Ballot Initiative to Expand Medicaid in Nebraska met with Skepticism

25 Oct Ballot Initiative to Expand Medicaid in Nebraska met with Skepticism

With Medicaid expansion on the ballot in this November’s midterm election, some rural hospitals have tempered their expectations of how it would increase their margins. The Nebraska Hospital Association, which has pushed expansion for years, indicated that rural providers might not fully benefit if enough patients in rural areas do not sign up for coverage. They worry that if enough people don’t enroll, rural hospitals could be negatively impacted by provider taxes or reduced provider reimbursement rates. In addition, the largest population of uninsured adults that would qualify for Medicaid under the expansion live in Omaha, the state’s largest city. 64 out of the 90 hospitals part of the Nebraska Hospital Association are critical-access. By 2020, states will have to pay 10% of the share for expansion, which could impact hospitals if the state looks to providers to help cover that cost. Projections indicate that of the 10-year $5.5 billion expansion expense, the state would be responsible for $592 million. Idaho and Utah also will have Medicaid expansion on the ballot.