BILL
FLAWS. This legislation does not expressly prohibit Medicaid
or subsidized health insurance for illegal aliens. A typical eligible participating family of 4
could have incomes up to $31,152, at 133% of the federal poverty line. It relies on federal government total
subsidization at 100%, dropping to 90% within years. However, this pledge is non-binding, and the
federal deficit may cause its reversal.
Then, state taxpayers must pay for the entire program. Recall that the feds reneged on their
promises to fully fund No Child Left Behind.
A new bureaucracy would oversee its implementation. Medicaid would expand to provide health care
coverage to additional adults through health insurance premiums paid by the
welfare dept. to purchase health plans on a health benefit exchange or
employer-sponsored insurance. The dept.
would pay the full cost of the premium for buying a qualified health plan on
the exchange and pay for co-payments, co-insurance, deductibles, and other
costs for some. Other benefits also available
for some non-emergency transportation.
These options would convince employers to dump their current employee
insurance plans and join the WIN plan, so that they would not have to pay the
full premiums. Then, other of their
employees would lose their insurance choices and become subject to a 2-tier
plan at their disadvantage, forced to pay their own costs while fellow
employees do not pay. Declining to take
a health risk assessment and annual physical to test for drug and alcohol abuse
would not prevent enrolling or subject enrollees to a monthly contribution
toward their premium. This huge
expenditure would siphon needed funds now pegged for the state highway system
and state aid to education. Medical
professionals would be unable to handle an influx of so many patients, though
the bill requires enrollees to see a provider within 60 days. Note that current Medicaid reimbursements for
physicians are 40c on the dollar, 70c on the dollar for hospitals, hardly an
incentive for medical professionals to accept additional Medicaid
patients.
CONSERVATIVE
ALTERNATIVES. NTF suggests a number of alternatives for state
senators that would accomplish most of the objectives that this bill intends to
accomplish. Allow untaxed state health
savings accounts. Permit groups of
citizens to pool together to buy insurance policies. Permit small businesses to pool together to
obtain lower insurance rates for their employees. Offer tax credits to the poor to purchase
health insurance. Allow wellness tax credits of $500 or more to
individuals and employees who follow a specific wellness regimen. Reform our state legal system to reduce
medical malpractice liability, offering as one defense a professional following
"best practices." Permit
medical licenses to apply across state lines, so that a physician could work
remotely from another state. Allow the
chronically-uninsurable to gain access to coverage in a high-risk state or
multi-state pool. Safeguard individuals with pre-existing medical conditions
from discrimination against purchasing health insurance by bolstering a state
high-risk pool. Lobby Congress to allow purchase of policies
across state lines. These proposals
would offer individuals, not government, control over their insurance and
increase competition among insurance companies to drive down costs. For example, Medicare Part D. One NTF member, after shopping around,
selected a private supplemental insurance plan to cover his prescription drugs
and saved $10 per month, or $120 per year.
The state could establish an information center where citizens could
find information on health insurance alternatives. These options would encourage personal
responsibility, benefit employers who want to offer employee insurance, and
focus on prevention and wellness, health promotion, healthy behaviors,
competition, consumer choice, and cost reduction in the private
marketplace. Moreover, these solutions
would not make more Nebraskans dependent upon government.
EXPERT
TESTIMONY. Several NTF members testified at the public
hearing on this bill on Jan. 29. The CEO
of the state welfare dept. then testified that LB 887
would cause Medicaid expansion at a higher cost, because the plan would pay
higher insurance premiums than in the private sector, including co-pays and
deductibles, additional mandated benefits like subsidized transportation, and
place undue pressure on the finite number of NE health care providers. The Medicaid budget is rising by $17 million
this year, and the bill would add 113,410 new eligibles through 2020. The Medicaid budget then will reach $3.3
billion, with 20% of Nebraskans on this welfare program. Administration costs would reach $6+ million
over the first 2 years, over $30 million eventually. The feds would pay only 50% of these costs. Waivers from onerous federal rules would appear
only temporary. The initial and ongoing
pilot programs would cost enormously and may not receive needed federal
approval. The feds initially would pay for much of the regular cost, but fed
impact aid overall will drop by 10% in 5 yrs. The head of the state insurance dept. stated
that many private insurers will refuse to participate under the rules of this
socialist program, thus narrowing options for enrollees. These companies must provide dental insurance
and offer rates without time and ability to gauge costs and network adjustments
to themselves. Only 4 insurance
companies in NE participate in the ObamaCare exchange here currently. The dept. will not promote this state
ObamaCare plan yet would have to hire additional employees, particularly legal
staff.
TAKE ACTION
NOW. Contact
your state senator immediately to oppose and vote NO on LB 887. Email
netaxpayers@gmail.com to locate your state senator and for state senator
contact information. Then mail, email,
or call your state senator to kill this socialist health care bill.
