LINCOLN, Neb. – During his monthly call-in show, Governor Pete Ricketts also explained the multiple parts that will be accounted for when trying to expand medicaid in Nebraska.
“This is a multi-faceted type program here. First of all I think we all agree that we want to make sure that we have a health care system that serves everybody and this is in need of reform. I was against medicaid expansion, I don’t think this is the answer for a variety of reasons. One of the issues is that this will be a big project to be able to implement. We’re talking about potentially 80-90,000 people on the program. We don’t have an enrollment system for those folks yet. We’re going to have to build that and that’s going to be a big project to be able to handle that many people coming in.”
Additional programs will have to initially be applied for before the state can start utilizing expanded medicaid.
“We also have to make an application to the Center for Medicare and Medicaid Services (CMS). We don’t even have the people on hand to be able to do all that so we’re going to have to hire up to be able to accommodate this new program and even to apply for it is going to take some time. Of course we’re going to have to get that application approved by CMS before we can do anything.”
Governor Ricketts has stated in the past that he will not expand the state budget for medicaid, he is going to find a way to make this fit into the thinned budget.
“2020 is the earliest we will see this get implemented, but we’re still doing the project work on it right now. I think the other thing that people have to understand is that we’re going to have to pay for this which means we’re going to have to fit this into the existing budget. This is a big responsibility we’re taking on, it’s going to be tens of millions of dollars to start with. The first four years probably $50-$60 million and go up from there to $80 million and as you go down the road, $100 million.
Initiative 427 did not include methods for funding this expansion and the challenge for Governor Ricketts and the state legislature will be figuring out how to pay for an additional cost in the budget.
“This is going to have to fit within the budget along with other spending priorities such as K-12 education, higher education and property tax relief. There will be less money for those sort of things because we have to make medicaid expansion fit into the budget. I’m not going to support raising anybody’s taxes so we’re going to have to budget this and all of those budget priorities are going to have to balanced off. I expect there is going to be a very lively debate in the legislature starting in January about how this gets implemented with regard to how we’re going to pay for this. There’s no funding mechanism for example in the ballot initiative.”
Governor Ricketts will look for alternatives to increasing state revenue to balance the state budget once the price tag of medicaid expansion is included.