Nebraska Appleseed

Becky Gould, executive director of Nebraska Appleseed, in the organization's meeting room on Monday, July 11, 2011.

Supporters of Nebraska's successful Medicaid expansion initiative are considering all options, including a potential lawsuit, to combat what they view as the Ricketts administration's slow-walk implementation of the expanded coverage directed by Nebraska voters.

"Our biggest concern is making sure that what the voters passed takes effect as soon as possible and in the way intended," Becky Gould, executive director of Nebraska Appleseed, said Monday. 

"We will use all the avenues at our disposal to make sure it happens," she said, and will consider a lawsuit as "a last resort."

However, she suggested, changes still could be made while the Legislature remains in session.

"Several senators are looking at ways they might shape the course and they still have time."

The path that the Nebraska Department of Health and Human Services has taken in creating a two-tiered Medicaid system was "not compelled by the initiative," Gould said, and is "not what voters intended to happen."

Gould said she is concerned about people whose health conditions may go untreated during the nearly two years before the department plans to implement the proposal mandated by voters last November.

"Our view is that what voters intended was straightforward and that was to put the expanded population on the program as quickly as possible," she said. 

"DHHS' choice to delay implementation and add complex tiered benefit plans and work requirements to expanded Medicaid coverage is irresponsible and contrary to the intent of Nebraska voters," Appleseed has proclaimed on its website.

Sen. Adam Morfeld of Lincoln has raised the possibility of requiring legislative approval for every administrative deviation from the traditional Medicaid program.

Morfeld, who helped lead the successful Medicaid expansion drive that culminated in a 2018 vote of the people to extend coverage to about 90,000 working Nebraskans, said the Nebraska Department of Health and Human Services is employing "smoke and mirrors and administrative gobbledygook" to delay implementation for almost two years.

"All delivered with a wink and a smile," he said. 

"They're ignoring the will of the people," Morfeld said, and creating "tens of millions of dollars of unnecessary regulation" while erecting "hurdles and barriers" to accessing coverage.

The early administrative costs of creating a bureaucracy separate from traditional Medicaid coverage have been pegged at $17 million, he said. 

Meanwhile, Morfeld said, Nebraskans who are eligible for Medicaid coverage under terms of the proposal approved by Nebraska voters are having their urgent health care needs go unmet while implementation of the program is delayed until Oct. 1, 2020, nearly two years after voters approved Medicaid expansion. 

"It's shameful," he said.

The average income of newly eligible Medicaid recipients, including waitresses, waiters and retail clerks, is $16,000 a year. 

So-called "1115 waivers" that are being employed to create a new administrative structure that differs from traditional Medicaid coverage allow the state to deviate from Medicaid requirements.

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Reach the writer at 402-473-7248 or dwalton@journalstar.com.

On Twitter @LJSDon.


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