AP NEWS

Don Walton: Medicaid expansion implementation intriguing

February 25, 2019

It’s hard to know yet what the Ricketts administration has in mind for implementation of the new program to extend Medicaid coverage to a pool of Nebraskans composed largely of working adults who hold low-wage jobs.

The Legislature’s Executive Board encountered a blizzard of bureaucratic language as it attempted to learn more about the implementation process during a hearing last week.

But “pathways to engagement” and incentives or factors associated with “wellness and life success” and access that “may be tiered” suggest the Department of Health and Human Services is looking at conditions for access, or continuing access, to those health care benefits.

Extension of Medicaid coverage to an estimated 94,000 Nebraskans was approved by voters last November in a result that largely — but not entirely — split the state along rural and urban lines.

Eighty-five of 93 counties voted no, but the initiative gained strong support in the urban complex of Douglas, Lancaster and Sarpy Counties.

You might guess there may be a similar split among the rural-urban divide within the Legislature.

Medicaid expansion supporters are on alert to the possibility that efforts may be underway now to limit or slow-walk implementation of the new program, although everyone no doubt understands that this process is complicated.

A couple of Appropriations Committee members, Sens. Kate Bolz of Lincoln and Tony Vargas of Omaha, already have signaled concerns that HHS may not have requested sufficient personnel funding to implement the program in an urgent or timely manner.

This is an intriguing issue to watch during this legislative session.

It has an urban-rural element and a legislative-executive branch component along with strong political or philosophical divisions.

It’s also a big state budget issue and a test of respect for and implementation of the people’s will as expressed last November.

And it directly impacts the health care needs of an estimated 94,000 Nebraskans, most of whom work at low-paying jobs such as food service and retail sales.

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Let’s take a brief look at some fresh polling results:

A Feb. 19-20 telephone survey of 500 registered voters in Nebraska who are likely to vote in the 2020 Republican primary election demonstrated a wide divide on fundamental state tax reform.

The question posed by We Ask America: “Do you support or oppose raising the state’s income and sales taxes in exchange for a reduction in your property tax bill?”

The results: 34 percent support, 26 percent oppose; 40 percent unsure.

The survey results included an 80 percent favorable opinion of President Trump among likely Republican voters; 78 percent favorable for Sen. Deb Fischer; 74 percent favorable for Sen. Ben Sasse.

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Finishing up:

* And here’s the top five in an initial survey of participants in the OLLI Politics Interest Group in Lincoln who were asked to rank the Democratic candidates for president: 1) Sen. Amy Klobuchar; 2) Sen. Elizabeth Warren; 3) Sen. Kamala Harris; 4) Sen. Sherrod Brown; 5) former Vice President Joe Biden.

* Good thing: More and more, the members of an increasingly interesting freshman class of state senators are speaking up in the Legislature.

* Another signal of legislative independence: The Revenue Committee puts a hold on Gov. Pete Ricketts’ proposal to exempt 50 percent of military retirement benefits from the state income tax pending action on property tax relief.

* What would John McCain think of Lindsey Graham today?

* Question for baseball free agents: What can you do with $300 million that you can’t do with $200 million? Go where you want to play.

* Stretching across the political spectrum: Joe Biden in Omaha on Thursday; Liz Cheney in Lincoln on Friday.

* President Trump has named Governor Ricketts to the Council of Governors, a body that coordinates on matters of national security, homeland security, disaster response and the National Guard.

* Ricketts will testify Wednesday at a legislative committee hearing on his proposals for a constitutional amendment to establish a 3 percent cap on property tax increases by local government and establish a statutory minimum of $275 million in the state’s property tax credit fund.

* They’re playing ball in Florida and Arizona now.