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As Nebraskans, we value healthy and thriving communities for all of our neighbors, no matter their income. We are down-to-earth people who work hard to contribute to this state we call our home. But when we are faced with obvious failings of government, we stand up to support our neighbors.

Last November, voters approved Initiative 427 to expand Medicaid coverage, choosing a healthier future for all Nebraskans. Nebraskans advocated for Medicaid expansion because a healthier Nebraska is a more productive Nebraska. It took a grassroots effort with hundreds of Nebraskans from all over the state to make this a success.

What we voted on in November was the simplest, most expedient way for Nebraska to expand Medicaid. But, when the Department of Health and Human Services (DHHS) announced its implementation plan for Medicaid expansion a few weeks ago, it raised major concerns for those who have already waited for more than six years to get coverage.

On April 1, DHHS proposed to expand Medicaid through an experiment they are calling the Heritage Health Adult Plan, which includes an unnecessary and complicated two-tiered benefits system, work requirements and a much delayed start date of Oct. 1, 2020.

Ironically, the administrative cost of the two-tiered plan will exceed the cost of the usual state expansion plans. In addition to slow-walking the rollout of Medicaid expansion, the department proposed changes that could reduce benefits for about 25,000 Nebraskans who currently have Medicaid coverage.

On Election Day, we voted for a plan that will help small business owners stay healthy and allow the server in our favorite restaurant to see a doctor. Those eligible for expansion coverage are contributing to communities across Nebraska in jobs essential to our state that often fail to provide affordable health insurance.

Essentially, every able-bodied Nebraskan that will become eligible works a job or two, goes to school, or helps young or older family members. This makes DHHS’ plan to include work requirements even harder to understand.

Every month we delay to start Medicaid expansion, we lose hundreds of thousands of our tax dollars that could be used to help Nebraskans. By waiting, we also lose out on the savings we would see in our state budget by expanding Medicaid.

Other states that expanded Medicaid years ago have realized savings in corrections, reduced spending in many public assistance programs and cut state-funded programs that Medicaid expansion will cover. If Nebraska expands Medicaid as the voters intended, we can start spending state dollars much more efficiently.

As a Nebraska state senator, I believe that honoring the people’s vote requires a plan to provide health coverage without delay. The ill-conceived plan DHHS is proposing creates unnecessary administrative expenses, ineffective work requirements and benefit changes Nebraska voters did not authorize. DHHS also proposes to implement this very costly complex process with little input from the Legislature or public. Many of my colleagues share my belief that the Unicameral should work with DHHS to ensure that the roll out of Medicaid expansion happens as the voters intended.

To achieve the healthy thriving communities we all want to see across our state, Gov. Pete Ricketts and DHHS should carry out the will of the voters and put the 90,000 Nebraskans living in the coverage gap on the current Medicaid program without delay. To do anything differently would be to ignore the will of the people.

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State Sen. John McCollister represents District 20, which covers portions of south-central and southwestern Omaha, in the Legislature.

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