>> Sreenivasan: AS ELECTION DAY

NEARS, MUCH ATTENTION HAS GONE

TO HIGH-PROFILE SENATE AND

CONGRESSIONAL RACES.

BUT ACROSS THE COUNTRY, VOTERS

ARE ALSO WEIGHING IN ON BALLOT

MEASURES THAT CAN BRING BIG

CHANGES TO THEIR STATES.

AS NEWSHOUR REPORTED FROM

IDAHO LAST WEEK, ONE OF THE HOT-

BUTTON ISSUES FOR VOTERS IS

HEALTH CARE, AND WHETHER OR NOT

TO EXPAND MEDICAID, THE JOINT

FEDERAL AND STATE HEALTHCARE

PROGRAM FOR LOW-INCOME

AMERICANS.

THE STATE OF NEBRASKA IS ANOTHER

OF JUST A FEW RED STATES WITH

MEDICAID EXPANSION ON THE

BALLOT, AND SOON, VOTERS IN THE

CORNHUSKER STATE WILL SEE IF

THEY CAN DO WHAT THEIR ELECTED

OFFICIALS HAVE BEEN UNABLE TO.

>> HI, SPENCER, MY NAME IS MARY.

I'M CALLING ON BEHALF OF INSURE

THE GOOD LIFE.

>> Sreenivasan: AT A MAKESHIFT

CAMPAIGN OFFICE IN OMAHA, ABOUT

A DOZEN VOLUNTEERS ARE MAKING

CALLS IN SUPPORT OF INITIATIVE

427, A BALLOT MEASURE TO EXPAND

MEDICAID IN NEBRASKA.

THE GROUP, INSURE THE GOOD LIFE,

IS BEHIND THE EXPANSION EFFORT

THAT WOULD PROVIDE HEALTH

INSURANCE TO AN ESTIMATED 90,000

UNINSURED NEBRASKANS-- THOSE WHO

MAKE TOO LITTLE TO GET FEDERAL

SUBSIDIES UNDER THE OBAMA-ERA

AFFORDABLE CARE ACT, OR A.C.A.

>> WE'RE VERY EXCITED ABOUT THE

INITIATIVE AND WHAT IT CAN DO TO

HELP THOSE PEOPLE THAT ARE

CAUGHT IN THE COVERAGE GAP.

>> Sreenivasan: ABOUT TEN MILES

AWAY, IT'S A SIMILAR SCENE, BUT

THE MESSAGE IS VERY DIFFERENT.

>> WE WOULD STRONGLY ENCOURAGE

YOU TO VOTE "NO" ON BALLOT

INITIATIVE 427.

>> Sreenivasan: THE NEBRASKA

CHAPTER OF THE CONSERVATIVE

POLITICAL GROUP, AMERICANS FOR

PROSPERITY, OR A.F.P., HAS

GATHERED ABOUT TWO DOZEN

VOLUNTEERS TO ENCOURAGE VOTERS

TO REJECT THE BALLOT MEASURE.

>> AND THEY'RE NOT TELLING THE

PUBLIC WHAT THE WHOLE COST OF IT

IS, AT ALL.

>> Sreenivasan: NEBRASKA IS ONE

OF THREE RED STATES, ALONG WITH

IDAHO AND UTAH, WHERE BALLOT

MEASURES ARE ATTEMPTING TO DO

WHAT REPUBLICAN LEADERS HAVE

NOT: EXPAND MEDICAID UNDER THE

A.C.A.

IN NEBRASKA, INITIATIVE 427

EXPANDS MEDICAID TO COVER ADULTS

WHO MAKE LESS THAN 138% OF THE

FEDERAL POVERTY LINE, ABOUT

$17,000 FOR A SINGLE PERSON, AND

ABOUT $35,000 FOR A FAMILY OF

FOUR.

UNDER THE HEALTHCARE LAW, THE

FEDERAL GOVERNMENT WOULD COVER

90% OF THE COST, BUT NEBRASKA

WOULD HAVE TO PAY FOR THE

REMAINING 10%, ESTIMATED TO BE

ABOUT $125 MILLION IN THE FIRST

THREE YEARS.

>> WHEN YOU REALLY, TRULY START

TO LOOK AT THE NUMBERS, YOU

REALIZE THAT THERE'S NO WAY WE

CAN AFFORD IT.

>> Sreenivasan: JESSICA SHELBURN

IS THE STATE DIRECTOR FOR A.F.P.

NEBRASKA.

>> MEDICAID WAS INTENDED FOR THE

MOST VULNERABLE IN OUR SOCIETY,

SO, THE ELDERLY, DISABLED,

LOW-INCOME CHILDREN, LOW-INCOME

PREGNANT WOMEN.

BY EXPANDING MEDICAID, WE ARE

RISKING THE RESOURCES THAT WE

HAVE AVAILABLE FOR THOSE

INDIVIDUALS, BECAUSE WE'RE GOING

TO HAVE TO COVER POTENTIALLY

90,000 OR MORE ABLE-BODIED

WORKING ADULTS.

>> Sreenivasan: SHELBURN

REPRESENTED THE VOTE NO POSITION

IN A DEBATE THIS WEEK ORGANIZED

BY A BUSINESS GROUP IN THE

STATE'S CAPITAL, LINCOLN.

>> THIS IS SOMETHING THAT, AS IT

GROWS, AND WE SEE MORE

INDIVIDUALS ENROLLING ON

MEDICAID EXPANSION, THE STATE

JUST CAN'T AFFORD.

>> Sreenivasan: HER OPPONENT WAS

STATE SENATOR ADAM MORFELD, A

DEMOCRAT WHO REPRESENTS PART OF

LINCOLN.

>> SO, I THINK THE BETTER

QUESTION IS, IS HOW CAN WE

AFFORD NOT TO DO THIS?

>> Sreenivasan: MORFELD HAS

INTRODUCED TWO BILLS TO EXPAND

MEDICAID.

IN FACT, THERE HAVE BEEN SIX

ATTEMPTS TO EXPAND THE PROGRAM

IN SIX YEARS.

ALL OF THEM FAILED TO PASS THE

LEGISLATURE OR GET THE SUPPORT

OF NEBRASKA'S REPUBLICAN

GOVERNORS.

>> I THINK THAT WHEN IT COMES TO

AFFORDABLE HEALTHCARE, OUR

CONSTITUENTS AND NEBRASKANS WILL

BE EMINENTLY MORE REASONABLE

THAN OUR ELECTED OFFICIALS.

>> Sreenivasan: MORFELD SAYS

EXPANDING MEDICAID WOULD NOT

REQUIRE NEW TAXES.

AS EVIDENCE, HE POINTS TO A NEW

STUDY BY UNIVERSITY OF NEBRASKA

RESEARCHERS FUNDED BY THE STATE

HOSPITAL ASSOCIATION.

IT FOUND MEDICAID EXPANSION

WOULD CREATE NEARLY 11,000 JOBS

AND GENERATE ENOUGH STATE AND

LOCAL TAX REVENUE TO PAY FOR

ITSELF.

CRITICS DISPUTE THAT WOULD BE

THE CASE.

AND EITHER WAY, IF NEBRASKA

VOTERS APPROVE INITIATIVE 427,

THE LEGISLATURE WILL STILL NEED

TO APPROPRIATE MONEY FOR THE

STATE'S SHARE OF THE COSTS.

>> IT BRINGS IN $1.3 BILLION IN

TAXPAYER FUNDS OVER THE COURSE

OF THREE YEARS, THAT NEBRASKANS

ARE ALREADY PAYING INTO THE

FEDERAL GOVERNMENT.

BUT THAT'S GOING TO OTHER

STATES.

>> Sreenivasan: LIKE MANY

DEBATES AROUND THE A.C.A., THE

INITIATIVE TO EXPAND MEDICAID

STIRS UP STRONG FEELINGS.

>> YOU'RE TAKING IT AWAY FROM

THE MOST NEEDY PEOPLE, TO GIVE

IT TO PEOPLE THAT NEED TO GET A

DAMN JOB AND WORK.

>> Sreenivasan: MEMBERS OF THE

PUBLIC TESTIFIED ABOUT THE

BALLOT MEASURE AT A STATE

HEARING THIS WEEK IN LINCOLN.

>> I AM A GOOD EXAMPLE OF WHAT

NOT HAVING ACCESS TO HEALTHCARE

CAN LEAD TO.

>> Sreenivasan: AMANDA GERSHON

DIDN'T HAVE HEALTH INSURANCE FOR

MOST OF HER ADULT LIFE,

INCLUDING WHEN A CHRONIC IMMUNE

DISORDER FLARED UP IN 2013.

>> I HAD BEEN A GENERAL MANAGER

OF A RESTAURANT, PUTTING IN A

LOT OF HOURS, AND STARTED

GETTING INCREDIBLY SICK.

>> Sreenivasan: GERSHON SAYS SHE

PAID CASH TO SEE HER DOCTOR WHEN

SHE COULD, AND WENT TO FREE

CLINICS, BUT GETTING TREATMENT

FOR HER CHRONIC ILLNESS WITHOUT

INSURANCE WAS DIFFICULT.

>> BETWEEN 2013 AND THE

BEGINNING-- UP TO THE BEGINNING

OF 2016, I JUST GOT SICKER AND

SICKER, AND HONESTLY, NO ONE

THOUGHT I WAS GOING TO MAKE IT

AT THAT POINT.

I DID APPLY FOR DISABILITY, AND

WAS BLESSED TO GET THAT.

BUT, THAT'S THE ONLY WAY I COULD

HAVE GOTTEN HEALTHCARE AT THAT

POINT.

>> Sreenivasan: WHEN SHE BECAME

UNABLE TO WORK AND RECEIVED

FEDERAL DISABILITY BENEFITS,

GERSHON QUALIFIED FOR MEDICAID

IN NEBRASKA.

SHE UNDERWENT SURGERY AND GOT

MEDICATION TO MANAGE HER

ILLNESS.

BUT, THE 36-YEAR OLD SAYS SHE

WISHES SHE COULD STILL BE

WORKING.

>> I REALLY BELIEVE IF I COULD

HAVE GOTTEN HEALTH CARE IN 2014,

I PROBABLY WOULD HAVE NEVER

ENDED UP ON DISABILITY.

>> Sreenivasan: DR. KRISTINE

McVEA IS THE CHIEF MEDICAL

OFFICER FOR OneWorld COMMUNITY

HEALTH CENTERS IN OMAHA.

IT SEES MORE THAN 40,000

PATIENTS A YEAR.

ABOUT HALF OF THEM ARE

UNINSURED.

McVEA SAYS CLINICS LIKE HERS

HAVE FEWER RESOURCES THAN THOSE

IN THE 33 STATES AND WASHINGTON

D.C. WHERE MEDICAID HAS

EXPANDED, INCLUDING NEIGHBORING

IOWA.

>> I FEEL LIKE NEBRASKA IS

REALLY FALLING BEHIND.

LOOKING AT IOWA JUST ACROSS THE

RIVER FROM US, THEY HAVE THE

ABILITY TO PROVIDE SERVICES TO

PATIENTS WHO FALL INTO THIS GAP

IN A MUCH BETTER WAY THAN WE DO.

>> Sreenivasan: ADVOCATES FOR

INITIATIVE 427 ALSO SAY

EXPANDING MEDICAID WILL MEAN

MORE FEDERAL AND STATE DOLLARS

TO SUPPORT HEALTHCARE PROVIDERS

IN NEBRASKA, INCLUDING HOSPITALS

AND COMMUNITY CLINICS LIKE

OneWorld.

>> AT BEST, IT IS A BAND-AID TO

FIX THE PROBLEM.

MEDICAID WAS NOT DESIGNED TO BE

A PROGRAM THAT WOULD HELP SHORE

UP OUR HOSPITALS, WHETHER IT BE

IN RURAL OR URBAN AREAS.

>> THE GREAT THING ABOUT LAWS IS

THEY CHANGE TO ADDRESS CHANGING

CIRCUMSTANCES.

AND CURRENTLY, THERE ARE

NEBRASKANS THAT ARE SUFFERING,

AND IN MANY CASES DYING, BECAUSE

THEY LACK AFFORDABLE HEALTHCARE.

>> Sreenivasan: IF NEBRASKA

VOTERS APPROVE INITIATIVE 427,

MEDICAID COULD BE FULLY

IMPLEMENTED IN THE STATE BY THE

BEGINNING OF 2020.