A new paper by Jonathan Ingram and Nic Horton examine the impact an Arkansas-style Medicaid expansion would have on Nebraska:
Nebraska legislators have taken a thoughtful approach to the Affordable Care Act, carefully reviewing the evidence and ultimately declining to expand Medicaid to a new class of able-bodied adults under the law. Nevertheless, a small group of legislators lobby their colleagues each year to expand the program. The latest proposal, offered by Senator John McCollister, would copy the expansion models used by Arkansas and Iowa, homes of the highest profile “alternative” expansion models.
Under this approach, able-bodied adults receive regular Medicaid benefits through private health insurance plans sold on the Exchange, rather than through traditional Medicaid managed care. But these expansions have been unmitigated disasters and replicating the results in Nebraska would move the state backwards.
This new approach to Medicaid expansion is unaffordable and unpredictable, pushes adults out of private insurance and into taxpayer-funded welfare, puts the truly needy on the chopping block, discourages work, and shrinks the economy. So it should be no surprise that, last year, Iowa policymakers scrapped the model entirely and Arkansas enacted legislation to repeal the expansion altogether at the end of 2016. Nebraska policymakers should learn from these mistakes, not repeat them.