Sen. Mary Landrieu got the "Louisiana Purchase." Sen. Ben Nelson got the federal government to pick up most his state's future Medicaid tab -- forever.
As part of the deal to win Nelson's support, the federal government will pay for Nebraska's new Medicaid recipients. It's a provision worth about $45 million over the first decade.
Medicaid is usually paid for with a mix of federal and state funding, but Nelson's carve out means that any Medicaid beneficiaries who join the program after the bill passes will be paid for in full by the federal government.
It's a sweet deal considering that many governors are worried that the Medicaid expansion will further strain already stressed state budgets.
The deal is emblematic of the kind of horse trading that gets done to win votes on any landmark piece of legislation. Senate Majority Leader Harry Reid sent $300 million in Medicaid funds to Louisiana as a sweetener to secure Landrieu's vote to begin debate on the bill.
Nelson would not comment on the provision, saying that he would leave it to Reid to discuss details.
"I'm comfortable it is taken care of," he said of his state.
Reid defended Nebraska's special treatment saying, "You’ll find a number of states that are treated differently than other states. That’s what legislating is all about. It's compromise." (continues here)