Midlands Voices: It's crucial we make new health care law work for all Nebraskans

By Jeremy Nordquist
Published in Omaha World Herald
September 16, 2010

The writer, of Omaha, is a Nebraska state senator who represents District 7.

In 2009, legislators from 49 states came together at the National Conference of State Legislatures and passed a resolution by a majority vote, asking Congress to pass comprehensive health care reform.

This overwhelming vote in support of reform wasn't about partisanship or political rhetoric. It was about the overwhelming recognition that the health care system in our country was headed down an unsustainable path and that a change of course was desperately needed.

As chairman of the NCSL's Health Committee, I work with legislators around the country, of both political parties, who are committed to making the new law work in our respective states. We are working together, politics aside, to focus on the task at hand.

Nobody thinks the new law is perfect, but it is important to recognize that there are positive changes that need a chance to work. Those who have private health insurance will have new protections for coverage when they need it and to require insurers to cover preventive care, like mammograms and colon cancer screenings, at no cost.

The law will prevent insurance companies from denying care for pre-existing conditions and will help small businesses by providing tax credits to help employers purchase health insurance for their employees.

Whether or not you agree with the new law, the fact remains that it is exactly that — law — and implementing it in a way that is best for Nebraskans will require committed leadership.

With the recent Milliman Inc. report projecting astronomical costs associated with Medicaid expansion, we have seen more rhetoric than leadership. The report has serious flaws, the most glaring being its failure to account for more than $2 billion in new federal money that will be injected into our state's economy. The amount of federal dollars coming into Nebraska will be more than 20 times the additional costs to the state.

According to a national health policy expert, the Milliman study significantly inflates the cost of expansion because it overestimates the number of people enrolling in Medicaid — including illegal immigrants who have never been eligible for Medicaid coverage — and assumes costs for provisions that are not even in the law.

The most troubling aspect of the taxpayer-funded Milliman report is its failure to account for savings that will certainly result when the law is fully implemented. State and local programs that have been pieced together to create a safety net, like Nebraska's Comprehensive Health Insurance Pool (NECHIP), become obsolete once the majority of Nebraskans have access to insurance.

The elimination of NECHIP, a program that provides health insurance to those with pre-existing conditions who are unable to obtain it, could result in approximately $25 million savings to the state each year or $150 million between 2014 and 2020.

The troubled assumptions and narrow scope of the Milliman report reveal it to be more useful as fodder for political grandstanding, not for credible policy analysis.

I applaud Gov. Dave Heineman for taking advantage of funding made available through the Affordable Care Act. He has applied for an Exchange Planning Grant and the Early Retiree Reinsurance Program, each anticipated to bring about $1 million in federal funds into our state. These are exactly the types of opportunities of which Nebraska must take advantage.

However, what is troubling about the governor's leadership of late is his use of threatening rhetoric against the federal law, while acknowledging the value in the law by taking advantage of its provisions. These sorts of political games are not helpful.

We need policy-makers in Nebraska to recognize that we have a job to do. This will require us to put our politics aside and engage in serious policy discussions about how to protect the health care coverage of those who have it — and help ensure that all Nebraska families are able to see a family doctor and have an opportunity to live healthy and productive lives.