Eight GOP governors so far have given their support to the expansion that aims to fill in coverage gaps for the poorest Americans made possible by the federal health care overhaul.
The latest was Gov. Chris Christie of New Jersey. Others include the governors of Florida, Arizona, Michigan, Ohio, Nevada, New Mexico and North Dakota.
Kansas Gov. Sam Brownback remains undecided.
Nebraska Gov. Dave Heineman, however, outlined his arguments against extending Medicaid coverage to thousands of low-income Nebraskans in an editorial that ran Wednesday in The World-Herald.
“The proposed Medicaid expansion is unaffordable and would result in less funding for the education of our children or higher taxes on Nebraska's middle-class families,” he said.
The column appeared on the eve of a Health and Human Services Committee hearing today for a measure expanding Medicaid as of Jan. 1.
Legislative Bill 577 would provide health coverage for low-income people without minor children who do not qualify for Medicaid now. It also would cover disabled adults and people with children who make too much to qualify for Medicaid under current income limits.
The bill was introduced by State Sen. Kathy Campbell of Lincoln, along with 11 co-sponsoring senators.
The hearing is expected to draw numerous advocates arguing that the expansion would be a good deal for Nebraska.
Federal funds will pay 100 percent of costs for the additional coverage from 2014 through 2016, declining to 90 percent of costs by 2020.
“It will grow the economy. And it's the right thing to do,” said a letter signed by Building Bright Futures Chairman Richard Holland and Executive Director John Cavanaugh.
Their letter emphasized both the money that would come into the state and the lives affected by broader Medicaid coverage. It said the expansion would cover at least 54,000 Nebraskans and save an estimated 500 lives.
Vivianne Chaumont, Nebraska's Medicaid director, emphasized the additional cost of the expansion, both to state and federal taxpayers.
The Department of Health and Human Services estimated the expansion would cost a total of $2.7 billion through fiscal year 2019-20.
According to HHS, Nebraska's share of that cost would be $116 million.
“(The governor) believes this is fiscally unsustainable, and we don't have the money for it,” Chaumont said.
But the Legislative Fiscal Office estimated the total cost at $2.5 billion over the same period, with Nebraska's share at $67 million.
The fiscal office included savings in other state programs from having more people with health care coverage.
Chaumont noted that several other states have rejected the Medicaid expansion. Among them are Iowa, Texas, Indiana, Louisiana and Wisconsin.
Recognizing that the administration's position means some people will remain without health coverage, Chaumont said, Nebraska “does what it can do” with its Medicaid program.
It already takes care of about 242,000 people, she said.
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