Nebraska Medicaid Expansion: LB577 in Limbo

NE Map Health Care Bad Medicine

LB577, the bill which would expand Nebraska’s Medicaid program, would help deliver a significant portion of the health care law to the state, a move that was ruled entirely optional by the U.S. Supreme Court

Just how much of the health care law will be implemented in Nebraska now depends in large measure 1 on what the events in the Unicameral Tuesday and Wednesday actually mean. State Legislators spent the majority of their time in their first two days back in session following a four day weekend debating a bill – LB577 – that proposes to expand Nebraska’s Medicaid program, but the status of that legislation is unclear, as is its future. (See chart, below, for a detailed list of session events for the bill prior to this week.)

nebraska-state-senator-ken-schilz-debate-lb577

Senator Ken Schilz, District 47, spoke against LB577

As Wednesday morning turned into afternoon, debate became increasingly heated over the bill and two specific amendments which had been introduced, but there were no calls for votes. Just before 4:00pm, Speaker Greg Adams announced that, since debate on LB577 totaled 10 1/2 hours at that point, business would move on for the day 2.

Anyone watching or listening to the action in the Chamber for any significant period of time on Wednesday, but particularly between 3:30pm and 4:00pm, would have been understandably confused by the mysterious shift away from the bill absent motions and votes.

My confusion was increased because Linda and I were discussing the status on the phone when the Speaker made his announcement, so I remained confused until I discovered it hours later on the video I’d recorded. But that discovery wasn’t particularly enlightening, because the Speaker didn’t explain where the bill stands or what might happen next, if anything, regarding it. And a read of the day’s Legislative Journal provides no additional insight.

As an eyewitness, I can report that, as the afternoon wore on and especially in the last 45 minutes or so, several Senators on both sides of the issue mentioned cloture and voting. I actually expected that a call for a vote was imminent, and had begun to wonder what, if anything, opponents intended to do to stop that from happening. The bottom line is that the people who support a bill and talk about voting, but don’t actually make an actual motion to vote, are signaling things aren’t going their way.

Note that the events in the Chamber on Tuesday and Wednesday have been described as a filibuster. Perhaps it is technically or commonly referred to as such in Nebraska, but, at least on Tuesday, the supporters seemed to have more microphone time than did the opponents. And what occurred was certainly not like the filibuster most of would conjure in our minds; Senators each have five minutes to speak. It is not like the famous scene in Mr. Smith Goes to Washington.

Jeremy Nordquist Legislative Picture

Senator Jeremy Nordquist wants people to think there are only 3 votes needed to pass LB577. Question is, is that true?

In writing this article, I find myself wearing two hats. What I’ve reported to you thus far, comes from me wearing my “average citizen hat”. What I’m going to tell you next is me wearing a hat that doesn’t really fit me very well. I’m frankly not very comfortable wearing it. But it’s what I’ll call my “insider hat”, which comes through my work with GiN in the last few years.

A couple of hours before the Speaker announced he was moving on in the agenda and away from debate over LB577, a Senator told us that there was an increasing amount of doubt regarding whether or not there were enough votes to close debate, just on an amendment to LB577. Obviously, that indicates questionable support for the overall bill.  The same Senator also warned that Speaker Adams might pull the bill from the agenda if debate were to continue.

Several Nebraska media outlets provide additional information which supports what we were told at the time. I’ve summarized those reports here, highlighting a few items that I believe are cause for concern:

  • A story published by the (formerly/http://www.omaha.com/article/20130417/NEWS/130419724/1688#medicaid-bill-stalled-by-filibuster) Omaha-World Herald at 4:48pm opened with, “A bill to expand Medicaid has been pulled from the legislative agenda…” and includes quotes from the bill’s sponsor, Senator Kathy Campbell, and one Senator who’d spoken in opposition throughout the debate, Senator Ken Schilz of Ogallala.
  • Senator Schilz cast doubt regarding whether there is enough time left in the session to revisit LB577, but – see further highlights
  • Senator Campbell indicated she’d be working behind the scenes to get support for her bill.
  • formerly http://watchdog.org/80380/medicaid-expansion-bill-falters/ that the bill had been removed from the agenda, but that it was unclear whether or not it would return. The story also featured a quote from Senator Jeremy Nordquist.
  • Nordquist said, “he believes his side has enough votes to override a veto (30), but wasn’t sure whether there were enough to end debate with cloture (33).”
  • Lincoln Journal Star’s preliminary report Wednesday evening was very brief, but it later published a lengthier piece, which in some ways might be best described as embodying the sentiment, “hope springs eternal”. By that, of course, I mean the newspapers’ hope that Campbell’s bill will rise again.

    kathy campbell front page ljs-175px

    Lincoln Journal Star coincidentally featured Senator Kathy Campbell on their front page the day before the LB577 debate with the headline “Her winning formula”

LJS legislative agenda aside (I’m not making that up, they’ve got one), there were a few interesting tidbits:

  • One point in the story I can confirm…”Omaha Sen. Brad Ashford had pleaded with senators…”. Ashford definitely did plead. I actually used the word “begged” in my own mind watching live, but “pleaded” is close enough.
    • LJS’ story confirmed that Kathy Campbell will work behind the scenes to get votes for LB577. “But it’s not the end, Campbell added.”
  • Speaker Adams indicated the bill won’t come back up, “unless there’s votes rounded up.”
  • Senator Scott Price, who did speak against the bill several times, described his vision of the next few weeks, “…because without this getting done those considerable forces (lobbyists) that were on the other side of the glass, those emails will continue to pour in…”. Both Linda and I, in reading this, were afraid we heard echoes of Senator Annette Dubas from 2011.

In addition to these reports, Linda heard a segment about this subject on Drive Time Lincoln, which featured an “analyst” whose name and credentials she wasn’t able to jot down but who gave an interesting analysis of the situation. When the podcast is available, we’ll be going over it.

Overall Assessment:

I’ll admit no small amount of surprise at the turn of events, and I think that statement accurately conveys the overall sentiment of GiN’s leadership, because, for good reason, we didn’t expect that LB577 would see any real resistance.

Nebraskans who do not want the Medicaid program expanded or who still understand how bad the health care law is, should not believe that this is over, and we’d caution that any reports or emails received which are throwing celebratory bouquets around are to be viewed with skepticism. Reasons for skepticism:

  • Kathy Campbell has an unfortunate history of very long-term and successful advocacy for such welfare programs
  • Jeremy Nordquist is trying to make people believe that there is a mere difference of 3 votes standing in the way
  • A number of Republicans did a better job of opposing LB577 than we’d expected and a good-sized handful should be pointed out and acknowledged – but…
  • Too many of the best arguments were left on the table, too much of the argument was framed by the supporters of LB577, and there is just way too much “Nebraska Nice”; civil debate can and should be passionate, brisk, and even heated, when important issues demand it.
  • The Speaker will take LB577 back up if enough votes are obtained
  • We have reason to be concerned, both based on remarks made during the debate and additional research we’ve just uncovered, that a number of key Republican State Senators are willing to engage in some kind of “compromise”

We will be reporting more information about the debate content and that information I’m referring to that is cause for growing concern. The reason that “insider hat” doesn’t fit me very well is because no one should need it to find out what is going on. You’ll note, the information coming from the insiders is all so similar, but so often it’s wrong and/or has an agenda attached. You’ll note the analysis is a bit different than others you’ll find.

LB577 Session Events Through April 15, 2013

January 30, 2013:
February 28, 2013:
March 13, 2013:
Senator Kathy Campbell designated as her priority bill
March 19, 2013:
Placed on General File (without debate)

Regular readers of our site began seeing a lot of information about the part of the health care law that the U.S. Supreme Court ruled must be optional – the expansion of States’ Medicaid programs – beginning in January, when Linda began publishing a series on the subject. If this is your first visit to the site, I highly recommend you give the series a read:

This first grouping of articles don’t necessarily have to be read in order as they are research, principle, and policy focused:

This next grouping of articles report events affecting the progress of legislation in the Unicameral, listed in the order in which they were published:

Email subscribers, click here to view the included music video

Images & Graphics Sources
The images and graphics in this article were obtained from the following sources:

Images of State Senators from snaps of videos streamed by NET

Scan of Lincoln Journal Star front page

Footnotes, References & Citations

Notes:

  1. The extent to which implementation of the health care law in the state will occur doesn’t rest solely upon the question of whether or not Medicaid will be expanded – equally as important is the extent to which an insurance exchange will be implemented. We have not yet provide a full accounting of the status of that aspect of the law, but hope to do so in the very nature future. ↩
  2. Adams explained that some visiting former Senators would be recognized and then the body would consider an unrelated bill introduced by District 32 Senator Russ Karpisek. Events followed that course with the exception that “the Legislature was at ease” for about twenty minutes between those two events. Following a vote on Senator Karpisek’s bill, Adams announced that although he’d originally intended to consider a bill by Senator Jeremy Nordquist – District 7, that the bill was complex and “we need a break”, so the body adjourned at about 5:30pm. The legislative journal for the day recorded LB577 and an amendment introduced by Hadley, as “PENDING” before notations regarding the ceremony, followed by the report of two amendments filed on LB577, which were not mentioned to my knowledge, on any microphone. One might presume that if debate would have continued, one of the next events would have been an effort to introduce one or both of those amendments. ↩
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