Nebraska Department of Health and Human Services officials told state senators Thursday that the nearly two-year delay in launching the expansion of Medicaid coverage directed by Nebraska voters was based on a determination to "take the time needed to do this right."
That was the message delivered by Matthew Van Patton, director of the Division of Medicaid and Long-Term Care, to members of the Legislature's Appropriations and Health and Human Services committees.
The department "met the only deadline in the initiative" enacted by Nebraska voters last November, Van Patton said. That was the April 1 deadline for submitting a state plan to the federal Centers for Medicare and Medicaid Services.
The launch date for extending coverage to an estimated 88,600 newly eligible adults, nearly all of whom work at low-paying jobs, is scheduled for Oct. 1, 2020, or 23 months after Nebraska voters approved Medicaid expansion.
Average income for the new recipients is estimated at $16,000 a year.
There will be "no so-called work requirement to receive basic coverage," Van Patton told the senators. But the state is creating a two-tier system that builds in "wellness and life success incentives" to receive and retain what is identified as "prime coverage," beyond the basic health care coverage.
Prime coverage includes dental and vision services, and over-the-counter medications.
Each recipient's eligibility will be redetermined every six months.
Sen. Anna Wishart of Lincoln questioned whether creation of a separate Medicaid program, along with "hurdles" for those recipients to clear, equates into additional staff and new costs that would not have been necessary if the state had simply expanded its current Medicaid program.
"It's more costly to the state than utilizing the current structure," she said.
Van Patton said the new recipients represent "a new population" that differs from current Medicaid recipients, who are largely children, the elderly and people with disabilities.
Sen. Tony Vargas of Omaha said it seems like the new system "creates more hoops for people to walk through" in order to receive the coverage approved by Nebraska voters.
The new system provides what was described as "community engagement requirements" and "personal responsibility and wellness activities" designed to help recipients lead "a productive life."