Nebraska state senators join national leaders in push for extending ACA credits, reversing health care cuts

By Jackie Ourada, Nebraska Public Media

(November 5, 2025)

Several democratic state senators this week teamed up with national heavy hitters in an effort to pressure Senate Republicans on federal health care changes. They’re looking to extend enhanced tax credits for people enrolled in the Affordable Care Act and reverse sweeping health care cuts made under President Trump’s One Big Beautiful Bill passed over the summer.

During a Zoom call with U.S. Sen. Amy Klobuchar (D-MN) and U.S. Sen. Peter Welch (D-VT), Sen. Machaela Cavanaugh said Tuesday that her constituents are tired of partisan politics and want to see Republicans come to the table to discuss the tax credits.

“This is about health care for everyone,” Cavanaugh said. “We should be coming to the table and discussing how we can have both an open government and health care for the people of Nebraska and this country.”

The federal government remains shut down more than a month after the Senate failed to pass a short-term funding bill on Oct. 1. Senate Democrats are refusing to sign on to the funding agreement unless lawmakers extend the ACA-enhanced tax credits, which are set to expire at the end of this year. Nebraska Republican U.S. Sen. Pete Ricketts said in late October that “there's nothing to negotiate, because they should just vote to open up the government.”

About 127,000 Nebraskans are enrolled in the ACA Marketplace and receive advanced premium tax credits. The average monthly payment sits around $602, but can vary depending on income levels and age. According to KFF’s analysis, if premium tax credits expire, those monthly $602 payments could jump to payments of several thousand dollars.

Analysis from KFF, a nonpartisan health policy research nonprofit, shows Nebraskans living in the mostly rural 3rd Congressional District, represented by Republican Adrian Smith, will see the most significant jump in the state when it comes to individual premium costs.

KFF found that a 60-year-old couple in the 3rd Congressional District who makes $85,000 would see their monthly ACA premium payment jump 434% – turning their $602 monthly payment into $3,216, if the enhanced tax credits expired. Similar sticker shock could happen in the 1st and 2nd Congressional Districts. According to KFF’s analysis, monthly premium payments with enhanced subsidies for an average 60-year-old couple could jump to $2,988 (396%) or $2,858 (375%) in CD1 or CD2, respectively.

For a 40-year-old Nebraskan who makes $32,000, rates would jump from $58 to $180 a month across all congressional districts in Nebraska.

While nearly every Nebraskan enrolled in the health insurance program would see an increase to their monthly payment, Nebraskans living above the poverty line would see more drastic jumps. KFF’s Lynne Cotter, who helped conduct the analysis, said this could include farmers or small-business owners. And since small-business owners with fewer than 50 employees aren’t mandated to provide health insurance, it could affect many small shop employees.

Audrey Horn, a health care advocate who lives in Omaha, talked in the Zoom roundtable with Cavanaugh, Klobuchar and Welch about her premium payments increasing. Horn and her husband rely on health coverage from the Affordable Care Act, since her husband works for a small construction business.

“We’re going to have to figure it out, right?” Horn said. “We have to have insurance. I have been calling and trying to get [lawmakers] to listen for months and months, and I feel like they have not listened.”

Horn and her husband have relied on the ACA, also known as Obamacare, since 2019. In her statement she received a few weeks ago, Horn said their bronze plan premium increased $688 to put her monthly payment at $2,433.27.

“We don’t know how much of that $2,433 we’re going to have to pay for insurance, but I think anyone knows that if you’re a regular middle class person and you have a bill that increases on a monthly basis [by] $688, that’s going to throw your budget totally out of whack,” Horn said.

In a separate news call held on Tuesday by Nebraska For Us, State Sen. John Fredrickson joined former Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure to discuss the expiring tax credits and cuts made to Medicaid under the One Big Beautiful Bill. The Center on Budget and Policy Priorities estimates the law will result in up to 15 million more people without health insurance in 2034 and cuts $1 trillion in health care spending through 2034.

“That’s the largest cut that we’ve seen in our nation’s history,” Brooks-LaSure said. “The massive cuts the congressional Republicans made to the Medicaid program will have ripple effects that could push Medicaid enrollees, like children with disabilities, adults juggling multiple jobs, and old Americans who rely on home and community-based services, as well as our health care system and state budgets, to their breaking points.”

Nebraska leaders pointed several times to the abrupt closure of a medical center in rural southwestern Nebraska. The CEO of the Community Hospital, which ran the Curtis Medical Center, said at the time that, “the current financial environment, driven by anticipated federal budget cuts to Medicaid, has made it impossible for us to continue operating all of our services, many of which have faced significant financial challenges for years.”

Analysis by Nebraska Appleseed, a nonprofit organization that advocates for affordable health care, showed Medicaid cuts could cause Nebraska to lose up to $4 billion in federal Medicaid funding over the next 10 years.

Fredrickson speculated on the call that if hospitals lose subsidies, it’s “very likely” that private insurers are going to increase their premiums for consumers who are covered by the private industry.

“This thinking, or this narrative, that this is only going to impact certain populations of folks, I think, is misguided in that we’re all in this same boat together,” Fredrickson said. “Big picture, long run, we’re all going to be impacted by this. We’re hearing from clinics about the possibility of them reducing services that they provide, and again, these are critical services – things like maternal health, things that are essential for people who are living in these areas to have access to.”