- Nebraska plans to expand Medicaid eligibility under the Affordable Care Act late next year, but an advocacy group has sued to make implementation occur sooner.
- The suit, filed by the group Nebraska Appleseed, wants expansion to begin no later than Nov. 17 of this year.
- Nebraska’s voters approved an initiative to expand Medicaid eligibility last November.
Nearly a decade after the Affordable Care Act was signed into law, state-level resistance to its implementation remains palpable. Fourteen states have yet to expand Medicaid’s income-based eligibility to 138% of the federal poverty level, and have no plans to do so.
However, there was a breakthrough of sorts last year, when voters in Idaho, Utah and Nebraska voted to expand eligibility (Montanans also voted to keep its expansion in place). Maine’s new governor also expanded coverage this year.
Nebraska’s initiative required the state to submit an expansion plan to the Centers for Medicare & Medicaid Services no later than April 1, 2019. Although state officials complied, the Nebraska Department of Health and Human Services will not expand Medicaid eligibility until October 2020 — nearly two years after the initiative was approved. Moreover, work eligibility requirements will be attached to the estimated 94,000 newly eligible Nebraskans in order for them to obtain full Medicaid coverage.
As a result, Nebraska Appleseed filed suit in state court against state officials earlier this week, claiming officials overstepped their authority by dragging their feet on expansion, and demanding that the implementation occur by Nov. 17 of this year.
The suit claims that Nebraska is not only endangering the health of those who are eligible for coverage by making them wait another 14 months, but that the state is failing in its duty to optimize the flow of federal dollars from the program.
The suit notes that if Medicaid is expanded this year, Nebraska would still qualify for 93% of the cost of the expansion being paid by federal dollars; an amount that shrinks to 90% next year. Moreover, the state is leaving another $149 million in federal funds on the table in 2020 by not expanding Medicaid until the fourth quarter.
The suit does not mention the fact that the ACA’s constitutionality is again being litigated in the federal court system, and it is possible the U.S. Supreme Court could strike down the law even before Nebraska expands coverage.
"Our clients in this suit are two individuals who are eligible for expanded Medicaid coverage and have serious health conditions for which treatment is critically needed. Tens of thousands of Nebraskans are experiencing similar challenges as they wait for coverage," said James Goddard, Director of Appleseed’s Economic Justice Program, in a statement. "This suit seeks to ensure our family members, friends, and neighbors receive Medicaid coverage this year and that Nebraska tax dollars are brought back to support our healthcare system."