Senate amends Medicaid bill to clarify MCOs may cover federal cost‑sharing; amendment adopted

The Legislature adopted a narrowed committee amendment to LB 9 29 to permit — not require — managed‑care organizations (MCOs) to cover certain Medicaid cost‑sharing charges that federal law allows. Sponsor Senator Fredericksen said the change aligns state practice with implementation of the federal budget law and that the white‑copy amendment removed the earlier fiscal note.

Senator Fredericksen explained the amendment is permissive: “MCOs, when they previously did have Medicaid co‑payments or deductibles, would just absorb the cost of the co‑payments,” and the amendment restores that permissive authority. He said the committee narrowed the bill so managed‑care organizations could choose whether to cover costs rather than imposing an obligation on the state.

Opponents warned of longer‑term fiscal and behavioral effects. Senator Koff said removing cost sharing risks creating dependency and later higher taxpayer costs. Senator Clemens noted Medicaid spending is already large and urged caution about expanding benefits beyond federal requirements.

Supporters including Senator Ballard and Senator Hart argued MCOs already have the option in practice and that allowing the permissive authority provides clarity for providers and administrators.

The committee amendment AM 29‑91 was adopted on the floor (recorded 29 ayes, 8 nays). The bill as amended advanced from general file (recorded 28 ayes, 9 nays).

Next steps: LB 9 29 advances for further consideration; sponsors said the amendment preserves federal compliance while giving MCOs flexibility to maintain prior practice of absorbing small co‑payments to reduce barriers to care.