NCPA - National Center for Policy Analysis


January 25, 2010

Should the oft-criticized Nebraska Medicaid deal in the Senate health care bill be extended to all states, the proposal would cost $35 billion over a three year span, according to the Congressional Budget Office (CBO). 

House Budget Committee ranking member Paul Ryan (R-Wis.) requested that the nonpartisan CBO score the hypothetical scenario: 

  • Net spending on health care would increase by an estimated $35 billion between 2010 and 2019.
  • All of the spending, however, would take place between 2017 and 2019.

The report comes as Democratic leaders are discussing the removal of the Nebraska deal from the health care bill in order to win over lawmakers in the House who oppose it. 

Republicans and some Democrats criticized the deal secured by Sen. Ben Nelson (D-Neb.) as an act to buy off the centrist senator's vote: 

  • Nelson was the final holdout senator to decide to vote for the Senate health care bill, which passed last Christmas Eve.
  • The CBO previously estimated that the deal specific to Nebraska would cost $100 million.
  • The deal would provide permanent federal funding for new Medicaid patients under a new federal mandate requiring the program to expand its coverage.
  • For the rest of the states, the federal government would cover the cost of new patients from 2014 to 2016. 

Nelson said in a floor speech that other states could get the same deal he secured for Nebraska. 

Source: Jordan Fabian, "Nebraska deal for all states would cost $35 billion over three years," The Hill, January 21, 2010. 

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