The writer, of Omaha, is a state senator representing District 7 in the Nebraska Legislature. He is a former chairman of the Health Committee of the National Conference of State Legislatures.
Access to affordable health care for working families helps keep our communities strong, helps our businesses grow and allows our economy to thrive. An important program that enhances access to care in Nebraska is Medicaid.
The Medicaid program helps us care for our parents and grandparents in their homes or in a nursing home, if necessary. Medicaid helps our disabled loved ones and neighbors lead independent lives. Medicaid ensures that low-income children can see a family doctor when they’re sick.
And now, because of the federal Affordable Care Act (ACA), Medicaid could provide coverage for low-income, working Nebraskans who don’t earn enough to afford the coverage their families need.
The ACA presents each state with an opportunity to increase access to health coverage through the Medicaid program. Nebraskans who make around $15,000 annually for an individual or $26,000 for a family of three would be eligible for this coverage. The federal government will pay the full cost for the first three years and, by 2020, will pay no less than 90 percent. Overall, it will cost our state less than 50 cents a day to provide health coverage to each eligible Nebraskan.
How does Nebraska pay for this coverage for the uninsured? The most basic answer is that we already do. Our health care system writes a blank check every year for the care of the uninsured — paid for through our private health insurance premiums and through a myriad of safety net programs that provide care for those unable to afford it.
When people seek care that they can’t pay for, the cost of that care does not magically disappear. Health care providers can’t afford to just absorb it, so they seek compensation for those services by charging higher prices to insurers. Insurers then pass on that increased cost to those with private insurance through higher premiums.
The average Nebraska family with health insurance pays a “hidden tax” of over $1,000 every year to cover this uncompensated care. This new Medicaid option will significantly reduce uncompensated care and thus lower the hidden tax on Nebraskans with private insurance.
We already spend millions of dollars every year to fund the programs that make up our health care safety net, which is necessary to fill in the cracks of our broken system. There are several state-funded programs that provide care for pregnant women, cancer patients, people living with HIV/AIDS, disabled Nebraskans and for those in need of behavioral health services, among others.
Also, in our state’s three largest counties, property taxes fund health care services for the uninsured at nearly $8 million per year. By expanding Medicaid and ensuring greater access to timely and appropriate health care, we will be able to realize significant savings in these programs.
And finally, Nebraskans are already paying for the Medicaid option in the ACA, regardless of whether we take advantage of it. There are several health- related revenue provisions in the federal law enacted to pay for such reforms. This money will continue to leave our state and flow into the federal coffers.
The question before us is whether we pull those federal dollars back into our economy by providing care for low- income, working Nebraskans, or leave those dollars with the federal government.
Thousands of hardworking Nebraskans, from single moms working for minimum wage to put food on the table to empty nesters who have lost their jobs during the economic recession, lack access to health coverage and are one illness away from financial ruin. By accepting federal funds and increasing access to Medicaid, Nebraska will ensure that more people will be able to see a doctor regularly, access preventive services and avoid unnecessary visits to the emergency room.
This isn’t a panacea — we still have a lot of work to do to make our health care system more affordable and efficient. But we can’t start to meaningfully reform the system until we stop writing a blank check for uncompensated care.
The Medicaid option is an opportunity to make a smart investment in our state’s work force and economy, to make our state’s health care system stronger and more cost-effective, and to provide hardworking Nebraskans with the security of good-quality health coverage.