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Nebraska committee hears emotional testimony on LB780, a bill to expand eating-disorder coverage
Summary
LB780 would require Nebraska-regulated health plans to cover diagnosis and all levels of eating-disorder care, including inpatient and residential services; survivors, clinicians and advocates described delays, denials and life-threatening consequences while insurers warned mandates raise costs and apply to a limited share of plans.
Senator George Dungan introduced LB780 on Feb. 24 to require Nebraska-regulated health plans to provide coverage for diagnosis and treatment of eating disorders across the full continuum of care. The bill would prevent insurers from denying or limiting services based on body weight or body mass index and would require nutrition counseling and treatment at inpatient, residential, partial-hospitalization and intensive outpatient levels.
The bill drew extensive, often emotional testimony from survivors and clinicians who said insurance barriers delay life-saving care. Gabriella Swift, Miss Teen Nebraska, told the committee eating disorders are "not choices" and said early treatment saves lives; she cited a Harvard Chan estimate that "approximately 9 percent of Nebraskans, nearly 170,000 people, will experience an eating disorder in their lifetime." Registered dietitian Emily Estes and mental-health clinicians said rural Nebraskans face provider shortages, travel burdens and frequent denials, forcing families to pay out of pocket or travel out of state.
Several speakers described clinical harms from forcing patients to "fail" at lower levels of care before approving higher-intensity treatment. "Eating disorders are life threatening," therapist Haley Pierce said, and denying appropriate levels of care can lead to emergency-room visits and ICU admissions. Testimony from parents recounted cases in which inpatient options were not available in Nebraska and families had to go to Tulsa or Denver for care.
Insurers and trade groups opposed LB780 as a state-mandated benefit rather than opposing coverage itself. Jeremiah Blakey of Blue Cross and Blue Shield of Nebraska said his company already covers eating-disorder services in many cases and cautioned that state mandates apply only to state-regulated plans — "about 19% of Nebraskans," he said — leaving ERISA and federal plans unaffected while shifting costs to taxpayers and some employers. Robert Bell of the Nebraska Insurance Federation urged caution about potential federal defray requirements under the Affordable Care Act for state mandates instituted after benchmark selection.
Supporters urged the committee to weigh human impact and clinical standards. Proponents asked that medical-necessity determinations rely on clinicians with eating-disorder expertise and emphasized that consistent coverage could reduce long-term costs by preventing escalations of care. The hearing record includes multiple survivor accounts and letters submitted in support; the chair closed testimony without a committee vote and moved the bill along in the day's agenda.
The committee recorded written testimony and audience statements; no formal action was taken during the hearing. Next steps for LB780 will depend on committee deliberations and any amendments.
