Last year’s harsh, controversial and lamentable change in public policy, by virtue of which the unborn children of impoverished, pregnant women who are unauthorized immigrants were made ineligible for prenatal-care services under Nebraska’s medical assistance program, is not forgotten during the current session of the Legislature. Whether there is enough interest, political will and short-term funding to reverse this horrible decision remains to be seen.
Recall that the federal government all of a sudden realized late in 2009 that Nebraska’s decades-long policy of covering prenatal care for the unborn children of impoverished pregnant women under Medicaid regardless of the women’s immigration status was impermissible. The reason is that the regular Medicaid rules do not recognize the unborn child as an eligible recipient in his or her own right and if the mother is an unauthorized immigrant, that fact makes her ineligible as well, poverty notwithstanding. Medicaid is jointly funded by the federal and state governments—several percentage points higher by the former—and is the primary component of Nebraska’s medical assistance program for the materially poor.
After the federal government’s dictate about Medicaid, Nebraska’s Department of Health and Human Services could have continued the policy by using the unborn-child option of the federal Children’s Health Insurance Program (CHIP), which covers more children from impoverished families and regards the unborn child as the recipient of prenatal care. But Governor Dave Heineman wouldn’t allow it, invoking his "no government benefits for illegals" mantra.
An attempt was made, by means of a late-introduced bill, to legislatively trump the Governor’s position by directing NDHHS to implement Chip’s unborn child option—the federal funding match rate is actually higher for CHIP than it is for Medicaid—but a majority of the legislators didn’t want any part of that action.
A new bill of this nature has been introduced in the current session of the Legislature by Senators Kathy Campbell, Jeremy Nordquist and Brad Ashford. It is LB 599, which has been scheduled for a late public hearing on March 17. Unless funding can be identified for the immediate and short term costs of providing this coverage, longer term savings notwithstanding, LB 599 has little chance of being debated.
If there was any mediating factor in the otherwise harsh and harmful policy decision to not use the available option to restore medical-assistance coverage for prenatal-care services, it was the quite modest factor that labor and delivery fall under the federal-rules definition of emergency medical services, making them eligible for Medicaid coverage regardless of the pregnant woman’s immigration status. Thus, as private medical-care providers, such as the federally qualified community health centers in Columbus and Omaha, as well as the medical professionals with whom they collaborate, have stepped up charitably to provide some of the prenatal-care services otherwise denied, they should be confident they will at least be (partially) paid for the costs of labor and delivery.
Unfortunately, the state’s performance since last May on this unquestionable provision has been alarmingly poor. There have been reports of inexplicable and unreasonable months’ long delays in payment, of lost paperwork and of other bureaucratic errors. Providers haven’t been able to count on responsive actions.
Improvements are underway, apparently, but to ensure that this aspect is attended to more conscientiously and efficiently, Senator Nordquist introduced LB 494. It would require DHHS to process applications for medical assistance—such as those for labor and delivery services for eligible poor women who are unauthorized immigrants—in a timely manner per federal regulations, which is typically 45 days. LB 494 might not proceed to passage, but it will be oversight in its own right and in waiting nonetheless.
And finally……….
This Legislature has the duty of redistricting; that is, using 2010 census figures to reconfigure the boundaries for the state’s federal congressional districts, state legislative districts and several other positions elected on a district or regional basis.
To lead in fulfilling this duty, the Legislature’s Executive Board has appointed nine legislators to serve as a redistricting committee; three who reside in each of the three Congressional districts. From District 1, the three are Senators Bill Avery and Danielle Conrad from Lincoln and Chris Langemeier from Schuyler. From District 2, it’s Senators John Nelson, Scott Lautenbaugh and Heath Mello, all from Omaha. From District 3, Senators Deb Fischer from Valentine, Ken Schilz from Ogallala and Annette Dubas from Fullerton were selected. Senator Langemeier is the chairman. Theoretically it’s a nonpartisan process in a nonpartisan Legislature, but for curiosity’s sake, there are five registered Republicans and four registered Democrats.
Their assigned task is to develop a plan for consideration by the entire Legislature. In days gone by, big maps, colored pencils and, especially, erasures were the tools of this task; now there are sophisticated computer programs that make the process more efficient, but not necessarily less complicated.
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