Is Nelson’s Medicaid Deal A Public Option?

Last week I noticed that sup­port for Sen. Ben Nelson’s spe­cial pro­vi­sion to fully fund Nebraska’s Med­ic­aid expen­di­tures gained sup­port from lib­eral Sen­a­tors for its poten­tial to spread to the rest of the states:

In 2017, as you know, when we have to start phas­ing back from 100 per­cent, and going down to 98 per­cent, they are going to say, ‘Wait, there is one state that stays at 100?’ And every gov­er­nor in the coun­try is going to say, ‘Why doesn’t our state stay there?’” [Sen. Tom] Harkin said. “When you look at it, I thought well, god, good, it is going to be the impe­tus for all the states to stay at 100 per­cent. So he might have done all of us a favor.”

That dream is already com­ing to fruition. Con­necti­cut Gov­er­nor M. Jodi Rell today sent a let­ter to state Attor­ney Gen­eral Richard Blu­men­thal which read, in part:

There­fore, if this bill passes into law in its present form, I am ask­ing you to imme­di­ately pur­sue legal action on behalf of the State of Con­necti­cut to ensure that Con­necti­cut also receives the 100% reim­burse­ment of costs for this under­funded fed­eral man­date.  Our 50 states should be treated equally; no pref­er­ence should be given to one state over another.

Full fed­eral fund­ing for Med­ic­aid expen­di­tures is a key step on the way to func­tional pub­lic health­care. And we have Sen. Nel­son to thank for it. In that sense, he’s used his 60th-​​vote posi­tion well; extract­ing per­son­ally impor­tant con­ces­sions (read: abor­tion) while obtain­ing an appar­ently “spe­cial” fund­ing deal that has national implications.