People packed into a hearing room Wednesday faced the Legislature's Health and Human Services Committee, which heard more than four and a half hours of testimony on the proposed Wellness in Nebraska Act.
The WIN Act would expand Medicaid for Nebraskans with incomes up to 133 percent of the federal poverty level, helping close a coverage gap for more than 54,000 Nebraskans who aren't covered by the Affordable Care Act or the current Medicaid system.
The mantra among proponents was that the act is a "win, win, win."
However, opponents, which include the Department of Health and Human Services, worried about having to cut the education budget to fund the expansion, or having the federal funding that is promised fall through, and having enough medical professionals to help treat the influx of people into the Medicaid system.
"(It) isn't about numbers and dollars -- it's about our friends and neighbors who need health care," said Sen. Kathy Campbell of Lincoln, who is sponsoring LB887.
The bill is a compromise that was drawn up after a Medicaid expansion bill failed last session in the Legislature.
Medicaid expansion is part of the Affordable Care Act, but the U.S. Supreme Court ruled the expansion was optional for states.
Campbell's bill would combine private insurance and Medicaid and make sure participants are involved in their own wellness, she said.
Nearly everyone would pay a portion of their coverage costs.
Gov. Dave Heineman has said he won't support the act if it goes through.
"The WIN Act is a unique solution tailored to our state's health care needs," Nebraska Appleseed Executive Director Rebecca Gould said during the hearing. "It provides affordable access to quality insurance coverage using a combination of public and private approaches and encourages wellness, prevention and appropriate use of our health care system.
"LB887 will help working Nebraskans get coverage, reduce uncompensated care costs and ensure a healthier population necessary for a strong economy, strong families and a strong future for our state," Gould said.
The committee heard from more than 30 proponents, many of whom told personal stories about their frustrations with the current Medicaid system.
Oksana King, a mother with seven children, testified that she pays rent with her husband's student loan money. She cannot work because of knee problems, and one of her sons has a string of health issues. She said her family made $6,000 last year but doesn't qualify for Medicaid.
A 31-year-old woman with arthritis said with Medicaid she'd be able to get the treatment she needs to get back into society. She said if she could go back to work full time, she would more than make up for the cost of her treatment. But she doesn't qualify either.
"Access to health care should not be relegated to the affluent, those who are covered by their employers or those who are fortunate enough to have an illness so great they are covered," said Brad Meurrens of Disability Rights Nebraska.
Nancy Fulton, president of the Nebraska State Education Association, supported the bill. She said she did not think LB887 would end up cutting funding from education, despite concerns, and said the health of children and school workers was a great investment.
"This significant legislation will lead to a healthy classroom and a healthier school system as well," Fulton said.
Opponents to the bill raised several concerns and offered some solutions.
Kerry Winterer, chief executive officer of the Department of Health and Human Services, stood in opposition to the bill, saying the expansion was unnecessary.
Doug Kagan of Nebraska Taxpayers for Freedom urged the senators to come up with something out of the ordinary. His organization came up with several alternatives, including letting people pool together to buy insurance and letting employers do the same.
"These solutions would not make more Nebraskans dependent on government," he said.
Paul Von Behren, a Nebraska resident who has a disabled daughter, also opposed the bill, saying it was a "classic solution:" throwing money at something and hoping it will work.
"How long do you think that federal funding is going to be there?" Von Behren asked. "And are you willing to sacrifice our education system and our people?"