The Nebraska State Legislature debated Legislative Bill 577 in mid April, and after two days of discussion lawmakers did not reach a decision. The bill introduced by Sen. Kathy Campbell required Nebraska to opt-into the expanded Medicaid coverage under the federal Patient Protection and Affordable Care Act (ACA). Opting-in required the Department of Health and Human Services to extend coverage to adults age 19-64 with incomes of zero to 133 percent of the Federal Poverty Level, which is just under $16,000. The Affordable Care Act does not automatically make low income adults eligible for Medicaid, as each State must decide whether to extend benefits to them.

If LB 577 were adopted the federal government would match 100 percent of the cost for the first three years and then the match will decrease each year until the match reaches 90 percent. An amendment to bill allowed the Legislature repeal the law if the federal match ever dropped but below 90 percent. The bill also provides that the eligibly for this age group will only continue until July 30, 2020 unless the legislature extends it.

One concern of the bill is the price that Nebraskans would have to pay. Sen. Campbell said that Nebraskans are already paying higher medical bills and insurance premiums due to uncompensated hospital care that individuals within this income group receive. Sen. Jeremy Norquist said adopting the bill would free up nearly $2.3 million in the state general fund. He also said that through insurance reform under the ACA, the cost of Medicaid expansion could be paid without endangering the budget.

Not everyone was in support of LB 577. Sen. Dan Watermeier expressed concern that the medical system is not prepared for the extra increase of Medicaid recipients. He said that the number of Medicaid recipients will already increase by 50,000 under another provision of the ACA, and with the potential of 54,000 more people covered by LB 577 raises concerns about the quality of care recipients would receive.

Senators debated the bill for 10 hours, before discussion stalled and without voting the Legislature moved on to another agenda item.