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LINCOLN, Neb. (AP) — Nebraska Gov. Dave Heineman turned to the public Wednesday for suggestions on how to create an online, statewide marketplace for health insurance, a key piece of the federal health care law designed to steer users toward a coverage plan.
The Republican governor announced a series of meetings that will start later this month and be held throughout the state. Health care providers and advocates for children, the poor, taxpayers and the insurance industry have been invited to participate.
"We're trying to keep the process very open, very public," Heineman said at a news conference. "We want to hear from citizens, and we think now is the appropriate time now that we're getting a lot closer to this final decision."
The public meetings come as the state prepares a blueprint for a so-called health exchange that is due to the federal government on Nov. 16. The online markets allow consumers and small businesses to shop for health insurance and see if they qualify for federal tax credits aimed at lower-income residents.
Heineman repeated his opposition to any proposals to extend Medicaid coverage to more Nebraska residents. The U.S. Supreme Court has ruled that the federal government cannot penalize states that choose not to expand Medicaid, as was required in the federal law.
Health care advocates argue that the Medicaid expansion is critical: Unless more Nebraskans are allowed to participate, some will have incomes too high to qualify for the program but too low to receive the federal tax credits.
The federal law picks up the entire cost of covering more people for the first three years, and then drops to 90 percent, with states covering the remaining 10 percent. Supporters say it's a great deal compared to current Medicaid rates wherein Washington pays as little as half of the cost in some states.
Heineman said the expansion would drain state money that should instead go to K-12 public schools, colleges and the University of Nebraska.
Supporters of the federal health care law cheered Wednesday's announcement, although some said the Legislature still needs to create an independent governing board to oversee the health exchange. Nebraska Department of Insurance Director Bruce Ramge has said the Department of Insurance, under Heineman's administration, is the best equipped to handle the duties.
Omaha Sen. Jeremy Nordquist, a Democrat who supports the federal health care law, introduced a measure during this year's session that would have created a 12-member oversight board. The proposal was shelved, as state officials waited for the U.S. Supreme Court to rule on the health care law.
"After the Supreme Court ruled, my first point was the governor needs to make this a more open and transparent process," Nordquist said. "Up until that point, all of the decisions and studies had been going on behind closed doors. I'm pleased that he's now responded to that criticism by moving forward with some public meetings in the coming weeks, and I hope that Nebraskans get engaged in this."
Heineman said he has invited more than 30 advocacy groups to the meetings in Lincoln. He said executives from two of the state's three largest health insurance companies — Blue Cross/Blue Shield of Nebraska, Coventry Health Care of Nebraska and United Health Care — have already agreed to participate.
The other meetings will take place on Aug. 27 in Gering, Aug. 28 in Kearney, Aug. 30 in Nebraska City, Sept. 10 in Omaha and Sept. 12 in South Sioux City.
"We have asked these stakeholders to come prepared to discuss which exchange option they prefer, why, and how they would fund it," the governor said.
Heineman has ordered state officials to prepare an exchange to meet the federal deadline, but the department won't start enacting it until after the November elections.
Ramge said the meetings will give the public a chance to question the state's exchange-planning team. Each gathering will start with a presentation, followed by an informal discussion and a question-and-answer session.
An estimated 28,400 uninsured Nebraskans would qualify for coverage if the state expanded Medicaid coverage, according to the Department of Insurance.
Nebraska Appleseed, a public interest group that advocates for low-income residents, applauded the announcement as "a positive first step" toward creating an exchange.
"Our focus should always be on how to make these opportunities work for Nebraskans and having input from the public is critical to achieving that goal," the group's health care access director, Jennifer Carter, said in a statement.
A few lawmakers have questioned the governor's authority to move forward with a health exchange without direct input from the Legislature. Heineman countered that the state constitution grants his administration the power to design a plan and submit an exchange to federal authorities to protect Nebraska's interests.
Nordquist said he won't oppose the governor as long as the process stays transparent. If it isn't, he said he will resubmit a bill to create a public governing board.