LINCOLN — Being without health insurance coverage means Monica Sheehan-Martz lives with worry.
She worries about injuries and accidents. She worries about cancer and chronic diseases and freak illnesses.
Mostly, the Omaha hairdresser worries that not having the money to take care of her own health could jeopardize her ability to care for her 8-month-old daughter, Joy.
“It would be really nice to know I had health care coverage in case something happened,” Sheehan-Martz said. “It would give me peace of mind.”
Sheehan-Martz, who is going through a divorce, told state lawmakers Thursday she cannot find insurance at an affordable price.
She could get the coverage she needs if Nebraska takes the controversial step of expanding its Medicaid program to cover more low-income adults.
But Mike Groene, chairman of the Western Nebraska Taxpayers Association, argued that Nebraska should not take that step.
“I'm paying for my family's health care and you're asking me to pay for someone else's health care?” he said. “I can't do it.”
The two took opposite positions at a well-attended public hearing before the Health and Human Services Committee on Legislative Bill 577.
Supporters far exceeded opponents at the hearing and included a long list of health care provider organizations and advocacy groups.
But opponents have Gov. Dave Heineman on their side. He was represented at the hearing by the state Medicaid director.
The bill would extend Medicaid to cover low-income people without minor children who cannot qualify for Medicaid now.
It also would cover parents and disabled adults who make too much to qualify for Medicaid under current income limits.
State Sen. Kathy Campbell of Lincoln, the bill's chief sponsor, described moral as well as fiscal reasons for the expansion.
She said the proposal would fill coverage gaps for poor Nebraskans, saving lives and reducing the cost of uncompensated care that gets passed on to those with private insurance.
Campbell noted that 12 percent of Nebraskans lack health coverage. Many would remain uninsured if Nebraska did not do the Medicaid expansion, which was made possible by the federal health care overhaul.
“Do we say to this group: 'We are so sorry we cannot insure you even though we have federal funds covering 100 percent of the cost for the first three years'?” she asked.
But Vivianne Chaumont, director of Medicaid and long-term care services in the State Department of Health and Human Services, said the federal funds represent taxpayer money just as much as state funds do.
She said mandatory provisions of the federal health care law will add an estimated 48,000 more Nebraskans to the Medicaid rolls. Those are people currently eligible for Medicaid who have not signed up for the program.
The expansion proposed in LB 577 would add another 54,000 to 80,000 people to Medicaid. A June U.S. Supreme Court ruling made the expansion voluntary for states.
Although federal funds will pay 100 percent of costs for the additional coverage from 2014 through 2016, they decline to 90 percent of costs by 2020.
That would leave Nebraska with a “staggering” burden, Chaumont said.
Officials with HHS estimated the state's share of the burden at $116 million for the seven years. But a newly revised estimate from legislative fiscal staff put the cost at $75 million.
Campbell said she is not sure how quickly the committee will act on the bill. She said she plans to name LB 577 as her priority bill if it gets out of committee.
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