Nelson: Medicaid exemption was only 'placeholder'

Nebraska Sen. Ben Nelson (D) is asking Senate Democrats to remove from their healthcare bill a guarantee that his state would not have to pay for its new Medicaid patients.

Although Senate Majority Leader Harry Reid (D-Nev.) added the exemption to the bill to court Nelson's much-needed vote in December, the Nebraska senator stressed on Friday that his party should instead nix his own "special deal."

He said the exemption was always envisioned as a "placeholder that would be removed" once the House and Senate combined their bills; a stepping stone for a better provision that would allow any state to opt out of the healthcare legislation's proposed Medicaid expansion.

"I believe I have been clear that my intentions during all stages of negotiations were not that the State of Nebraska be given a special deal, but rather that all states be given the same tools to address an unfunded federal mandate," Nelson said in a letter to Reid.

Nelson's position switch on the so-called deal -- which Republicans have derided as the "Cornhusker Kickback" -- follows weeks of intense political pressure from all sides in the healthcare fight.

At the beckoning of Nebraska's governor, Nelson initially asked Democrats to create an "opt out" clause for states whose financial situations may have precluded their participation in the expanded entitlement program. Democrats instead offered solely Nebraska an exemption from that expansion, which ultimately won Nelson's vote.

But the deal proved instantly and politically noxious to both Nelson's own constituents and party members. Republicans frequently cite the exemption as evidence that Democrats have filled their healthcare legislation with nefarious projects. Some Democrats, similarly fearful of what the Medicaid expansion might mean for their states, have even asked for its exclusion from the final bill.

Concern about the deal's lasting impact on Nelson's political career even prompted the senator to run a lengthy advertisement during college football's Bowl Championship Series, in which he explained to voters his decision to support Democrats' reforms. Nelson's poll numbers, however, continue to lag.

Consequently, Democrats are likely to nix Nebraska's exemption during their informal conference negotiations. But whether negotiators replace that language with another Medicaid provision targeting all states -- and how that may effect Nelson's support -- remains to be seen.

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