Residents in Nebraska Medicaid gap ask for coverage

By GRANT SCHULTE - Associated Press - Wednesday, March 8, 2017

LINCOLN, Neb. (AP) - Nebraska residents who fall into the Medicaid coverage gap are once again asking lawmakers to expand the program through the federal health care law, despite uncertainty about the law’s future.

Supporters packed a legislative hearing on Wednesday to push for a bill that would extend Medicaid coverage to an estimated 90,000 low-income residents between ages 19 and 65.

The Affordable Care Act is in limbo given Republican control of Congress and President Donald Trump’s promises to repeal and replace it. Gov. Pete Ricketts opposes the measure, arguing that it’s unaffordable.

The measure’s sponsor, Sen. Adam Morfeld of Lincoln, said it would help make coverage affordable for residents who have had to forego medical care.

Not addressing the problem “is simply unacceptable,” Morfeld said in testimony to the Legislature’s Health and Human Services Committee. “Every year, we kick the can down the road while ordinary Nebraskans go bankrupt.”

The bill faces long odds in a Legislature that has rejected four previous attempts to expand coverage. Calder Lynch, the state’s Medicaid and Long-Term Care director, said he was concerned that expanding coverage could overwhelm the state’s current provider network and increase the state’s long-term costs.

Lynch, a Ricketts appointee, said residents should focus on federal efforts to replace the health care law

Residents who fall into the so-called coverage gap have incomes that are too high to qualify for regular Medicaid but too low to receive tax subsidies available through the federal health care exchange.

Among them is Diana LaCroix of Omaha, who works for a kid’s club program at Omaha Public Schools and collects survivor benefits from her late husband. LaCroix said she doesn’t make enough to qualify for insurance tax credits, and her husband lacked coverage until he was diagnosed with late-stage pancreatic cancer in 2014.

“If he had access to health insurance, he could have gotten earlier screenings and specialized treatments,” she said. “He might have had a longer lifespan.”

Shawn Murphy of rural Hall County said he avoids the getting medical assistance or goes straight to the emergency room when he needs treatment. The single father and convicted felon said he received better medical care in prison.

“At the end of the day, if something went wrong, I was always taken care of,” he said. “I am not anymore. I work, I pay taxes, I raise my children, and I can’t get taken care of.”

Nebraska is one of 19 primarily conservative states that have rejected efforts to expand Medicaid, the health care program for the poor and disabled. Thirty-one states and the District of Columbia have agreed to the expansion.

The Nebraska bill would extend coverage to childless adults who make up to 133 percent of the federal poverty level, or roughly $11,900 per year. It also would apply to uninsured parents who make more than 58 percent of the poverty level, or about $11,700 a year for a family of three.

The coverage gap exists because tax subsidies are only available to people with household incomes between 100 percent and 400 percent of the federal poverty level.