By GRANT SCHULTE-Associated Press
OMAHA, Neb. (AP) - A group that advocates for low-income residents said Friday that it has asked a judge to strike down Nebraska's two-tiered Medicaid expansion system that imposes extra requirements to qualify for dental, vision, and over-the-counter drug coverage.
Nebraska Appleseed filed the lawsuit Thursday against the Nebraska Department of Health and Human Services and its top administrators.
The lawsuit alleges that agency officials exceeded their legal authority when they created a two-tiered system comprised of a "basic" plan that covers physical and behavioral health care services and a "prime" plan that also includes dental, vision and over-the-counter drug coverage. The two-tiered system only applies to people who qualify for expanded coverage, not those who received benefits through the traditional Medicaid program.
"Medicaid expansion must include access to crucial health care services like dental, vision, and over-the-counter drug coverage for all enrollees without barriers," said Sarah Maresh, an attorney for the group.
To qualify for prime coverage, recipients must meet work or volunteer requirements or participate in educational or job-training programs. They also have to meet with a health care provider for a wellness assessment.
Voters expanded Medicaid through a 2018 ballot measure, but state officials have been slower than other expansion states to implement its requirements. Activists placed it on the ballot after years of failed attempts to expand Medicaid in the Republican-dominated Legislature and strong opposition from the state's GOP governors.
The ballot measure extended coverage to able-bodied, working-age adults who earn too much to qualify for regular Medicaid but too little to be eligible for tax credits to help them buy health insurance under the Affordable Care Act.
Officials with the Nebraska Department of Health and Human Services didn't immediately respond to a message seeking comment.
The lawsuit was filed the same day that state officials said that their plans to offer prime benefits starting April 1 had been put on hold because federal officials tasked with reviewing them raised concerns.
Officials under Republican Gov. Pete Ricketts had planned to require that recipients meet "wellness and personal responsibility" goals to qualify for those benefits.
State Medicaid Director Kevin Bagley told a legislative committee Thursday that President Joe Biden's administration objected to the plan and wasn't likely to approve it in time for the rollout.
"The reality is, any direction we take at this point probably adds months to the implementation," Bagley testified before the Legislature's Appropriations Committee.
In a news release, the Nebraska Department of Health and Human Services said it had submitted all the necessary information for federal approval and blamed the delay on federal officials. Supporters of Medicaid expansion have countered that the process wouldn't have been slowed down if state officials had simply approved the expansion without imposing additional requirements on recipients.
Some pro-expansion advocates contend that state officials have been dragging their feet on the expansion effort because Ricketts vehemently opposes it. State officials have disputed that assertion, saying they wanted to take the time to launch the program without any hiccups.
Expanded Medicaid recipients will still qualify for basic coverage, including check-ups and behavioral health services.
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