Nebraska abandons two-tier benefit plan for Medicaid, standardizes care

Rural Health

Last fall, nearly two years after voter approval, Nebraska expanded Medicaid coverage to adults earning less than 138% of the federal poverty level, or about $17,000 per year. 

While this was good news to tens of thousands of Nebraskans caught in the “coverage gap,” where they neither qualified for Medicaid nor could afford insurance on their own, some services were delayed as the state sought special permission from the federal government to create a two-tiered system of benefits. Under that system, some beneficiaries would receive a stripped-down level of care, and others would receive a “prime” level by participating in a variety of programs. This would require a complex bureaucratic structure creating more red tape and costing more money to administer.

After being notified the federal government would not approve this new requirement, the state withdrew its application. This means all Medicaid beneficiaries will receive the standard benefits starting Oct. 1. The state will still provide access to, and recommend, programs to assist Medicaid users in finding gainful employment, however.

This is a better route for efforts to promote life success and self-sufficiency. Rather than split beneficiaries into two groups with lesser or greater levels of care, this change will limit spending on bureaucratic costs while ensuring a standard level of treatment across all beneficiaries. At the same time, it will still provide access to important job-training services. This is a more efficient way to run the program, all while supporting families and encouraging progress toward self-sufficiency.