Sen. Adam Morfeld of Lincoln said Wednesday that "it is time to allow the people of Nebraska to decide" whether to expand Medicaid coverage to 90,000 low-income, working Nebraskans who have no health care insurance.
His appearance before the Legislature's Health and Human Services Committee kicked off a familiar battle fought on unfamiliar ground.
Every Legislature since 2013 has rejected bills to statutorily expand Medicaid coverage in the wake of enactment of the Affordable Care Act; the new Morfeld proposal (LR281CA) would place the issue before Nebraska voters in the form of a constitutional amendment in the November general election.
The proposal would establish affordable health care as a constitutional right and direct the Legislature to act.
"The Legislature has repeatedly refused to take action on this issue," Morfeld said.
Most of the Nebraskans who would be impacted by expanded coverage have been generally described as "the working poor," people who work in occupations such as food service, construction and a variety of other occupations that often are low-wage jobs.
Those uninsured people currently fall into the so-called "coverage gap" in which they do not qualify for traditional Medicaid coverage and could not acquire health care coverage under provisions of the Affordable Care Act.
A parade of supporters urged the committee to send the resolution to the floor of the Legislature for its consideration, and most had personal stories to tell about medical and health care needs that go unaddressed without the ability to acquire funding assistance.
Some of those who appeared before the committee were making the same plea to state senators for the sixth time.
A number of people who addressed the committee during the lengthy hearing noted that 32 states have chosen to expand Medicaid, recognizing that the decision has stimulated the economy in their states and helped rural hospitals survive.
Rocky Thompson, interim director of the division of Medicaid and long-term care in the Nebraska Department of Health and Human Services, opposed the resolution, arguing that it would cost an estimated $800 million in state tax-supported general fund spending over 10 years.
Those projected costs come "at a time of state budget stress," he told the committee, and during a period of ongoing change at the federal level.
The Medicaid program is focused now on providing assistance for children and the elderly, he said, and adding a large, new fiscal burden for the state could "divert resources away from the truly needy."
The resolution faces a tough road ahead, ultimately requiring at least 30 votes to gain approval if it reaches the floor of the Legislature and traveling that difficult path without priority designation.