The deadline is fast approaching for the Department of Health and Human Services to complete the next step of implementation of Medicaid expansion in Nebraska. A state plan amendment is due to the Centers for Medicare and Medicaid Services by April 1, 2019, as was set forth in ballot Initiative 427, and approved by voters last November.
However, this deadline does little to provide a timeline for enrollment for 94,000 of our hardworking neighbors who continue to fall in the insurance coverage gap. The department has been tepid and allusive about providing a date for enrollment to begin or a detail of benefits.
Nebraskans in the coverage gap continue to work to support their families as employees on our farms, in our small rural businesses, and as caregivers in our elder care facilities. Yet, they are still unable to access the health care coverage they need. Despite their hard work, their incomes fall short of the threshold to qualify for subsidies to purchase coverage from the insurance marketplace, and surpass eligibility requirements for existing Medicaid coverage.
So, too, are our rural hospitals and communities asking when expanded Medicaid coverage will take effect. In the meantime, uncompensated and charity care costs continue to accrue, pushing costs onto all patients and rural hospitals closer to closure. This delay and inaction harms our rural residents and communities.
Nebraska voters have spoken—Medicaid expansion is law. Now it is time for the department to lay out an expedient and efficient program to provide expanded coverage no later than Jan. 1, 2020.