Menu
- Deadly rural roads and securing a safe ride home (12/17/24)
- The fall of Assad: A sobering lesson in pragmatism (12/13/24)
- Finding transparency in TEEOSA (12/12/24)
- In with a heavy hand, and out with a whisper (12/10/24)
- Applauding leadership that listens: a triumph for local representation (12/6/24)
- Are elected officials above the law? (12/4/24)
- Shopping tips to reduce holiday stress (11/29/24)
Editorial
Medicaid expansion or no, fair, equitable system needed
Wednesday, December 3, 2014
Red Willow County is being used as an example of what can happen to people without health insurance.
Nebraska Appleseed testified Tuesday before a legislative committee examining the effects of our state's decision not to participate in Medicaid expansion under the Affordable Care Act.
More than a fourth of the people filing bankruptcy in Red Willow, Dawson and Otoe counties cited major medical expenses for at least 20 percent of their debt.
Red Willow County was chosen because of our heavy reliance on agriculture, although we wonder whether most of those filing were actually involved in farming. Otoe has both urban and rural residents, and Dawson County has a large population of slaughterhouse workers who often lack insurance.
Appleseed attorney James Goddard said the report identified only medical debts clearly labeled as such in court filings, so the actual number was likely much higher.
"A lack of health insurance is a clear theme running throughout, and the majority of the debt is held by local businesses within Nebraska's borders," Goddard said.
Despite bills in 2013 and 2014 that were defeated by filibuster, proponents are preparing a Medicaid expansion bill for this year's Legislature to consider.
The bill would expand coverage to about 54,000 Nebraskans whose incomes are too high to qualify for Medicaid but too low to receive subsidies available under the federal law.
Opponents are afraid federal funding won't be sustainable over the long term, and Nebraska's share of the expenses could grow. Gov. Heineman has argued that the Medicaid expansion would pull money away from other priorities, such as education. Gov.-elect Pete Ricketts is also opposed to Medicaid expansion.
The whole issue could become moot, if, as some observers predict, Obamacare collapses because of legal technicalities surrounding federally-run health insurance exchanges.
Whether or not that happens, the goal of health insurance, be it a revised Obamacare or an entirely new system, must be to provide health care to those who need it in as fair and equitable a way as possible.
Returning to the old system -- shifting expenses from those who are unable to pay to those fortunate enough to be able to buy health insurance -- is definitely neither fair nor equitable.