Legislature.
"It would be a really interesting campaign," Hibbing said. "I'm sure (supporters) are thinking, 'What have we got to lose?'"
In 2014, Nebraska voters approved a minimum wage increase from $7.25 to $9 an hour that was placed on the ballot through a petition drive, despite opposition from a majority of lawmakers.
However, in 2012, voters rejected an effort to loosen legislative term limits and give senators a raise. A majority also voted to reinstate the death penalty in November 2016, overriding lawmakers who abolished the punishment in defiance of Ricketts.
Morfeld said lawmakers who want to expand Medicaid have worked in good faith to address opponents' concerns over the years, but nothing has worked so far.
"I'll just say it's incredibly frustrating to work in the Legislature and with the governor when they constantly oppose affordable health care legislation and provide absolutely no alternative," he said.