Posted 6 months ago
By Kevin Horn
Box Butte General Hospital (BBGH) CEO Dan Griess is urging area residents to contact their state senators in support of the Wellness in Nebraska (WIN) Act – LB 887. Debate is scheduled to begin on Tuesday, March 18, in Lincoln.
The nation is split with half of the states expanding Medicaid eligibility and half, including Nebraska, undecided or not. If Nebraska expands Medicaid to 133 percent of the federal poverty level ($15,856 for an individual and $26.951 for a family of three), many more adults will gain coverage, coverage especially important for working people in rural areas where employer-provided health insurance is less common and where poverty is more prevalent.
“The WIN Act is a strong foundation for good health care policy. It maximizes enhanced federal funding, strengthens the private marketplace, supports employer insurance and enhances stakeholder engagement. It provides the groundwork for much needed Medicaid reform that includes more primary care focus through the utilization of patient centered medical homes and integrated care for chronic conditions,” said Griess. “The WIN Act incorporates wellness incentives, personal responsibility and reduces the inappropriate use of emergency rooms by requiring co-payments in those situations. Monthly contributions of two percent of income for newly eligible adults will be required and there are incentives for members to engage in health and wellness activities,” Griess added.
“With the WIN Act, there are costs of providing coverage to the newly eligibles and there are savings where federal funds will pay for services rather than state funds. According to the Legislature’s Fiscal Office, the net cost to the state for the next six years would be $64 million – not per year, but through 2020,” Griess stated.“This is a great return on investment for Nebraska to further strengthen the state’s economy,” Griess added. “For every day Nebraska refuses to expand the Medicaid program, the state turns its back on approximately $990,000 – more than $360 million per year.”
“In visiting with District 43 State Sen. Al Davis, who supports the WIN Act, he shared some myths he runs into from his constituency; myths I would like to address,” Mr. Griess said. “The first is the WIN Act will expand a welfare program for the unemployed. This is false and, more than likely, a little offensive to nearly 20% of the Nebraskans who fall into this gap where there are no affordable health insurance options,” said Griess. “Approximately 21% of the 1.8 million Nebraskans have incomes equal to or less than 133% of the Federal Poverty Level. Our state’s unemployment rate for January was 3.5. If 21% of our state is at 133% of the federal poverty level, there is no way they can all be unemployed,” Griess added. “The WIN Act is a method to provide affordable health coverage to our proud, hard-working friends and neighbors who often are working more than one job at a time to make ends meet.”
“For those that contend $64 million is too much for the state to pay for this coverage, and that it will take money away from education, the economic activity stirred by the infusion of $2.3 billion of federal funds over six years alone would more than offset those costs. Education also will benefit by having healthier children living in healthier households – children that are more ready to learn, helping our state’s education system to achieve even greater efficiencies and outcomes,” Griess emphasized.
“Nebraska hospitals are already treating many of these currently uninsured individuals in their ERs for both emergency and non-urgent care,” Griess stated. He added, “The WIN Act creates the opportunity and incentives for providers to redirect more individuals to preventive care through PCMHs, accountable care organizations (ACOs), federally qualified health centers (FQHCs) and other sources of health care services that are much less costly.
Through this coverage, the current health care system would redirect those non-urgent care patients to clinics for their primary care needs at lower costs. Those efforts will reshape Nebraska’s health care delivery system into one focused on reducing costs and producing higher quality outcomes while meeting the growing demands – a system that can accommodate both the newly eligibles they are already treating and the individuals seeking care for the first time.”
“In response to rumors that the federal government will not be able to honor its enhanced federal Medicaid match under the Affordable Care Act, the WIN Act contains a provision that requires the legislature to revisit this issue should federal funding drop below the 90% required by the ACA,” said Griess
“The consequences of not expanding Medicaid will create a significant health care urgency,” Griess said. “More than 50,000 people will fall into the health insurance ‘coverage gap,’ leaving them without health insurance coverage or options for coverage for needed health services. The long-term result of this gap will be a lack of coverage for necessary medical care, with severe financial outcomes for those in the gap and without health insurance,” Griess added.
“Driving people into the coverage gap will result in less healthy people as medical issues and conditions go untreated at early, less expensive stages. This will exacerbate the health disparities in areas where higher rates of nearly every disease and condition exist, due in some measure to the lack of health insurance coverage,” said Griess.
Mr. Griess pointed out that failure to expand Medicaid is affecting the finances of rural hospitals more than urban ones due to the larger number of uninsured in rural areas.
According to a report from the Center for Rural Affairs, “A review of the U.S. Census Bureau Small Area Health Insurance Estimates reveals that rural Nebraska has significantly higher uninsured rates than urban Nebraska for those under 65 years of age. Among the 64 Nebraska counties classified as ‘rural,’ 2010 uninsured rates range from 32.6 percent in Keya Paha County to 10.6 percent in Hamilton County. Based on a recent study from the Center for Health Policy at the University of Nebraska Medical Center, 15 rural counties are considered “High Uninsured” counties with uninsured rates at 21 percent or higher .… The new Medicaid initiative in the Affordable Care Act would provide health insurance coverage to a significant number of rural Nebraskans and could potentially reduce the rural uninsured rate nearly in half to between 6 percent to 7.5 percent (when combining the rural and micropolitan data).”
Mr. Griess concluded by saying, “I would like to commend Senator Al Davis for his full support of WIN as he recognizes this legislation will improve the health of Nebraskans by ensuring everyone is connected to a primary care provider and/or a patient-centered medical home to guarantee people get the preventative care they need, manage chronic conditions and reduce trips to the emergency room and hospital admissions. WIN will begin to transform the delivery of healthcare services to the more than 50,000 newly qualified Nebraskans who need it the most. We are asking area residents to contact their Legislative District Senators in the Panhandle Region in support of WIN – LB 887. It’s the right thing to do for the state and for Nebraskans.”