The Nebraska Supreme Court on Wednesday shot down a last-minute appeal seeking to block a proposal to expand Medicaid in the state from appearing on the November ballot.
Now, voters will be the ones to decide whether health care coverage should be expanded to include lower-income adults ages 19 to 64 who don't currently qualify for traditional Medicaid or federal tax subsidies under the Affordable Care Act, commonly known as Obamacare.
Supporters say it could help an estimated 90,000 people, largely described as the working poor.
The court decision coincided with release of new projections by the Legislative Fiscal Office that estimate state budget (general fund) costs for Medicaid expansion would be $19.8 million in fiscal 2020, rising to $32.2 million in fiscal 2021 and $38.8 million in fiscal 2022.
New federal funding flowing into the state was estimated at $342.8 million in fiscal 2020 and $443.7 million and $572.8 million in the two following years.
The fiscal estimate, requested by Sens. John Stinner of Gering and Kate Bolz of Lincoln, is not an official legislative fiscal note. Stinner is chairman of the Legislature's Appropriations Committee and Bolz is a committee member.
"As he has said before, Governor Ricketts is concerned that Medicaid expansion would crowd out funding for essential priorities like property tax relief and K-12 education," said Matthew Trail, communications director for the governor's re-election campaign.
"Now, the decision rests with Nebraska voters," Trail said.
In July, state Sen. Lydia Brasch and former state Sen. Mark Christensen filed the lawsuit in Lancaster County District Court in an attempt to keep the measure off the ballot. In it, they alleged the initiative petition drive had violated the single-subject rule, failed to identify Nebraska Appleseed as a sworn sponsor and unconstitutionally delegated the Legislature’s authority to make such decisions.
Late last month, District Judge Darla Ideus rejected their arguments, prompting the appeal, which the Supreme Court agreed to take up before the deadline to print ballots had come and gone.
Wednesday, the state’s high court affirmed the dismissal of Brasch and Christensen’s lawsuit.
In a 19-page decision, Justice John Freudenberg wrote that the right of initiative is "precious to the people and one which the courts are zealous to preserve to the fullest tenable measure of spirit as well as letter.”
The court rejected the argument that the initiative should be invalidated because Insure the Good Life was identified as a sponsor and not Nebraska Appleseed. Brasch and Christensen had contended Appleseed was trying to deceive voters by listing the registered name instead.
Freudenberg said the court agreed with the district court that the list of sponsors, which need not include all financial contributors to the petition, had been complete.
The Supreme Court also agreed with Ideus’ finding that the initiative language didn’t violate the single-subject rule because Medicaid expansion and its funding have a “natural and necessary connection with each other, and, thus, a singleness of purpose.”
Freudenberg said: "The voters considering the initiative petition here at issue are unlikely to be confused and persuaded to vote for the primary purpose of expanding Medicaid in order to obtain, more generally, federal funds.”
The court found that the rest of Brasch and Christensen’s challenges weren’t ripe for review unless the initiative passes and the measure becomes law.
Meg Mandy, campaign manager for the initiative petition effort, said Medicaid expansion would create and sustain 10,000 new jobs in Nebraska, reduce medical bankruptcies and bring a billion dollars of Nebraska's federal tax contributions back to the state.
It would also result in significant savings by reducing uncompensated care for those who lack health care coverage, Mandy said, while "helping keep the doors of hospitals and clinics across the state open."
The expanded health care coverage would go to Nebraskans whose jobs generally earn them less than $17,000 a year, she said.
Nebraska Appleseed hailed the decision.
"We were always optimistic the Nebraska courts would not deny the people their chance to vote on such an important issue and we're grateful the Supreme Court soundly ruled in favor of the petition process today," Appleseed deputy health care director Molly McCleery said.
"Now, the people of Nebraska will be able to vote for a healthier future in November for our hard-working friends and neighbors who should be able to get the health care they need."
Those expected to be most affected by the change would be food-service workers, followed by workers in office and administrative support, retail sales, construction, and cleaning and maintenance.