Menu
- New nursing home rules threaten rural communities (4/23/24)
- Human wages, robot purchases in lock-step (4/11/24)
- Heed the call for caution this year in road work zones (4/9/24)
- This year, heed the call for caution in highway work zones (4/9/24)
- Railroad safety should not be left to contract negotiations (4/5/24)
- Rejecting LB764 upholds fairness in Nebraska (4/4/24)
- A wake-up call for young adults: Get your cancer checkups (4/2/24)
Editorial
Medicaid expansion all about who pays the cost
Wednesday, April 8, 2015
It's all about who pays.
Some of the facts in the debate over Medicaid expansion under Obamacare are easy to quantify.
Others take a little research.
Ricketts opposes LB472, being debated today, which would expand Medicaid to about 79,000 more Nebraskans, most of whom work, but in jobs that do not provide health insurance.
Although the Affordable Care Act promises to pay 90 percent of the cost of Medicaid expansion, Ricketts is afraid the poor condition of the federal government will force it to renege on that promise. It has done so before by changing its Medicaid match-rate, which left Nebraska holding the bag for an extra $75 million.
But there are costs that don't show up in the state budget, but do show up in the budgets of the state's hospitals, who must balance them to stay in operation.
The Nebraska Hospital Association and AARP released a study indicating that Medicaid expansion would result in a net savings of $13.7 million over the next five years, after a projected cost of $59.3 million is subtracted.
A total of $73 million over five years would be saved from the state disability program, HIV/AIDS drug program and behavioral health program, and another $3.6 million from the Department of Corrections, because inmates who receive treatment outside of the facility would be covered under Medicaid expansion.
NHA President Laura J. Redoutey says LB472 addresses Ricketts' concern in that it requires that if federal funding for Medicaid expansion falls below 90 percent, coverage for individuals would terminate immediately.
Besides the direct savings, the $2.1 billion in matching federal funds would spur more than $5 billion in economic activity and generate more than $174.8 million in state and local taxes, as well as supporting more than 10,000 jobs by 2020.
One way or another, people who desperately need medical care receive it, whether through private insurance or by having the cost of emergency room visits absorbed into hospital budgets shifting costs to other patients.
Ways must be found to control costs while distributing the cost of medical care in a fair way.