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Nebraska opens up Medicaid expansion, drops plan for restrictions
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Nebraska opens up Medicaid expansion, drops plan for restrictions

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The Biden administration is planning to eliminate Medicaid work requirements. According to reports, it will reverse policy from the last administration that allowed states to require people to do some form of work to be eligible for Medicaid.The Trump administration said the work requirement helped people move away from reliance on the health program so they could get jobs where employers cover health care.The Supreme Court is currently looking at a case about those requirements. Last month, President Biden signed an executive order aimed at removing barriers to getting Medicaid coverage. 

State officials announced Tuesday that all Nebraskans covered by the Medicaid expansion program will get the full range of benefits, starting Oct. 1.

State officials have estimated that eventually 90,000 Nebraskans will sign up for the program.

The decision represents an about-face for Gov. Pete Ricketts’ administration and comes on the heels of a shift in policy from the Trump to Biden administrations. Ricketts had been pursuing a two-tier system of coverage since voters approved Medicaid expansion in November 2018.

Under Ricketts’ original plan, most low-income, working-age adults were to get a limited set of benefits, which included physical and mental health care and prescription drugs.

To get dental, vision and over-the-counter medications, which are covered under traditional Medicaid, applicants would have had to comply with several wellness, personal responsibility and community engagement requirements. The latter included working, volunteering or doing other specified activities for 80 hours a month.

Tuesday’s announcement means the state will provide the additional benefits without additional requirements.

State Sen. Adam Morfeld of Lincoln, who led the petition drive that put Medicaid expansion on the ballot, welcomed the announcement but noted the delay in reaching that point.

The Trump administration gave initial approval to Ricketts’ two-tier plan in October last year.

But President Joe Biden’s administration made clear early this year that it would not approve the community engagement requirements.

Biden team looking to block Medicaid work requirements in Nebraska

In a Feb. 12 letter, federal Medicaid officials said the community engagement requirements “would not promote the objectives of the Medicaid program” and that the other requirements were under review.

At the time, state Medicaid Director Kevin Bagley said the state would halt the implementation process for the requirements. That left the majority of Medicaid expansion patients with no way to get the additional benefits.

State pushes back on objections to Medicaid work requirements
Health advocates file lawsuit challenging Nebraska's two-tier system for Medicaid expansion

On Tuesday, even as they announced dropping the requirements, Nebraska officials described them as “a critical part of the program designed to encourage gainful employment and other opportunities.”

Although Nebraska voters approved Medicaid expansion in November 2018, the Nebraska Department of Health and Human Services did not launch the program for almost two years, the longest delay in the nation.

Coverage began in October last year. Through April, a total of 41,640 Nebraskans had enrolled in Medicaid expansion, including 31,163 who got only the basic tier of coverage.

Expanded Medicaid offers coverage for working-age adults whose incomes fall below 138% of the federal poverty level — $17,774 for a single person or $36,570 for a family of four.

The state has provided a full range of benefits to some groups covered under Medicaid expansion. Those are pregnant women, people considered medically frail and young adults ages 19 and 20.

Filibuster derails bill expanding services for developmentally disabled Nebraskans

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