This is the legislative update for March 14, 2022. View all updates here.
- Congress passed a $1.5 trillion omnibus appropriations bill to fund the government through the end of the current fiscal year.
- The Nebraska State Legislature is working to pass the mid-biennium budget proposal.
- Children’s is monitoring several bills that would impact pediatric care.
- Nebraska is about to lose 14 of 49 state senators, mostly due to term limits. The 2022 midterm elections are approaching.
- The Omaha City Council will hold a public hearing on a proposed ordinance that would remove epidemic decision-making powers from the city health director, in the wake of mask mandates during the COVID-19 pandemic.
The March 14, 2022 legislative update includes highlights from federal, state, and local legislatures.
Just ahead of the weekend, Congress passed a $1.5 trillion omnibus appropriations bill (Translation: A package of budget measures and policy changes consolidated under one single bill) that would fund the federal government through the end of the current fiscal year. The continuing resolution (CR) was set to expire March 11 at midnight.
At the final hour, House Democrats pulled $15 billion in COVID-19 preparedness funding that had been attached to the omnibus package when some lawmakers expressed concerns about spending offsets for the new funding. This week, the House plans to vote on a separate bill with the COVID-19 preparedness funding without the controversial offsets, but its prospects in the Senate are uncertain.
The 2,000 page budget contains significant provisions for healthcare:
- Extending and expanding telehealth flexibilities for 151 days after the end of the COVID-19 public health emergency.
- Adopting flexibilities similar to those already maintained in Nebraska, like expanding the originating site and extending coverage for audio-only telehealth services.
- Expanding eligible practitioners for telehealth services to include audiology and occupational, physical, and speech therapies.
- Requiring The Medicaid and CHIP Payment and Access Commission (MACPAC) to study the expansion of telehealth and requiring Health and Human Services (HHS) Secretary to publicly post telehealth utilization data.
- Cyber Incidents:
- Requiring hospitals and health systems to report cyber incidents within 72 hours and any ransomware payments made within 24 hours to the Cybersecurity and Infrastructure Security Agency at the Department of Homeland Security.
- Public Health Service Act:
- Providing grants to train health care professionals about perceptions and biases; support states and tribal organizations for integrated health care services, and instruct HHS to include pregnant and postpartum women as part of their public awareness campaign.
- 340B Eligibility:
- Protecting certain 340B hospitals that lost their 340B eligibility due to a drop in their disproportionate share hospitals (DSH) adjustment percentage below the required threshold for 340B eligibility to gain limited access to the program.
- HHS will receive $108.3 billion — an increase of $11.3 billion:
- $4 billion budget to the Centers for Medicare and Medicaid Services (CMS) — an increase of $50 million.
- $1 billion to establish the Advanced Research Projects Agency for Health (ARPA-H) to accelerate the development of scientific breakthroughs for diseases like cancer and diabetes.
- $45 billion to the National Institute of Health (NIH) — an increase of $2.25 billion — with a focus on cancer.
- $8.5 billion budget for the Centers for Disease Control and Prevention (CDC) — an increase of $530 million — to invest in the nation’s public health infrastructure, including data collection and monitoring.
- $6.5 billion for the Substance Abuse and Mental Health Services Administration (SAMHSA) — an increase of $530 million — to invest in mental health programs, specifically for youth.
- $8.9 billion budget for the Health Resources and Services Administration (HRSA) to improve access to care in underserved communities, develop workforce, and improve maternal and child health outcomes.
Monday, March 14 is the 41st day of 60 in this legislative session. (If you are struggling to adjust to daylight savings, you’ll be happy to know the legislature advanced a bill to remove daylight savings in Nebraska in the first round of debate today!)
On Friday, Speaker of the Legislature Mike Hilgers (R-Dist. 21, Lincoln) outlined this week’s debate to ensure quality time is available for budgetary discussions. On Tuesday, the body will debate the mid-biennium budget proposal released Friday by the Appropriations Committee.
The bill includes a favorable 15% provider rate increase (originally intended to be 10%) for nursing homes, behavioral health, developmentally disabled and child welfare totaling $54 million.
The other big winner in the budget was the work done by the STAR WARS Committee. The Committee is focused on the investment of recreational attractions, like developing a marina at Lake McConahauey and a lake between Lincoln and Omaha. $450 million of un-earmarked funds were set aside for other great ideas that are coming to the floor.
The bill also includes:
- LB792, a bill to invest in the Youth Rehabilitation Treatment Center in Kearney
- LB1071, a bill to invest in rural workforce housing
- A request from Nebraska Medicaid for $20 million ($114 million federal) to finance the increased Medicaid cases due to the continuous eligibility requirements during the public health emergency (PHE).
- When the PHE ends, the enhanced Federal Medical Assistance Percentage (FMAP) will end, but case volume will remain high until the agency evaluates eligibility for Medicaid for all enrollees.
Children’s will be in the rotunda to ensure passage of the budget all week.
Lawmakers voted 45-0 to advance Senator Kolterman’s LB698 — a bill to require Medicaid coverage for continuous glucose monitors (CGMs). LB698 would require the Department of Health and Human Services (DHHS) to provide Medicaid coverage for the devices by January 1, 2023.
Senator Kolterman said that Nebraska is one of five states that does not require Medicaid to cover the monitors — monitors which enable an individual with diabetes to be aware of their blood sugar level constantly. HHS Committee Chair Arch addressed the cost of the bill, explaining the state could see reduced costs and better health outcomes for diabetic Nebraskans if they have fewer emergency room visits due to sudden changes in blood sugar levels. The bill is on Final Reading and will have one more round of debate before the Governor signs it into law.
Children’s supported this bill to reduce hospitalization related to uncontrolled blood sugars and diabetes complications.
Senator DeBoer’s LB741 — a bill that would expand state review of child deaths to allow inclusion of stillbirths — was given first-round approval by the Legislature. It would allow the State Child and Maternal Death Review Team to review stillbirths to help identify preventable causes of stillbirths.
The HHS Committee amended LB741 to add provisions of Senator Vargas’s LB626 to separate the State Child and Maternal Death Review Team into the State Child Death Review Team and the State Maternal Death Review Team. Each group would submit an annual report to the Legislature.
Dr. Anderson Berry testified in support of this bill on behalf of Children’s and it would allow the State Child and Maternal Death Review Team to review stillbirths to help identify preventable causes of stillbirths.
Senator Lynn Walz’s LB905 — a bill focused on mental health disorders in pregnant women and new mothers — advanced on the consent calendar Monday (the first of three rounds of debate). If the bill passes, Nebraska will develop a validated screening tool for perinatal depression, which will also be administered by providers at the infant’s well-child checkups up to the 12 months of their life. A referral network may also be implemented in the instances where a mother screens positive for depression or anxiety.
Dr. Ann Anderson-Berry and Dr. Mel St. Germain testified on behalf of Children’s in support of this legislation.
Senators voted to advance LB1073 — a bill that would require Governor Ricketts to apply for $120 million in a second round of emergency rental assistance available to states through the American Rescue Plan Act (ARPA), as well as any future federal assistance programs during a public health emergency (PHE).
There has been growing contention about accessing these funds. Nebraska is currently one of only two states to not apply for a second round of funding, which means the program will end in the fall of this year. The federal government has extended the deadline to March 30th to give states another opportunity to apply and extend the program to 2025.
The debate was mostly positive, especially from Senator Stinner, chair of the Appropriations Committee. He pointed out that it is fiscally irresponsible to not access these funds when the committee already has almost $4 billion in requests to spend the state’s existing $1 billion in ARPA funds. However, some senators still doubted the need for additional rental assistance, especially in rural areas.
2022 Midterm Elections
There is a sad reality setting into the legislative body: We are about to lose 14 of 49 state senators, mostly due to term limits.
In fact, that number could increase if sitting senators are successful in their external races:
- Speaker Mike Hilgers is running for Attorney General with the endorsement of Governor Ricketts
- Senator Mike Flood (R-Dist. 19, Norfolk) and Senator Patty Pansing Brooks (D-Dist. 28, Lincoln) are contesting incumbent Congressman Jeff Fortenberry for the 1st congressional district. Flood has the endorsement of Governor Ricketts and former Governor Dave Heineman.
- Senator Tony Vargas (D-Dist. 7, Omaha) is running against Congressman Don Bacon for the 2nd congressional district race.
- Newly appointed Senator Mark Jacobsen (R-Dist. 42, North Platte) will also need to be officially voted into his district. He was recently appointed by the Governor when former Senator Mike Groene resigned.
Senator Steve Lathrop (D-Dist. 12, Omaha) and Senator Tim Gragert (R-Dist. 40, Creighton) have decided not to seek a second term in office.
The 12 senators we are losing to term limits include:
- Senator Robert Hilkemann (R-Dist. 4, Omaha)
- Senator Brett Lindstrom (R-Dist. 18, Omaha)- gubernatorial candidate*
- Senator John McCollister (R-Dist. 20, Omaha)
- Senator Mark Kolterman (R-Dist. 24, Seward)
- Senator Matt Hansen (D-Dist. 26, Lincoln)
- Senator Patty Pansing Brooks (D-Dist. 28, Omaha
- Senator Curt Friesen (R-Dist. 34, Henderson)
- Senator Dan Hughes (R-Dist. 44, Venango)
- Senator Adam Morfeld (D-Dist. 46, Lincoln)
- Senator John Stinner (R-Dist. 48, Gering)
This is a truly collaborative and bipartisan group, and we will certainly miss their comradery and their expertise.
As we look ahead to the midterm elections in November, we now know which candidates we have for each office. Please let Liz Lyons know if you have connections with any of these candidates outlined here.
Save the Date: Tune in Thursday, March 24 at 7pm to watch the Nebraska Gubernatorial Debate broadcast on Nebraska Public Media!
Nebraska’s Primary Election is May 10, don’t forget to register to vote!
Omaha City Council
On March 29, the Omaha City Council will hold a public hearing on a proposed ordinance that would remove epidemic decision-making powers from the city health director. The decision is a result of the most recent Omaha mask mandate applied by Douglas County Health Director Lindsay Huse.
Councilman Vinny Palermo and Omaha Mayor Jean Stothert are seeking the opportunity — in a future epidemic — to create a new epidemic health director whose orders could be vetoed by the mayor.
(Sources: CHA, AHA, NHA, Nebraska Chamber, Congress.gov, Nebraska Legislature, World Herald, Peetz & Co.)