As we approach the next legislative session, discussions about the state budget will continue to intensify. Some have proposed across-the-board spending cuts to address our expected budget shortfall. Broad, sweeping cuts may be politically appealing, but good budgeting isn’t about cutting everything equally—it’s about cutting wisely. This week, I’d like to highlight the Nebraska Prescription Drug Donation Program as an example of why targeted budgeting produces better results.
Full disclosure—I introduced the bill that created the Nebraska Prescription Drug Donation Program. It was enacted through LB1035 in 2024 and officially launched on July 1, 2025.
This program is simple. Unexpired prescription medications in tamper-evident packaging, such as blister packs, can be donated and provided at little or no cost to uninsured or underinsured Nebraskans with incomes at or below 200 percent of the federal poverty level.
The idea came from one of my constituents, Dr. Twila Fickle, who shared Iowa’s successful program with me. Rather than creating an entirely new state bureaucracy, Nebraska partnered with Iowa’s established SafeNetRX program. Nebraskans had long been able to donate eligible medications to SafeNetRX, but until the passage of LB1035, those same medications could not be redistributed to Nebraskans who needed them. That changed with this legislation.
Why does this matter?
Last year alone, Nebraska taxpayers spent more than $72 million on prescription drugs through Medicaid and the Children’s Health Insurance Program (CHIP). Nebraska’s share of these costs has steadily increased, and recent federal policy changes are shifting even more responsibility to the states. Programs that reduce healthcare costs without sacrificing care are exactly the kind of investments we should protect.
The need is also significant. Last year, 43 percent of Americans reported not filling a prescription because of cost. When people cannot afford preventive medications, many eventually require emergency care. Hospitals are required to provide that care regardless of a patient’s ability to pay, and those uncompensated costs ultimately contribute to higher healthcare expenses for everyone.
Perhaps the strongest argument for continuing this program is that it is already paying for itself. During its first nine months of operation, the Nebraska Prescription Drug Donation Program generated more than $575,000 in savings while costing the state approximately $475,000 to operate. Fourth-quarter figures are still pending, and I expect the savings to grow even further. Few public investments recover their costs in the first year.
Iowa’s experience shows what is possible over the long term. After nearly two decades of operation, SafeNetRX now generates healthcare savings measured in the tens of millions of dollars. Last year alone, the program produced approximately $41 million in savings while serving more than 160,000 Iowans. As participation grows in Nebraska, there is every reason to believe we can achieve similar success here.
The Prescription Drug Donation Program is exactly the type of investment that deserves continued support. It saves taxpayers money, reduces healthcare costs, and helps Nebraskans get the medications they need to live healthier, more productive lives. Those benefits may not always fit neatly on a balance sheet, but they are real—and they are worth protecting.
As always, if I can be of assistance to you in any way, please do not hesitate to contact my office. My staff members – Matt and Katie – are available to assist you with your needs and they pass along messages, so if you’d like a call back, please let them know!
Email: jana.hughes@leg.ne.gov
Phone: 402-471-2756
Facebook: Senator Jana Hughes
