Mike Jacobson: Agreeing on MediGap legislation

With the session just a couple of weeks away, I want to update you on a couple of topics I intend to work on this year.

First, I met with the health insurance providers late last week regarding LB 32 (MediGap) and we agreed on amendment language to move this bill ahead.

Medigap laws require health insurance providers who offer Medicare supplement plans to make those plans available to those who are handicapped and younger than 65.

As a rule, I don't like government mandates on businesses. However, in this case, I believe the industry would not voluntarily offer this coverage.

One concern is the premium increases that may be felt by plan participants from adding handicapped individuals younger than 65 to their pool. Remember, those who would avail themselves of this coverage would only be doing so because they are currently handicapped and need coverage now, as opposed to those who take insurance to prepare for future needs.

To address premium increases, the industry wanted to place these insureds into a separate risk pool. However, this would have likely price these individuals out of coverage altogether, making the requirement moot.

In the end, we agreed handicapped individuals younger than 65 would be eligible to participate in existing pools, but could be required to pay up to 150% of the regular premium cost. I think this will be a reasonable price point, and is certainly lower than the 300% sought by the industry's actuarial experts.

The amendment will also include a carve-out for those who suffer from end-stage renal disease (ESRD) since ESRD patients are eligible for Medicare Advantage plans and receive additional subsidies from Medicare that help offset the additional costs for ESRD treatments.

However, I have been critical of Medicare Advantage policies since many providers no longer accept their coverage, and will be keeping a close eye on how far Medicare Advantage participants have to travel for treatment, particularly if they are rural ESRD patients.

I hope the private sector will participate in fair and reasonable negotiations so the government doesn't have to become an intermediary between providers and insurers.

Although there may be some special interests who are still unhappy with LB 32, I have listened to all parties and believe that this agreement is the best option to get a deal done and provide hundreds of handicapped residents in the state with the health insurance coverage they need.

I also plan to introduce a bill this session that brings state policy in line with federal laws relating to payments of durable medical devices.

Some Nebraska providers are accepting Medicaid reimbursements and then "back-billing" the patient for the difference between the full list price and the reduced Medicaid price.

This is prohibited by Medicare but not addressed by our state's Medicaid laws. I intend to end this practice to protect unsuspected patients who need these devices.

Finally, I'll mention again that I plan to designate LB 31 (two-person crew) as my personal priority bill and will be working to get the Transportation and Telecommunications Committee to move this bill to the floor as soon as possible.

Since the speaker has made it clear that none of the priority bills from the last session will keep their priority status, the faster you get your priority bill to the floor, the sooner you can get it moving through the process.

Next week, I plan to give you an overview of all the bills I intend to introduce in the 2024 session. It will be a short session, so I have had to pare back my list to ensure that I can give every bill a good chance to make it across the finish line. Any bills that are not passed will need to be reintroduced in 2025 and start from the beginning of the legislative process.

In closing, Julie and I want to wish everyone a very blessed and Merry Christmas! This is a season when we all need to prioritize spending quality time with family and friends and truly appreciate that the very special gift that God has given us all!

I look forward to continuing to hear from you regarding issues that are important to you. It is a privilege to serve as your State Senator and I will continue to give my full effort to make a positive difference for the District and the State. You can reach me at mjacobson@leg.ne.gov or by calling my legislative office at 402-471-2729.