$130 million

Amid several maneuvers used by the Appropriations Committee to send a balanced budget to the legislative floor for debate next week was a $130 million transfer from the state’s cash reserve. This will be in addition to the $152 million transfer from the reserve approved in 2025, set to take effect at the end of the biennium in 2027. 

The state has both a minimum reserve and a Cash Reserve Fund. The state’s minimum reserve is a statutorily-required buffer within the General Fund, amounting to 3% of spending for the biennium. In unforeseen circumstances, these reserves ensure that the state has the cash flow to pay its bills from month to month. The Cash Reserve Fund is intended to help the state weather economic downturns. A strong cash reserve, or “rainy day fund,” positions the state to manage future economic uncertainty. The Cash Reserve Fund can be replenished when tax revenue exceeds projections, or at the discretion of the Legislature.

The Appropriations Committee also voted to advance several other spending reductions to the body for consideration, including a $6 million investment in biomedical research and an $11 million transfer from the Nebraska Environmental Trust to the General Fund. The full budget package is due to begin debate on March 9. 

228

In an analysis of downstream effects of Medicaid cuts from  H.R. 1, known as the One Big Beautiful Bill Act, the Flatwater Free Press estimates that 228 Nebraska child care providers may lose health care coverage in coming years. A higher percentage of child care workers are enrolled in Medicaid than the general adult population, meaning cuts and additional paperwork requirements will hit the industry particularly hard. Around 13% of child care workers in Nebraska reported that they used Medicaid in 2023, the most recent year data is available. That number was up from 11% in 2019.

Child care workers, particularly those who are self-employed, may be forced to shutter their businesses in order to take jobs with employer-sponsored health care benefits, according to the Century Foundation, who offered insight for the Flatwater Free Press coverage. They outlined a chain reaction where 1 in 5 seniors could lose nursing home care, both due to the coverage loss and closures due to reduced revenue. Then, a provider may leave to care for a parent or other older adult due to the loss of care, resulting in multiple families losing child care, to the point where one parent in those families must leave the workforce. The economic impact due to lost wages and workforce participation could be substantial. The Buffett Early Childhood Institute projects a $335 million economic loss over 10 years in the Omaha metro area alone, the result of nearly 4,500 children being unable to access care. 

$75,000

Hiring incentives of up to $75,000 may be available to individuals willing to live and work in health care professions in rural areas, including those in Nebraska. The funds are part of the Rural Health Transformation Fund, passed as part of H.R. 1. They would be part of the $88 million earmark for mitigating staffing challenges, which also include relocation subsidies and housing assistance. 

Rural healthcare workforce challenges were cited as a reason for the recent change from a level II to level III trauma center at Regional West Health Services in Scottsbluff. Though hospital leaders communicated that the change would impact a small portion of patients who have a need for speciality services, the downgrade will leave the Panhandle without a level II trauma center, with the nearest available level II being in Cheyenne, Wyoming, and Rapid City, South Dakota, according to reporting by Nebraska Public Media. 

These choices may become more common according to Jed Hansen of the Nebraska Rural Health Association, who shared that Medicaid reductions and the failure to extend premium tax credits to make healthcare marketplace insurance plans more affordable will cause rural hospitals to struggle to keep their operations afloat. Unlike staffing, the Rural Health Transformation Fund cannot be used to address shortfalls due to Medicaid cuts. 

For more on the Rural Health Transformation Fund, check out OpenSky’s Lillian Butler-Hale on the Dan Parsons podcast. Make sure to subscribe for weekly updates.