- Associated Press - Wednesday, August 28, 2019

LINCOLN, Neb. (AP) - Advocates for expanding Medicaid in Nebraska filed a lawsuit Wednesday to force state officials to offer coverage starting this year instead of the official October 2020 rollout date.

The group Nebraska Appleseed announced the lawsuit on behalf of two Lincoln residents who were denied Medicaid coverage but will be eligible once the program is expanded.

“Tens of thousands of Nebraskans are experiencing similar challenges as they wait for coverage,” said James Goddard, director of the group’s economic justice program. “This suit seeks to ensure our family members, friends and neighbors receive Medicaid coverage this year and that Nebraska tax dollars are brought back to support our health care system.”

The lawsuit argues that the long timetable violates the state’s duty to collect as much federal money as possible for the program. That requirement was included in the Medicaid expansion ballot initiative approved by voters in November.

Nebraska will lose $149 million in federal money by waiting until October 2020, according to the lawsuit. That’s because the federal government’s reimbursement rate will drop from 93% of the state’s Medicaid expenses to 90% on Jan. 1, 2020.

Nebraska Appleseed asked the Nebraska Supreme Court to review the case right away so coverage can begin by Nov. 17, which would guarantee the state gets the 93% reimbursement for the current year.

Officials with Nebraska Department of Health and Human Services have said they need the time to ensure the expansion goes smoothly. Department officials say they still need to negotiate details of the expansion with the federal government, upgrade their computer system, hire more workers and negotiate new contracts with the managed-care companies that will serve Medicaid recipients on the state’s behalf.

Goddard countered that most other states that expanded Medicaid have done so within 8 to 12 months. He said the ballot initiative gives state officials no choice but to launch the program this year.

“Our position is this isn’t an option,” he said. “They don’t get the discretion to decide when they’re going to implement it.”

The department operates within the administration of Republican Gov. Pete Ricketts, who vehemently opposed efforts to expand Medicaid in the Legislature but pledged to respect the will of voters who approved it.

“This lawsuit is a distraction from effectively delivering Medicaid expansion for the people,” said Taylor Gage, a spokesman for the governor.

Gage noted that state officials met the mandatory April 1 deadline to submit its expansion plan to the federal government. He said the administration is still waiting for federal approval.

Activists placed the measure on the 2018 ballot after Nebraska’s conservative lawmakers and governors repeatedly rejected expansion proposals in the Legislature. It won support from nearly 54% of voters statewide, although much of the support came from the Omaha and Lincoln areas.

Once in place, the expansion will cover adults ages 19 to 64 who earn up to $138% of the federal poverty level - about $16,753 a year.

The department’s approach to expanding Medicaid has drawn criticism from Nebraska Appleseed and some state lawmakers. The department unveiled a two-tiered plan in April that provides basic coverage for all newly qualified recipients and “premium” coverage that’s only available to people who are working, in school, volunteering or caring for a relative. The premium plan would cover dental and vision appointments and over-the-counter drugs.

The lawsuit was filed on behalf of Melissa Ely and Gerald Brown, of Lincoln.

Ely had a heart attack in July, suffered from strokes on 2014 and 2016 and also deals with arthritis in both hands and a lump in her lymph node that hasn’t been diagnosed, according to the lawsuit. The 46-year-old works as a caretaker for her aging mother and makes $30 to $75 a month for delinquent child support payment, the lawsuit states.

“If Ms. Ely had Medicaid expansion coverage, she would seek treatment for her untreated health issues and engage in any follow up course of treatment for her heart attack,” the lawsuit states.

Brown, 51, earns less than $1,000 a month in his job and suffers from chronic shoulder pain that needs surgery but hasn’t been treated, according to the lawsuit. The lawsuit says he also needs a colonoscopy and dental treatment.

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