Banking, Commerce and Insurance Committee
March 10, 2025
Committee Chair: Sen. Mike Jacobson | Bills Heard: 3 | Full Transcript (PDF)
LB410: Clarifies that prosthetics and orthotics which are medically necessary shall be covered by insurance plans in Nebraska
Introduced by: Sen. John Cavanaugh | Testimony: 6 proponents, 1 opponents, 0 neutral | Read bill text (PDF)
Nebraska lawmakers heard emotional testimony on prosthetic coverage gaps as amputees describe insurance denials costing them six figures. LB410 would require state-regulated health plans to cover prosthetics and orthotics at Medicare levels when medically necessary—a standard already adopted by 21 states including Iowa and Missouri.
Why it matters: Amputees testified that insurance denials force monthslong delays, leading to secondary health complications like obesity and diabetes that increase overall healthcare costs. One testifier said his nonprofit has distributed over $100,000 in prosthetics to people denied coverage. Proper devices enable people to return to work and participate in society.
What they're saying: - Proponents: "Prosthetics are medically necessary, and Nebraska law should reflect that," said Sen. Cavanaugh. Physical therapists noted that patients receiving devices within three months experience 25% lower healthcare costs. A prosthetist testified that Medicare has covered microprocessor knees since 2005, yet commercial plans still deny them as "experimental." - Opponents: The Nebraska Insurance Federation warned that mandating Medicare-level coverage could expand essential health benefits and increase costs. They noted that ERISA plans (35% of the private market) would be exempt, creating inconsistency. Insurers argued their ability to negotiate rates is a major driver of consumer savings.
By the numbers: 37,000 Nebraskans are amputees. One testifier spent six figures on medical costs since 2005, hitting his deductible every year. Prosthetic socks alone cost $600 for six pairs.
What's next: No vote was taken. The bill remains in committee.
Committee sentiment: Supportive: Sen. George Dungan, Sen. Brad von Gillern, Sen. Mike Jacobson Skeptical: Sen. Merv Riepe
Sentiment estimated from questions and comments — not stated positions.
LB639: Requires dental insurers to spend at least 85% of premium revenue on patient care (dental loss ratio)
Introduced by: Sen. Stan Clouse | Testimony: 3 proponents, 4 opponents, 0 neutral | Read bill text (PDF)
Dental insurers and patient advocates clashed over an 85% loss ratio mandate, with opponents warning it would shrink Nebraska's dental insurance market. LB639 would require dental plans to spend at least 85 cents of every premium dollar on patient care—matching the medical insurance standard under the Affordable Care Act.
Why it matters: Dentists argue patients are overpaying for coverage that doesn't deliver care. One testified a patient pays $900 annually but receives only $100 in benefits. But insurers warn the mandate would force premium increases and market exits, reducing consumer choice and access to dental coverage.
What they're saying: - Proponents: "If Medicaid can meet 85%, why can't commercial plans?" asked Dr. Sedillo. Dentists noted that state employee and university plans already meet the standard and that insurers should seek efficiency rather than threaten premium increases. - Opponents: "A dental plan would have only $15 per month for all administrative costs," testified Kate McCown of Ameritas. She cited Massachusetts, where seven carriers exited after adopting an 83% ratio—a 30% decline in options. Of 20 states that introduced similar bills in three years, none passed.
By the numbers: Dental premiums average $100/month (medical averages $2,000). Currently, as much as 40% of dental premiums go to non-care expenses. Massachusetts saw a 30% reduction in carrier options after implementing an 83% loss ratio.
What's next: No vote was taken. Sen. Clouse indicated he hopes to work with stakeholders to reach agreement on a revised approach.
Committee sentiment: Skeptical: Sen. Merv Riepe, Sen. Brad von Gillern Opposed: Sen. Mike Jacobson Unclear: Sen. George Dungan, Sen. Matt Hallstrom
Sentiment estimated from questions and comments — not stated positions.
LB715: Requires state-regulated insurers to provide coverage for pre-exposure prophylaxis (PrEP) medication for HIV prevention
Introduced by: Sen. Eliot Bostar | Testimony: 2 proponents, 0 opponents, 1 neutral | Read bill text (PDF)
Nebraska lawmakers heard testimony on a bill to protect HIV prevention coverage as federal legal challenges loom. LB715 would require state-regulated insurers to cover pre-exposure prophylaxis (PrEP) medication, ensuring access to a drug that is over 99% effective at preventing HIV transmission.
Why it matters: PrEP is already covered by all ACA-compliant plans without cost-sharing, but ongoing federal litigation (Kennedy v. Braidwood Management) threatens the Preventive Services Task Force authority that mandates that coverage. The bill protects Nebraskans from losing access if the Supreme Court weakens federal protections. Nebraska saw 107 new HIV diagnoses in 2021, the highest since 2010.
What they're saying: - Proponents: "Preventing HIV is far more cost-effective than treating it," testified Dr. Dworak. Generic PrEP costs $240 annually versus $4.5 million in lifetime treatment costs. A pharmacist noted that less than 1/3 of eligible people have been prescribed PrEP, with particularly low uptake in rural areas and communities of color. Newer formulations include six-month injections for people facing barriers to daily medication. - Neutral: The Nebraska Insurance Federation testified that PrEP is already covered and appreciated the bill's allowance for cost-sharing if federal protections are weakened.
By the numbers: Generic PrEP: $240/year. Lifetime HIV treatment: $4.5 million. One prevented infection saves approximately $300,000 in medical costs. Nebraska's 2021 HIV diagnoses: 107 (highest since 2010); 35% in rural areas.
What's next: No vote was taken. Sen. Bostar clarified in closing that the bill maintains the status quo and protects against federal legal uncertainty.
Committee sentiment: Skeptical: Sen. Merv Riepe, Sen. Brad von Gillern Unclear: Sen. George Dungan
Sentiment estimated from questions and comments — not stated positions.
Session Notes
Committee Chair Mike Jacobson opened the hearing and explained committee procedures, including the three-minute light system for testifiers. Committee members present included Sen. Merv Riepe, Sen. Brad von Gillern, Sen. Dave Wordekemper, and Sen. George Dungan. Legal counsel Joshua Christolear and committee clerk Natalie Schunk assisted. Pages Kathryn Singh and Ayden Topping were introduced. Jacobson left during the LB639 hearing to attend another committee and turned the gavel to Vice Chair Matt Hallstrom. The committee heard three bills: LB410 (prosthetics/orthotics coverage), LB639 (dental loss ratio), and LB715 (PrEP coverage). No votes were taken on any bills during the hearing.
Generated by NE Wire Service | Source: Nebraska Legislature Transcribers Office This is an AI-generated summary. Verify all claims against the official transcript.