Unicam backs bill on Medigap access

A 2023 Unicameral measure inspired by a North Platte couple's struggles with health insurance won 38-0 first-round approval in the Legislature Thursday.

State Sen. Mike Jacobson of North Platte sponsored both this year's Legislative Bill 852 — the measure advanced by senators — and a revised version of 2023's LB 32, which lawmakers officially added to LB 852 during brief afternoon debate.

LB 32 would make Nebraska insurers that sell "Medigap" insurance policies to Medicare-eligible senior citizens offer at least one such policy to people younger than age 65 with disabilities rendering them eligible for Medicare before 65.

Longtime North Platte lawyer Stephen Kay described at LB 32's February 2023 public hearing how he and his wife, Jean, faced a financial crisis when she was diagnosed in 2002 with multiple sclerosis.

Though Jean Kay began receiving Medicare and federal disability benefits in 2016, he said, he had to close his private practice in 2018 to get a federal job with health insurance for the couple.

Stephen Kay commuted back and forth to Fargo, North Dakota, until Jean turned 65 in 2021 and qualified for full Medicare, he said at the 2023 hearing.

Jacobson's newer bill, LB 852, now contains compromise language worked out with insurers that dropped LB 32's original call to also require that Medigap policies be offered for people suffering from end-stage renal disease.

Private Medicare Advantage plans would still be available for those patients, he told senators. But "I want to make sure Medicare Advantage providers work in good faith with the dialysis facilities in rural Nebraska."

LB 852's main thrust would block nonparticipating Medicare suppliers of durable medical equipment from charging unlimited amounts to Medicare beneficiaries or insurers offering Medigap. They wouldn't be allowed to charge more than 15% over what Medicare permits under the bill.

Banking, Commerce and Insurance Committee members voted 8-0 to combine Jacobson's two bills into LB 852 and send it to the floor.

Jacobson, the committee's vice chairman, said during Thursday's debate that the combined bill would let insurers charge no more than 150% of their regular Medigap premium in selling a policy to under-65 disabled people.

Sen. Rob Clements of Elmwood, who himself sells health insurance policies, said he expects a premium increase for his own Medigap policy as a result but would still support LB 852.

"It's reasonable to let the companies charge a somewhat higher premium, but if it were much more, (disabled) people couldn't afford it," he said.

Sens. Tom Brewer of Gordon, Steve Erdman of Bayard and Brian Hardin of Gering joined Jacobson in backing the combined LB 852. Sumner Sen. Teresa Ibach was present but did not vote.

Earlier in the week, the Legislature amended the 2024 session's main budget bill to include a Jacobson measure meant to restore a $1 million state housing grant the city of North Platte won last year but then saw derailed.

That measure, introduced as LB 850, recasts language governing the Rural Workforce Housing Land Development Program created in 2022 with some of the state's share of federal COVID-19 aid.

North Platte, McCook and Arnold were among 12 Nebraska cities that won grants from the program in March 2023. North Platte's $1 million grant would have been used to bolster a city revolving fund to acquire decrepit homes or vacant lots and prepare them for resale and construction of new affordable housing.

But U.S. Treasury guidelines for using American Rescue Plan Act funds forced the Nebraska Department of Economic Development to offer the 12 cities loans instead of grants. The cities declined.

Jacobson's measure, added to LB 1412 Wednesday, is meant to satisfy the guidelines and restore the grants. Lawmakers gave the budget bill 39-4 first-round approval after a filibuster that took much of Tuesday and Wednesday to run its course.