Health and Human Services Committee
March 13, 2025
Committee Chair: Sen. Brian Hardin | Bills Heard: 4 | Full Transcript (PDF)
LB318: Medicaid and CHIP coverage for incarcerated youth pending adjudication
Introduced by: Sen. Victor Rountree | Testimony: 24 proponents, 2 opponents, 0 neutral | Read bill text (PDF)
Nebraska would extend Medicaid coverage to youth awaiting trial in detention facilities, a move that could reduce county costs while improving care for vulnerable adolescents. LB318 requires the Department of Health and Human Services to seek a federal waiver allowing Medicaid and CHIP coverage for youth in secure settings pending adjudication—a gap that currently forces counties to pay for all healthcare. Two-thirds of detained youth have mental health or substance use disorders; 40% have identified disabilities. The bill would allow outside providers to deliver services and prevent medication gaps during detention.
Why it matters: Counties currently absorb full healthcare costs for detained youth, straining property tax budgets. Federal Medicaid funds would shift much of that burden to Washington while ensuring youth don't lose continuity of care—a factor research links to reduced recidivism. Youth wait an average of 49 days for trial; coverage gaps delay critical treatment.
What they're saying: - Proponents: "Continuity of care is critical. If youth are suddenly separated from care they've been receiving, they can spiral down," said Sen. Rountree. Lori Harder, a former DHHS consultant, noted keeping Medicaid open allows youth to access treatment programs funded by Medicaid, enabling quicker transitions to community placements. Sarah Maresh of Nebraska Appleseed emphasized the bill ensures access to the full array of Medicaid services required under federal law. - Skeptics: Sen. Hansen pressed whether treatment is actually delayed or just payment, and questioned whether the same number of healthcare professionals would be available under the new system.
By the numbers: 24 proponents testified online; 2 opponents. Lancaster County estimates the bill could impact over 100 youth annually, representing $250,000 in annual cost savings to property taxpayers.
What's next: No vote was taken. The bill advances to General File for further consideration.
Committee sentiment: Supportive: Sen. John Fredrickson, Sen. Dan Quick, Sen. Merv Riepe Skeptical: Sen. Matt Hansen
Sentiment estimated from questions and comments — not stated positions.
LB96: Medicaid Section 1115 waivers for reentry and health-related social needs
Introduced by: Sen. George Dungan | Testimony: 18 proponents, 2 opponents, 1 neutral | Read bill text (PDF)
Nebraska would submit federal waivers to provide Medicaid coverage for incarcerated individuals 90 days before release and for health-related social needs like housing and food assistance. LB96 targets a critical gap: people released from jail or prison often face immediate crises—no home, no job, no food—that drive recidivism. The bill would allow Medicaid to cover case management, medication-assisted treatment, housing assistance, and food support for up to six months post-release.
Why it matters: Housing insecurity is a primary driver of recidivism. It costs over $100 per day to incarcerate someone; investing upstream in reentry services saves money long-term while improving public safety. Nineteen states have already implemented reentry waivers; 16 have implemented health-related social needs waivers. Federal funds would cover much of the cost, reducing burden on counties and state.
What they're saying: - Proponents: "Reentry is a crisis," said Jasmine Harris of RISE. "People are released with no home, no job, no food." Brad Johnson, Lancaster County Corrections director, emphasized housing is a significant issue and appropriate resources would be a tremendous benefit. Sen. Dungan noted the fiscal note assumes maximum usage—that every person uses every service for the full period available—which is unrealistic. "Very few individuals are actually going to utilize that service," he said. - Fiscal concerns: The $8 million fiscal note (with $5 million federal, $3 million state) assumes maximum utilization. Dungan argued actual costs will be substantially lower because many people don't need or want these services.
By the numbers: 18 proponents testified online; 2 opponents; 1 neutral. As of January 2025, CMS has approved reentry waivers in 19 states and health-related social needs waivers in 16 states.
What's next: No vote was taken. The bill advances to General File for further consideration.
Committee sentiment: Supportive: Sen. John Fredrickson Skeptical: Sen. Matt Hansen Unclear: Sen. Merv Riepe
Sentiment estimated from questions and comments — not stated positions.
LB283: Express Lane Eligibility for Medicaid and CHIP enrollment
Introduced by: Sen. Danielle Spivey | Testimony: 36 proponents, 4 opponents, 1 neutral | Read bill text (PDF)
Nebraska would automatically enroll children in Medicaid and CHIP based on SNAP eligibility, a streamlined approach proven to save states millions in administrative costs while reducing coverage gaps. LB283 implements Express Lane Eligibility (ELE), allowing government agencies to share data so children already enrolled in SNAP are automatically enrolled in health coverage. The bill does not expand eligibility or create new mandates; it simply removes bureaucratic barriers for families already qualified.
Why it matters: Over 8,000 beneficiaries lost Medicaid or CHIP coverage and were re-enrolled within 12 months in FY24; over 4,000 were children. These coverage gaps—called "churn"—cost the state $400-600 per redetermination, totaling $3-5 million annually in excess administrative costs. More importantly, coverage gaps lead to delayed care, emergency room use, and worse health outcomes. Approximately 4,000 Nebraska children are enrolled in SNAP but not Medicaid—exactly the population this bill would reach.
What they're saying: - Proponents: "ELE will save Nebraska money, just as it is for other states," said Garret Swanson of Holland Children's Movement. Louisiana reduced per-application cost from $116 to $12-15; one state saved $7.3 million between 2011-2014. Amy Behnke of Health Center Association noted enrollment is challenging for families; streamlining helps children "get enrolled and keep coverage." Kelsey Arends of Nebraska Appleseed emphasized SNAP eligibility is much lower than CHIP, so SNAP enrollees are income-eligible for Medicaid. - Concerns: DHHS noted a 11% error rate in passive ELE models at federal level, though that was attributed to states not checking citizenship—something Nebraska already does.
By the numbers: 36 proponents testified online; 4 opponents; 1 neutral. Approximately 4,000 Nebraska children enrolled in SNAP but not Medicaid would be impacted. Over 175,000 children currently rely on Medicaid and CHIP in Nebraska.
What's next: No vote was taken. Sen. Spivey agreed to DHHS-requested amendment changing implementation date to January 1, 2027. The bill advances to General File.
Committee sentiment: Supportive: Sen. John Fredrickson, Sen. Matt Hansen
Sentiment estimated from questions and comments — not stated positions.
LB588: Adjust Aid to Dependent Children benefits to inflation
Introduced by: Sen. Danielle Conrad | Testimony: 8 proponents, 2 opponents, 1 neutral | Read bill text (PDF)
Nebraska's Aid to Dependent Children program has lost purchasing power to inflation since 2015, and Sen. Conrad proposes tying benefits to annual inflation adjustments to help the state's poorest families. LB588 would change how ADC maximum payment levels are calculated, moving from a fixed 55% of standard of need to an inflation-adjusted formula. A family of three received $364 monthly in 1996; adjusted for inflation to 2025, that would be $744. Today, that same family receives $552—a gap that has widened as inflation erodes the program's value.
Why it matters: Nearly 60,000 Nebraska children live in poverty; close to 25,000 experience extreme poverty. Research shows each additional $1,000 states spend annually on public benefits per person in poverty reduces child maltreatment reports by 4.3%, substantiated maltreatment by 4%, and foster care placements by 2.1%. Cash assistance could reduce CPS investigations by 11-20% annually, with 29% reduction for children of color. Investing in public benefits is a child welfare prevention strategy.
What they're saying: - Proponents: "Children must have their basic needs met to develop and succeed," said Anahi Salazar of Voices for Children. "For those growing up in poverty, every additional dollar can make a significant difference in a family's financial stability." Sen. Conrad emphasized the Legislature has historically balanced tax cuts for the wealthy with updates to programs helping the working poor—a tradition that has been lost in recent years. - Fiscal reality: DHHS CFO John Meals noted Nebraska's TANF grant balance of $113 million (down from $125 million last year) will be depleted within fiscal year 2028 at current spending rates. Using a 2.9% inflation factor, the cost would be roughly $500,000 annually.
By the numbers: 8 proponents testified online; 2 opponents; 1 neutral. ADC serves approximately 3,000 of Nebraska's poorest families. No official fiscal note available due to drafting error; cost estimate pending.
What's next: No vote was taken. A committee amendment corrects the original drafting error. The bill advances to General File for further consideration.
Committee sentiment: Unclear: Sen. Matt Hansen, Sen. Brian Hardin
Sentiment estimated from questions and comments — not stated positions.
Session Notes
Committee Chair Hardin opened with procedural instructions regarding testifier sheets, time limits (3-minute green light system), and written position comment deadlines (8 a.m. day of hearing via nebraskalegislature.gov). Committee members present: Sen. Merv Riepe (District 12), Sen. John Fredrickson (District 20), Sen. Glen Meyer (District 17), Sen. Dan Quick (District 35), Sen. Beau Ballard (District 21). Research analyst Bryson Bartels and committee clerk Barb Dorn assisted. Pages: Sydney Cochran and Tate Smith. The committee heard four bills: LB318, LB96, LB283, and LB588. No votes were taken during the hearing; all bills advance to General File for further consideration. Committee will reconvene in executive session following 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.