Voters in Nebraska on Tuesday approved a ballot measure to expand Medicaid to 90,000 low-income people in the state.
State lawmakers next will need to work out a funding mechanism to pay for the state share of the costs of the expansion. The majority of funding for the expansion comes from the federal government, but the state will need to procure 7 percent of costs in 2019 and 10 percent in 2020 and beyond, adding up to millions of dollars in spending each year.
The bill is expected to cost Nebraska $591 million over a decade, according to an analysis from the health department.
As Obamacare was originally written, all states were set to expand Medicaid to people making less than $17,000 a year beginning in 2014. A Supreme Court decision made the provision optional, and as a result certain states have expanded while others have not.
The ballot initiative served as a way for pro-Obamacare advocates to circumvent state lawmakers who had blocked expansion in the past. Nebraska was one of three states considering expansion through a ballot measure this November.
Americans for Prosperity, an organization affiliated with the libertarian Koch brothers, worked to defeat the initiative.
Republican Gov. Pete Ricketts had been opposed to expansion but indicated in media reports that he would be hands-off if voters approved the move. State Sen. Bob Krist of Omaha, his Democratic challenger, supported the expansion.
