Last week, the Nebraska Department of Health and Human Services (DHHS) released its State Plan Amendment for expanding Medicaid, revealing a process that is contrary to the intent of Nebraska voters and the health of hard-working Nebraskans.
In the five months the department has had to draft its plan, it arrived at an approach that would delay Medicaid coverage for nearly two more years and institute a complicated tiered benefits package.
During my service as a state senator, I spent years working to expand Medicaid for the thousands of Nebraskans unable to get health care coverage. I received letters, emails, and phone calls from people across the state who had a diagnosis of cancer, diabetes, high blood pressure or other acute illnesses.
They needed consistent, on-going treatment, a medical home. Some utilized hospital emergency rooms, the most expensive care. Often, others waited too long before seeking care which led to far more expensive care and treatments.
It’s unconscionable that the health care coverage gap has gone unaddressed in our state for multiple years. There can be no debate this delay has led to loss of lives, compromised quality of life and a heavy financial burden on our health care system.
When voters passed Initiative 427 last November, the shadow cast by these consequences of inaction began to lift.
A healthier future for our hardworking neighbors and our state was finally in sight. The people elected to expand health care access for 90,000 of their fellow Nebraskans and bring nearly $600 million in federal funding back home to support our economy and strengthen our overall health care system.
Thirty-four other states have chosen more efficient and direct routes to expand Medicaid for their residents. This is not to imply that Nebraska is not unique, but on the issue of managing our health care system, we have the capability to create and execute a Medicaid expansion plan that is just as efficient as those developed by our peers.
In my years as chair of the Legislature’s Health and Human Services Committee, I gained significant insight into DHHS and have confidence that the agency has the ability to move much faster on Medicaid expansion implementation than its current plan would seem to indicate.
Department leaders have stressed that Medicaid be implemented carefully and methodically. On that, I agree; however, a careful and methodical implementation is not mutually exclusive to moving forward with urgency and efficiency. The vote of the people should dictate a number one priority be given to its implementation.
Over the course of three legislative sessions, I introduced three different versions of Medicaid expansion. During debate on the bills, time and again, colleagues urged simplicity to the plan. Easier for participants to understand and follow, more efficient to administer. I believe that it what the voters wanted and assumed in the ballot issue.
The complicated tiered benefits structure proposed by DHHS creates unnecessary barriers for people in need of health care. The complex tiered structure would require significant administrative costs and lock Nebraskans out of higher levels of care for months at a time if they are not engaging in certain activities.
The proposed structure also challenges people’s ability to access a better health package by establishing requirements voters did not authorize. The overriding goal should be to improve people’s health and their productivity -- and enable them to care for their families.
The best way to support a path of wellness for Nebraskans in the coverage gap is to allow them to participate in health care open enrollment this year, so that they can begin 2020 with the coverage they have waited seven years to access.
I believe it prudent for DHHS to alter its course and implement direct Medicaid expansion by Jan. 1, 2020, as voters elected and as the Legislature has budgeted.