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SD public defense duties shift from counties to state; SCOTUS appears skeptical of restricting government communications with social media companies; Trump lawyers say he can't make bond; new scholarships aim to connect class of 2024 to high-demand jobs.

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The SCOTUS weighs government influence on social media, and who groups like the NRA can do business with. Biden signs an executive order to advance women's health research and the White House tells Israel it's responsible for the Gaza humanitarian crisis.

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Midwest regenerative farmers are rethinking chicken production, Medicare Advantage is squeezing the finances of rural hospitals and California's extreme swing from floods to drought has some thinking it's time to turn rural farm parcels into floodplains.

Medicaid Expansion in NE: Taking It to the People

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Monday, April 2, 2018   

LINCOLN, Neb. — After six failed legislative attempts, supporters of Medicaid expansion in Nebraska want the people to decide on the issue. The Insure the Good Life campaign is collecting signatures to put the choice to expand Medicaid before voters in November.

Deputy director of the health care access program at Nebraska Appleseed Molly McCleery said nearly 90,000 people are without health care because they can't afford private insurance and earn too much to qualify for Medicaid. But those Nebraskans, she added, are not the only ones who would benefit from expansion.

"Not just for those people and their families but also for local economies, for health care providers who would have a new source of payment,” McCleery said. “For employers, their employees would have the ability to get the care they need to be healthy and productive. "

Under the Affordable Care Act, the federal government pays for the majority of expansion costs for states through 2020. But opponents, including Gov. Pete Ricketts, say expansion puts the state budget at risk and would favor able-bodied Nebraskans over the most vulnerable already in the program.

Idaho and Utah are working on similar ballot measures.

McCleery admits it will take state investment to expand Medicaid coverage, but she said it would create efficiencies in other state spending.

"Everyone who has private insurance is paying more in their premiums to offset the cost of uncompensated care,” she said. “We are also paying for it through programs through the state for behavioral health for public assistance and through counties through general-assistance programs."

Montana expanded its Medicaid program in 2016, which a recent study found triggered a half-trillion dollars in health care spending. And McCleery contended accepting the federal money for expansion should be a no-brainer.

"We use federal dollars for a lot of different programs, and we seem to have a hesitation around accepting federal dollars when it comes to caring for the health of our population,” she said. “But we don't have that same hesitation for other programs like roads or ag or criminal justice or things like that."

About 85,000 signatures are needed by July to get the initiative on the November ballot.


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