LINCOLN — Gov. Dave Heineman on Wednesday ratcheted up his opposition to the Medicaid expansion that's part of the new federal health care law.
He told state lawmakers he will not send the state Medicaid director to a legislative meeting on the health care overhaul.
The governor said he's doing so because the meeting will be with advocates who support the expansion of the state Medicaid program.
But State Sen. Kathy Campbell of Lincoln, one of three senators calling today's gathering, said a wide variety of people with interests in health care have been invited.
She said she was disappointed that Vivianne Chaumont, Nebraska's Medicaid director, would not be speaking.
“I think it's too bad because we could gain some valuable information through that,” Campbell said. “There's a lot of education to be gained here before we say we are going to do something or we aren't going to do something.”
Heineman has made clear he opposes the expansion of Medicaid to more Nebraska residents. He said paying for the expansion would force Nebraska to cut funding for education or raise taxes.
“My position is very clear — Nebraska can't afford an unfunded Medicaid expansion,” the governor said.
Supporters of the law disagree that the Medicaid expansion is an unfunded mandate. Starting in 2014, it would be 100 percent federally funded for three years, scaling back to 90 percent federal funding by 2020.
The federal support does not alter Heineman's position. “They'll say it's free federal money,” he said. “No, it's not. It's our tax dollars.”
He also said the federal government has a history of not fulfilling its commitments. Federal funding of special education, for example, has not kept pace with the costs of that mandate.
The U.S. Supreme Court ruling on the federal law gave states the choice of opting out of the expansion. Heineman and nine other Republican governors have indicated they will opt out or are likely to do so.
Today's meeting is being called by Sens. Jeremy Nordquist of Omaha and Mike Gloor of Grand Island, along with Campbell, who is chairwoman of the Health and Human Services Committee.
About 80 people have been invited. Among them are insurance representatives, health care provider groups, academics, advocates and state senators. An official from the U.S. Department of Health and Human Services regional office also is to appear.
The agenda included time for Chaumont to talk about what the Medicaid program is doing on implementing the federal law.
Nordquist said the governor does not seem to want public dialogue about health care policy in the state.
“It appears that all the governor's interested in is ginning up the politics” of the issue, he said. “We can't make policy behind closed doors, and we can't make policy in silos, either.”
The governor's spokeswoman, Jen Rae Hein, expanded on Heineman's objections, noting that the meeting is invitation-only. She said representatives of the administration have appeared at “fair and formal” public legislative hearings on the matter.
Even if the state does not do the Medicaid expansion, Campbell said, it would have been useful to hear about how the federal law would affect the existing Medicaid program.
The federal health care law is expected to provide coverage to about 30 million uninsured Americans. An estimated 17 million of the poorest Americans were to gain coverage through Medicaid, a joint state and federal program.
The Medicaid expansion would cover anyone with an income below 133 percent of poverty — $14,856 for a single person or $25,390 for a family of three.
Estimates vary on the number of people who would be added to the Medicaid rolls and on the potential cost to the states.
About 93,500 uninsured people in Nebraska could become eligible for Medicaid and approximately half to three-quarters of those are likely to actually enroll in the program, according to the Kaiser Family Foundation.
The state's cost for those people would range from $93 million to $107 million after the federal funding is pared back from 100 percent, according to the Kaiser study of the impact in 2014-19.
A separate study done for Nebraska Medicaid estimated that the federal law would cost the state more than $526 million from 2011 through 2020.
However, that study was not limited to costs of the Medicaid expansion alone. Some new costs would come from covering people who had previously been eligible for the existing program but had not yet enrolled in it.
The study also estimated the number of people who might switch from private insurance to Medicaid, some of whom could do that under the existing program.
World-Herald staff writer Paul Hammel contributed to this report.
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