Among the 168 legislative bills that hit the Clerk’s desk on January 23, the tenth and last day for individual senators to introduce new legislation for the 2013 Session, were a couple of heavyweights bills. Omaha senators led or were instrumental in introducing them.
The Reader sought out conversations with Omaha-area senators and, despite full committee hearing and meeting schedules at the beginning of the session, caught a few.
Cook—Number 1.5 Issue
Like so many legislators in the early days of the session, Senator Tanya Cook can only return calls at the end of the day. Amazingly, most do. Cook represents an Omaha District that runs roughly from 72nd to the River and from Maple north to the County line.
Asked to name three issues she thought would shape the 2013 session of the Legislature, she laughed and said the Governor’s proposal to eliminate income tax in favor of sales tax would be number 1.5, for its sweeping scale. “It’s unlikely there will be a wholesale elimination of income tax,” she said, “but we can take a look at sales tax exemptions.”
She said she would be focused on another big issue that carried over unresolved from prior years, the matter of the State’s child welfare reforms. “We have reports now. We need to see what the reports are telling us,” she said. As a member of the newly influential Health and Human Services Committee, she is likely to be immersed in that process.
She also mentioned the extension of Medicaid as part of the enactment of the Affordable Care Act. “That’s been framed so politically,” she said.
Then she took a moment to discuss the recent character of the Legislature. “I’ve been extremely impressed with most of the members so far, with the questions they ask. It seems as if they’re more dialed in to their constituents, less driven by the national stage, by party,” she said, sounding hopeful.
Ashford’s Priority—Juvenile Justice Reform
Senator Brad Ashford, representing an Omaha district running roughly from 72nd to 144th and from Pacific to as far south as Q, was busy ducking in and out of news conferences on January 23. Mid-morning that day, as Chair of the Judiciary Committee, he presented what he told The Reader would be his personal priority going into the session—major changes to the juvenile justice system.
“This is a return to the original intent of the juvenile justice law—treatment, not punishment,” he said, “We need to go back now and complete what we started in the 1970s.” Ashford’s mind is on the legacy of the Legislature since he has returned for a second round of service. He was first elected in 1986 and again in 1990. His second tour of duty began in 2006 with reelection in 2010, but he now seeks a new office as the mayor of Omaha.
Legislative Bill (LB) 561, also originally signed by senators Bob Krist of Omaha and Kathy Campbell and Amanda McGill, both of Lincoln and later by Ernie Chambers of Omaha, would, by 2015, eliminate the current Office of Juvenile Services along with the Youth Rehabilitation and Treatment Centers for boys at Kearney and for girls at Geneva.
At the news conference Ashford said all funds now committed to programs that will be eliminated would go to the court system to be redistributed with heavy reliance on juvenile probation offices. He said he was presenting the change legislation because 70 percent of the young people in the justice system have major undiagnosed mental illness or an illness that is being treated incorrectly or not at all.
Ashford told The Reader that the State had piloted new programs in which 89 percent of juveniles were handled outside of facilities, while in the current system only 40 percent could be handled that better and less expensive way.
Krist—Taking Bold Stances
Bob Krist, an Omaha senator representing north central Douglas County, from about Military north to the County line and from 90th to 204th, lent his support to the bill at the news conference. Not necessarily known for leading on such issues, he was convinced by the successful results of the Nebraska Juvenile Delivery System Project pilot program that was developed with the interest of the Supreme Court in Douglas County and the cities of Scottsbluff and North Platte.
The program contained an embedded evaluation process, Krist said. After reviewing preliminary results of “Evidence-Based Practice” models, he and the other sponsors agreed to seek the phase out the current system. Evidence-based practice is a medical term describing a process for taking a patient’s values, best research available and clinical expertise into account when developing a treatment plan for a specific individual.
Krist said the pilots led to treatment of juveniles “in the home and in the community,” rather than transfer to State-run centers such as Kearney or Geneva. He said that it delivers “services up front, not later in the system,” and has resulted in less recidivism or return to the behavior that gets a youth back into the justice system.
Krist said that the new evidence-based approach is so much more efficient that less than half the money appropriated for the pilot program in Douglas County has been spent.
In an interview Krist said it was his friendship with Brad Ashford and the interest of Supreme Court Chief Justice Mike Heavican that got him interested in the pilot project. He laughed and asked, “Do you know the difference between a rocket and a missile? A guidance system. Brad is both a rocket and a missile. He takes off like a rocket to build enthusiasm for something like this but he’s also a missile and brings it together.”
On the topic of the character of the current legislature, Krist said, “The term-limited Legislature has come into its own. It has developed its own identity.” Part of that identity, he said, is the ability to see beyond party registration to get work done.
A Session Shaper—Extending Medicaid
Another big issue bill that dropped on the tenth day was developed by Health and Human Services Chair Kathy Campbell and Omaha Senator Jeremy Nordquist through the summer. It was the proposal to extend Medicaid, as envisioned by the national Affordable Care Act, to cover people who have not previously qualified for Medicaid but would not be able to afford health insurance policies in the soon-to-be-developed health insurance exchanges.
These are envisioned to be mostly the “working poor,” who earn up to 139 percent of the federal poverty guideline. Nordquist has identified this as an annual income of about $23,000 for a mother and two children or about $31,000 for a family of four. The extension would also include new categories of people not previously allowed—low-earning men, for instance, not just mothers and children.
Part of the theory for extending the program is that uninsured people are most likely to use high cost emergency rooms for health care and wait until health crises before seeking help. Ultimately taxpayers and insurance premium payers pick up the tab anyway, but for high cost and inefficient care. The goal is to get them some kind of coverage and, if possible, preventive and regular health care to reduce costs. This is a critical component of the national Affordable Care Act or Obamacare. It is also the component the Supreme Court ruled optional for states.
Since the ruling, Governor Heineman had taken the position that such an extension would be too expensive for Nebraska and pitted it against education or property tax increases. He relied on cost estimates supplied two years ago by a national consultant that showed high-end costs of implementing the extension but did not calculate the net effect of federal reimbursement and other cost savings of the extension. The Governor said he feared a federal default on promised reimbursements.
At a news conference, Campbell assembled an array of senators in support of Medicaid extension, LB 577, another bill that promised to lend shape to the session. Five of seven committee members had signed the bill, including Omaha senators Tanya Cook, Sara Howard and Susan Crawford. Other Omaha senators who signed were Rick Kolowski, Heath Mello, Ashford, Chambers and Nordquist. In addition Lincoln senators Danielle Conrad and McGill had signed on.
Campbell posted graphics showing that the state would come out ahead by extending Medicaid in the first seven years during which the federal government would reimburse the State for direct and administrative costs of Medicaid. In years one through three, the rate would be 100 percent; years four through seven would be on a declining scale to 90 percent and then would stay there. She did not foresee the Governor’s predicted expense but instead a gain through transfer of current cost items like , for instance, medical costs for state prisoners to Medicaid.
Krist made another unaccustomed trip to the news conference microphone to observe that Governors Brewer of Arizona, Martinez of New Mexico and Sandoval of Nevada, all Republicans, had decided extending Medicaid was in the best interests of their states.
“Can we afford to leave this many tax dollars on the table?” Krist asked, “I think the answer is ‘No’.” Despite the favorable financial analysis, in the end, he said, he supported the bill because “it’s the right thing to do.”
Nordquist—Pressing for Change
In the well-orchestrated news conference, Campbell sent Nordquist forward to rebut familiar arguments. Nordquist often shows a smooth mastery of data, familiarity with the arguments that will rise around an issue and a patience for repeating his answers as long as it takes to win the day or go down trying. His background as a legislative aide and committee research analyst show.
What about fears that the federal government will renege on reimbursement? “In the history of the Medicaid program, our payments from the federal government have never gone down. There’s no precedent for this,” Nordquist said with assurance.
What about those who say we shouldn’t participate because this so-called “federal money” is just our own money—it comes from us in the first place? “The question is then, should we pull those dollars back?” Nordquist asked rhetorically. He believed Nebraska should.
He pointed out that the Affordable Care Act will eliminate payments made to hospitals to compensate them for treatment of the uninsured. Extending Medicaid is the way the Act intends for those costs to be recovered. “It’s a trade off,” he said.
Campbell closed the news conference rebutting one more argument which might be raised against the bill—delay. “We have to begin at the start to get the full reimbursement,” she said. The rules allow states to opt in and out of Medicaid extension when they wish. “But,” Campbell cautioned, “We can’t come in later and get these savings.” The 100 percent reimbursements will only occur in the calendar years in which they are currently offered.
“We’ve done our homework. We have a strategic plan,” she said, thanking everyone for being there.
After the hearing, Nordquist, who represents an Omaha district that runs roughly from Harrison to Dodge and from 24th to the River, had time for a walking conversation and a short chat in his office. He still had bills to introduce on the last day. He is Chair of the Nebraska Retirement Systems Committee, a low visibility committee with big responsibility for retirement money that is rarely noticed—unless something goes wrong. He will shepherd bills on the Committee’s behalf. His name is on 28 bills, above the average.
What about the bill to extend Medicaid? “I’m very optimistic we have the support to pass it,” he said. Not dwelling on the mechanics of the bill-passing, he continued, “It’s related to the juvenile justice changes. We need it so parents who seek mental health care can actually get it.”
There are lots of facts, lots of issues on Nordquist's mind. Looking across a conference table, the wheels are almost visibly spinning in his head. The number of legislative issues he’s balancing seems like so many spinning plates on the ends of tall poles.
What else will shape the legislative landscape of 2013? He says he’s watching the changes to the Omaha Public Schools board, worried about a superficial change that may not do what’s really needed. “What are we doing about schools that aren’t making the grade? That’s what I’m interested in,” he says. He wants to shore up “human capital,” whether that’s intervention teams or leadership support. He’s got an eye open for trendy proposals like charter schools. He believes in public schools. “There’s no research that shows benefits from just bringing in charter schools.”
And one more big issue. “Water,” he says, “Another year of drought? Who pays? Are we over-irrigating?” He thinks this could be a huge issue this session.
Sara Howard—Election Commissioner Changes
Senator Howard is quick to identify herself as a freshman. She represents an Omaha district running roughly from 30th to 72nd and from Dodge to Military. It may be a wise strategy to hold back and watch but she has not been too shy, introducing 15 bills with one of particular interest to Omaha.
Her LB 235 calls for “best practices” in changes of precinct boundaries and polling places and sets up “consumer” advisory boards to assist the Election Commissioner in that process.
Howard says her interests are a good fit with her committee assignment on the Health and Human Services Committee and she is pleased to be serving on the Banking, Commerce and Insurance Committee.
How can you find out who your State Senator is?
Try your local Election Commissioner. On the Douglas County Election Commissioner’s website, www.votedouglascounty.com, you can select at the left “For Voters” and from a dropdown menu “Political Districts.” You’ll get a page that asks for your “House #” and “Zip Code.” I got a helpful list of districts and at “Legislature – District XX,” clicked “Elected Official” There was the name of the senator and when I clicked it, a place to click for the senator’s website. That took me to the home page of the Nebraska Legislature which is a treasure trove of all things legislative. I did not check the address of an unregistered voter so I’m not sure what happens then.
Way down where the districts are, on the Election Commissioner’s screen there’s an invitation to “Check Your Party.” When you click it, you’ll find yourself on the website of the Nebraska Secretary of State, an excellent place to be. You can check your party registration or any other registered voter's. It’s public record.