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LINCOLN, Neb. (AP) — Another proposal to provide health care coverage to low-income Nebraska residents under the federal health care law was effectively killed by lawmakers Tuesday.
Senators voted 28-20 to bracket the measure, which would have used federal Medicaid and state money to cover an estimated 97,000 uninsured people whose incomes are too high to qualify for traditional Medicaid but too low to receive federal tax credits to help pay for insurance.
Supporters described the proposal as the nation's most conservative approach to covering the so-called Medicaid gap population, which exists because tax subsidies are only available to people with household incomes between 100 percent and 400 percent of the federal poverty level. But opponents, including Gov. Pete Ricketts, had raised concerns about the bill's long-term costs.
Three other attempts to expand Medicaid have failed in the previous three years.
Sen. John McCollister of Omaha, the bill's lead sponsor, said he was disappointed by the vote but expressed optimism that some version of the proposal will eventually pass. McCollister said lawmakers will look for new ways to provide coverage between this session and the next one in 2017.
"At some point we'll have a tipping point," he said. "We'll get a consensus and have a bill succeed on the floor."
Sen. Kathy Campbell of Lincoln, a longtime supporter of Medicaid expansion efforts, said the newest bill sought to address concerns raised by opponents over the last several years.
"We have brought forth the most conservative plan in the country," she said.
The Affordable Care Act doesn't provide the subsidies for people who make less than the federal poverty level because the law originally required all states to expand Medicaid, which would have made the subsidies unnecessary. But in 2012, the U.S. Supreme Court ruled that the federal government can't punish states that don't expand Medicaid.
Instead of expanding Medicaid, the new Nebraska bill would have used the funding to buy coverage for residents without access to an employer-sponsored plan or to pay the worker's share of premiums for employers that offer plans. People deemed medically frail would receive coverage through the state's current Medicaid program.
Supporters also included a provision that would end the program after three years unless lawmakers choose to renew it and require an independent review of its fiscal impact so that lawmakers and the governor could decide whether to continue it.
Bill opponent Sen. Bill Kintner of Papillion pointed to cost overruns in Ohio, Washington, Illinois, Kentucky and Montana as soon as those states agreed to expand Medicaid.
"There's always a lot more people (who enroll) than you think. It's more expensive than you think. They're sicker than you think," he said.
Ricketts praised the vote Tuesday during a news conference on an unrelated issue.
"I'm pleased to see they've rejected it again," he said. "We need to look for sustainable solutions on how we address these things, and the plan that was on the table today was not one of those solutions."
Supporters of the proposal gathered at the Capitol on Tuesday, dressed in black and wearing signs with the name of their senator and the estimated number of uninsured people in that senator's legislative district.
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The bill is LB1032
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Associated Press writer Anna Gronewold contributed to this report.
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