A hearing was held in the Health and Human Services Committee on Wednesday for LB 1032, the Transitional Health Insurance Program Act (T-HIP). The bill would allow nearly 77,000 Nebraskans to obtain health insurance. It is the fourth time lawmakers have made an attempt to expand Medicaid in the state.
T-HIP is an alternative plan to Medicaid expansion that would use Nebraska’s private health insurance market to provide coverage for people with low incomes and bring more than $2 billion in tax dollars back to the state.
LB 1032 would use the money Nebraska would have received to expand Medicaid to create T-HIP. Participants in T-Hip would be covered in one of three ways. Most would be enrolled in a private market insurance plan called premium assistance. Others would obtain assistance in buying coverage through their employer and some, including those with serious or chronic health conditions, will receive traditional Medicaid coverage.
Nebraska Appleseed Executive Director Rebecca Gould released a statement Tuesday in support of LB 1032.
“Everyone in Nebraska needs to be able to see a doctor when they get sick or injured, and LB 1032 creates a path to affordable health insurance that is long overdue for 77,000 Nebraskans that can’t currently afford coverage,” Gould said. “This bill is a unique solution that meets the specific needs of Nebraska and would allow our state to recoup more than $2 billion of our tax dollars that would strengthen our health care system and our workforce.”
Senator John Stinner, of Scottsbluff, says he is keeping an open mind about the bill. His main concern is determining whether or not it would be a sustainable program.
“I owe it to my constituents to give it a fair shot,” Stinner said. “I will take a very look hard at sustainability, which is on the fiscal side of the things.”
The fiscal note to the bill, which was released on Thursday, is 16 pages long and details the potential impact on businesses and organizations in the state.
Governor Pete Ricketts said in a statement that nobody wants to restrict access to health care, but he wants to halt the unnecessary expansion of the program which will shift Medicaid’s focus away from its core mission and expose our state’s budget to unreasonable risk.
“Special interest groups and a few senators are pushing for Nebraska to expand Medicaid expansion by using taxpayer dollars to buy private insurance,” he said. “While this is a new plan, it’s the same story: Medicaid expansion is an expensive and an unreasonable risk to Nebraska taxpayers.”
Sen. Bill Kintner, of Papillion, said expansion has been stopped three times before in the state.
“Now they’ve come up with a new way to do it that’s more expensive than the first three,” Kintner said.” One billion dollars over three years is unsustainable.”
Kintner was also concerned about what would happen should the federal government decide to reduce the amount it will pay.
“We cannot take on some huge obligation and have the possibility that the government will say we’re only going to do 70 percent,” Kintner said.
Ricketts and other opponents of the bill cited difficulties in Arkansas, which the LB 1032 is modeled after, including being $137 million, or 61 percent over budget.
Medicare expansion under the Affordable Care Act was a way to make sure people with incomes up to 133 percent of the federal poverty level had health insurance. Thirty-One states and the District of Columbia chose to expand. For other states are still considering expansion.