LINCOLN — No money from expanded Medicaid coverage of family planning services could go to Planned Parenthood, under an amendment adopted Tuesday by Nebraska lawmakers.
But opponents warned the restriction could be a poison pill that jeopardizes the expanded services.
Senators attached the prohibition to Legislative Bill 540 on a vote of 25-8, then gave first-round approval to the bill.
LB 540 directs state officials to seek a Medicaid waiver to provide family planning services for women who make up to 185 percent of the federal poverty level.
State Sen. Tony Fulton of Lincoln pushed for the amendment, which bars any funds from the expanded coverage from going to any entity that "performs or promotes elective abortion."
In practice, that would mean Planned Parenthood and its affiliates, he said.
"I want to draw a bright line between abortion and these other services," Fulton said.
But Sen. Ken Haar of Lincoln said the limitation could kill the expansion of family planning coverage intended under the bill.
He said federal Medicaid officials in December denied a request by Texas for a waiver that included a similar prohibition on funding going to Planned Parenthood. The officials said Medicaid could not restrict a patient's access to a qualified health-care provider.
Anti-abortion groups around the nation have been trying to ban public funding for Planned Parenthood, one of the nation's largest abortion providers.
Fulton said he does not intend to sink the expanded coverage and will work with Sen. Kathy Campbell of Lincoln, who chairs the Health and Human Services Committee, about any potential legal issues.
The committee introduced the bill to save the state money and improve the health of women and children.
State law now bars Medicaid funds from being used for abortions, except to save a woman's life or in cases of rape or incest.
LB 540 would direct state officials to seek the same federal Medicaid waiver granted to 29 other states, including Iowa and Missouri.
Under the waiver, the state Medicaid program would cover family planning services for women who make up to 185 percent of the federal poverty level.
That equals a household income of $42,643 for a woman in a family of four.
The Medicaid program already covers family planning services for women who are eligible for full Medicaid coverage, which means most have incomes below the federal poverty level.
Planned Parenthood now provides care for some of those women and could continue to do so under Fulton's amendment.
The Nebraska Department of Health and Human Services estimated that 26,000 more women could qualify for the expanded coverage.
Campbell said Nebraska could reap savings of $5.5 million in general funds by spending an estimated $514,000.
Medicaid family planning waivers have been shown to save money in states where they have been adopted.
Iowa, for example, saved $7 for every $1 spent during the first year it had the federal waiver. A 2009 study projected those savings would grow after five years to $15.12 for every $1 spent.
In Minnesota, the number of abortions dropped significantly after the state got a Medicaid family planning waiver. That state estimated it saved $4 in general funds for every $1 spent on family planning.
Nebraska lawmakers took up the debate at the same time national controversy rages over a federal ruling about health insurance coverage.
The ruling would force Catholic colleges, hospitals and social service agencies, to include coverage of birth control, female sterilization and the morning-after pill in employee health insurance plans.
Opponents say the provision infringes on religious freedom by forcing institutions to pay for services to which they have a moral objection.
The Nebraska Catholic Conference also opposes LB 540 and has been lobbying heavily against it.
But the measure would expand existing coverage in a public program, funded with state and federal tax dollars.
Contact the writer:
402-473-9583, martha.stoddard@owh.com
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