Loren Lippincott
Healthcare costs in Nebraska are surging, mirroring national trends, but are unfortunately amplified by our state’s rural landscape and policy vulnerabilities. In 2023, average family health insurance premiums reached $23,938 — double the inflation-adjusted figure from 2000 — with employees contributing $6,542 on average. When the books close in 2025, the increase is forecast to be 8 percent. For over 135,000 Nebraskans reliant on the Affordable Care Act (Obamacare) marketplace — which includes many low-to middle-income farmers, smallbusiness owners and ranchers — these hikes threaten a “dis-enrollment crisis,” where unaffordability forces coverage gaps.
A primary cause of the premium shortfall is workforce shortages and escalating labor costs. Post-COVID, Nebraska hospitals faced an exodus of staff due to burnout, and workforce expenses have climbed nearly 27 percent since 2020. Many rural critical access hospitals operate at a loss and struggle to attract providers. The Nebraska Hospital Association reports 2024 operating margins at 1.4 percent, far below sustainability levels. This scarcity inflates wages and overtime, passing costs to insurers and patients.
Nationally, McKinsey Global surveys estimates post-pandemic inflation will add $370 billion to U.S. healthcare spending by 2027, with supply chain disruptions hitting Nebraska’s isolated providers hardest. Technological advancements confound the issue. New medical devices, diagnostics and therapies —while improving outcomes — demand higher utilization and reimbursements. Insurers like Blue Cross and Blue Shield of Nebraska cite these as key factors in their 29 percent preliminary rate hikes for 2026 ACA plans. In a state where rural patients travel far for specialized care, adopting costly innovations strains budgets already squeezed in rural areas.
The price of medicine coupled with insurer-provider tensions compounds the problem. “Aggressive practices” from large insurers and Big Pharma negotiate lower reimbursements while drug costs soar, forcing hospitals to offset losses through higher charges elsewhere. Nebraska’s 2025-27 state budget shortfall, now at $471 million, stems partly from a $235 million drop in federal Medicaid matching funds — shifting burdens to taxpayers and providers. Medicaid covers 20 percent of Nebraskans and lagging reimbursements (up just 21.3 percent since 2020 against 26.8 percent cost rises) hit safetynet facilities, like federally qualified health centers, hardest. Meanwhile, Medicaid is 20 percent of our state budget!
On his radio show in 2016, Dave Ramsey questioned the workability of the newlyenacted Obamacare and asked this rhetorical question, “They (Obama White House) fully intended to destroy the health insurance industry and completely put them out of business so that the government would be the only provider of health insurance.” Ramsey went on to say, “They are announcing today a 62 percent increase in premiums for next year. If your blue jeans or a gallon of milk, or a gallon of gas all went up 62 percent people would be storming Washington with pitchforks and torches, but Americans are gonna stand back and look at this and yawn because it’s coming through their companies and they get the bill and they say, ‘Oh my goodness, my health insurance went up, what am I gonna do? I can’t afford my health insurance!’ It is all because of Obamacare. It’s because socialism does NOT work.”
Obamacare caused premiums to increase 80 percent, which translates to $12,000 per year for a family of four. Deductibles have increased 50 percent and the results are worse care and higher costs. The U.S. leads the world in medical innovation, yet has a shorter lifespan than other developed nations. (AFPI.com) Medicaid was meant to lift people up from below the poverty line, however, today there are more people above the poverty line receiving Medicaid than below it. (Senator Ted Cruz, 2025) The federal government spent $2.2 trillion out of $3.8 trillion in mandatory spending on Social Security and Medicare in 2023, according to the Congressional Budget Office. And federal government handout programs account for nearly 70 percent of our federal spending.
What all this shows is that, thanks to Obamacare, America is racing toward socialized medicine. Oh, that we had early heeded the wise counsel of Thomas Sowell who said, “The Welfare State is the oldest con game in the world. First you take people’s money away quietly and then you give some of it back to them flamboyantly.”
Loren Lippincott represents Legislative District 34 in the Nebraska State Senate. Read his column in the Nance County Journal.