LINCOLN - More than 100,000 Nebraskans have lost their job-related health insurance due to economic fallout from the coronavirus pandemic, and pressure is mounting for state officials to finally implement the Medicaid expansion approved by voters in 2018.

Sarah Maresh, staff attorney for the group Nebraska Appleseed, said expanding coverage would help protect the health of all Nebraskans, because when people don't have insurance, they are less likely to get tested.

"And we know that when folks have coverage and they're able to get care without concerns of financial ruin, they are more likely to seek out care and get the care they need," said Maresh, "especially in the middle of this pandemic."

That view is borne out by the latest research from the health-care advocacy group Families USA.

While other states expanded Medicaid coverage in eight to 12 months, Nebraska's planned Oct. 1 rollout comes nearly two years after voters approved expansion.

Enrollment is expected to begin in August. State officials have said the delay is necessary to improve technical capacity for enrollment and filing claims, and to seek federal approval for a waiver that would add work requirements and other provisions.

Maresh stressed that loss of health coverage can be devastating for local economies, especially in rural parts of the state, where hospitals -- as economic engines and primary employers -- face the prospects of bankruptcy. Hospitals and other care facilities are expected to see a spike in uncompensated care when people without insurance can't pay their bills.

"But when Medicaid is brought in as the payer, it's particularly important, because they are a guaranteed payer," she explained. "And those hospitals that are working so hard as front-line providers on this pandemic are able to get financially compensated for it."

Maresh said the majority of people who lost job-related coverage between March and May of this year would be eligible for Medicaid coverage, along with an estimated 90,000 Nebraskans who were eligible before the pandemic.

She added that expansion would bring hundreds of millions of dollars that Nebraskans already have paid in federal income tax back to the state. The move also is projected to create 10,000 new jobs.