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Volunteers for the ballot initiative to place Medicaid expansion on the November ballot stand in front of some of the boxes filled with petitions during a press conference near the Secretary of State’s Office on July 8, 2018. 

The Medicaid expansion battle is heating up in Nebraska as voters approach a decision that's now just three weeks away.

Eleven state senators penned what they termed an editorial warning that the costs of expanding Medicaid assistance to 90,000 Nebraskans described as the working poor would "make property tax relief nearly impossible" and endanger funding for local schools, the University of Nebraska and current Medicaid recipients.

In response, Medicaid expansion campaign manager Meg Mandy said the ballot initiative would bring hundreds of millions of dollars flowing into the state from the federal government, create and sustain nearly 11,000 jobs and keep hospitals and clinics open across Nebraska while providing needed health care assistance and reducing the costs of uncompensated care. 

"Only a group of politicians would think it's a good idea to leave $600 million of our (annual) tax money in Washington, D.C., money that is going to 33 other states instead," Mandy said.

The 11 state senators argued that expansion of Medicaid "would hurt our most vulnerable Nebraskans by removing the focus of Medicaid benefits from people with disabilities, children and pregnant women and placing the focus on working-age adults without disabilities or children."

The senators overwhelmingly represent districts in rural Nebraska, with only Sen. Lou Ann Linehan of Elkhorn representing a metropolitan Omaha district and no senators from Lincoln joining the list. All 11 are Republicans who serve in the nonpartisan Legislature.

"Medicaid expansion would create an unpredictable financial obligation on Nebraska, as seen in other states, which could throw our balanced budget into jeopardy," the senators wrote.

"Tax increases would create an overwhelming financial hardship for most Nebraskans," they said, "and cutting funds to existing programs is an equally unappealing option."

A new study by University of Nebraska at Kearney business and economics professors conducted on behalf of the Nebraska Hospital Association argued Monday that Medicaid expansion actually would generate more in combined local and state revenues than it would cost the state.

"It would also ensure that rural Nebraskans continue to have access to care by alleviating the financial stress that rural hospitals and clinics face," according to a news release issued Monday by Insure the Good Life, the coalition that sponsored the initiative.

"Forty-five percent of Nebraska's critical-access hospitals are in severe financial distress as a result of the high amount of uncompensated care," the coalition stated.

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"The choice in this election is whether we are going to bring our tax money home from Washington, D.C., to help hard-working Nebraskans get health care and create jobs or whether we are going to continue to watch our money go to 33 other states to pay for their health care and help their economies instead," Sen. John McCollister of Omaha said. 

McCollister is a Republican.

Mandy, speaking for Insure the Good Life, said the proposed expansion of Medicaid would apply to "individuals working at jobs that come without health care coverage and (who) earn less than $17,000 a year."

Recent estimates from the legislative fiscal office envision $1.3 billion in federal funding flowing into the state during the first three years of Medicaid expansion, with state matching funds totaling $90.8 million over that period. 

Senators who signed the opposition statement: Joni Albrecht of Thurston, Lydia Brasch of Bancroft, Curt Friesen of Henderson, Jim Scheer of Norfolk, Bruce Bostelman of Brainard, Tom Brewer of Gordon, Rob Clements of Elmwood, Steve Erdman of Bayard, Steve Halloran of Hastings, John Lowe of Kearney and Linehan.

The UNK study was authored by professors Allan Jenkins and Ron Konecny. 

Reach the writer at 402-473-7248 or

On Twitter @LJSDon.


Political reporter

Don Walton, a Husker and Yankee fan, is a longtime Journal Star political and government reporter.

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