Senators advance health care funding despite federal concerns

The Nebraska Legislature advanced two bills Tuesday intended to pay for expanded health care coverage, amid questions about whether anticipated federal cuts will cancel them out.

The first bill considered Tuesday was one by Sen. Merv Riepe, to pay for expanded syphilis testing for pregnant women. Currently, testing is required only once, during the first trimester of pregnancy. The bill would add two more tests, one during the third trimester, and one at birth. The tests would be voluntary. Riepe, who represents Ralston, said they’re intended to address a problem in the state’s two most populous counties.

“This bill was brought to me by former senator Sarah Howard on behalf of the problem that we currently have much in -- mostly in Douglas County and somewhat in Lancaster,” he said.

Statewide, Nebraska saw a 373% increase in syphilis cases between 2017 and 2023, according to the Department of Health and Human Services.

Riepe said his bill for increased testing would cost the state about $78,000 a year, with another $105,000 to come from the federal government. Sen. Ashei Spivey of Omaha asked about the possibility that those federal funds would be cut, leaving the state to pick up the difference. Riepe acknowleged that’s possible.

“With everything that's going on with funding at the federal level, we do have concerns, but we need to move forward as we do in life, and if that becomes an obstacle, then we'll have to come back and reassess this, as we will with a lot of other bills,” he said.

Congressional Republicans have been discussing an $880 billion cut in Medicaid funding, of which Nebraska’s share could be around $400 million, according to the Kaiser Family Foundation.

Spivey said rising syphilis rates are just part of the problem facing Nebraska women and children.

“We in the state of Nebraska are in a maternal and child health crisis, and we don't have to be," she said. "What we are seeing is that the data is showing that a lot of the outcomes and outputs around pre-term births, NICU stays, bad health experiences inside the hospital are preventable. Even the maternal deaths or mortality, as well as infant deaths or mortality, 90% of those can be preventable."

Spivey said a lack of accessible care, made worse by low Medicaid reimbursement rates, is contributing to the problem.

Senators voted 38-0 to advance Riepe’s funding bill. They then took up a proposal by Sen. Mike Jacobson, to distribute proceeds from a tax on health maintenance organizations designed to attract additional federal funds to support Medicaid services.

Jacobson acknowledged that federal funding is uncertain as well. But he said 18 other states had enacted similar legislation, and said it was worth trying.

“When I look at the bill itself and the possibility of this getting approved at the federal level, I don't know," he said. "What I do know is, if we don't ask, we will definitely not get the money. Okay, that we know for certain: if you don't ask for it, you're not going to get it. If we ask for it, then we've got a chance of getting the funding. And if this gets canceled two or three years down the road, then we can count our blessings that we got it for two or three years."

Senators voted 33-0 to advance Jacobson’s bill. But Sen. Danielle Conrad said a proposal to weaken a paid sick leave law approved by voters last fall could undercut any progress being made.

“Will we choose to actually support healthy moms and healthy babies, or will we undermine the will of the voters? Will we undermine maternal health? Will we undermine the health and welfare of Nebraska's children? It should be an easy question. Unfortunately, in this body, it is not,” she said.

The paid sick leave bill was on Tuesday’s agenda, but senators adjourned for the day before reaching it.

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