Nebraska estimated that about 200 people from its expansion population have lost Medicaid coverage Aug. 1 amid its first work requirements check.
Tradeoffs reported on the projection from Nebraska’s Medicaid director, Drew Gonshorowski, July 30. Over the next year, Nebraska will verify each member’s adherence to work requirements during their renewal month. Under HR 1, Medicaid enrollees in expansion states or states with aligned waivers must work, engage in community service or attend school — or some blend of these — for a minimum of 80 hours per month.
In the Tradeoffs interview, Mr. Gonshorowski said Nebraska could use income and healthcare data to automatically check 74% of people’s compliance or qualification for exemptions without additional paperwork.
Nebraska was an early adopter of Medicaid work requirements under HR 1, with other states needing to follow suit by 2027. Nebraska Public Media reported in December that more than 70,000 Nebraskans would be alerted to the work rules, and about 30,000 would need to take action to comply. The state did not anticipate hiring more staff to assist with implementation, the Nebraska Examiner reported in April.
The state’s Medicaid program, Heritage Health, is administered by Molina Healthcare, UnitedHealthcare and a Centene subsidiary. Molina President and CEO Joseph Zubretsky mentioned Nebraska during the company’s second-quarter earnings call, pointing to the state as “the only real data point” on work requirements so far.
Mr. Zubretsky said identifying what information can be used to prove eligibility, as well as defining “medical frailty” for exemptions, are the two biggest challenges as work requirements get underway.
“In Nebraska, they have 290 pages of diagnosis codes to support medical frailty,” he said. “They have a very comprehensive program of the types of information that they will accept to verify eligibility.”
Nebraska’s first wave of enrollment cuts comes just days after a federal judge shut down 25 states’ attempt to block the rules.
Becker’s contacted the Nebraska Department of Health and Human Services and will update this story if more information becomes available.
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