Implementing Medicaid Expansion in Nebraska

Rural Health
Click the image to download.

Last year, voters accomplished what the Legislature could not—the expansion of Medicaid coverage for 90,000 Nebraskans in the insurance coverage gap. These residents earn too little to qualify for subsidies to purchase coverage from the insurance marketplace and too much to qualify for traditional Medicaid.

  • This newly eligible population is between the ages of 18 and 64, and earns an income at or below 138 percent of the federal poverty level, or approximately $17,000 for an individual or $35,000 for a family of four.
  • Most importantly, people who fall in the coverage gap are our hardworking neighbors. Two-thirds of people who fall in the coverage gap are currently employed. They are working parents, farmers, servers at the coffee shop, and adult children caring for an elderly parent. Currently, they can’t access the health care coverage they need to take care of themselves and their families.

The appropriation of funds

The state’s share of Medicaid expansion costs, 10 percent, was accounted for in the governor’s budget for the biennium. The remaining 90 percent of costs will be assumed by the federal government. During the 2019 legislative session, senators approved a $49.6 million appropriation over the biennium for Medicaid expansion. This will cover the first nine months of implementation, beginning in October 2020.

What’s next?

There are steps that have been and must be taken by the Nebraska Department of Health and Human Services before those who are eligible may enroll under Medicaid expansion.

  • The state submitted a state plan amendment to the Centers for Medicare and Medicaid Services for review on April 1, 2019.
  • Centers for Medicare and Medicaid Services must approve the state plan amendment for Nebraska to be eligible for matching funds.
  • The Department of Health and Human Services must set forth a benefits package.
  • Necessary information systems and technology updates will need to be made, as well as the hiring and training of staff to administer the program, and the updating of contracts.
  • Most expansion states began enrollment within 8 to 12 months.

When will Nebraskans be able to get coverage under Medicaid expansion?

The Department of Health and Human Services has set forth an October 2020 start date for enrollment. This is nearly two years after voters expanded Medicaid coverage, leaving tens of thousands of Nebraskans with an uncertain future.

In the meantime, 90,000 hardworking Nebraskans are still unable to access health care coverage.