Monday, February 10, 2014

FIGHT OBAMACARE MEDICAID EXPANSION IN NEBRASKA

BACKGROUND.  Liberal state senators, led by Sen. Kathy Campbell, have introduced LB 887, the Wellness in NE (WIN) Act bill.  This bill seeks to improve the health of and coverage for uninsured Nebraskans, reduce the per capita costs of health care, and improve access to affordable health care for the poor through government subsidization.  

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.