The state of Nebraska fast-tracked Congress’ Medicaid work reporting requirements, starting the requirements 8 months early with no federal rules and no time to prepare. Since May 1, our state has strapped everyday Nebraskans with needless paperwork and added mountains of work to our already overloaded state workers’ plates. The first three months of work requirements in Nebraska have been filled with confusion and unanswered questions. From long call center waits, inoperable language lines, understaffed and undertrained caseworkers, policy questions gone long-unanswered, and the lack of public state data, one thing is obvious – Nebraska is not prepared.
- Mass Confusion: People in Nebraska do not know whether they are subject to the work requirements, largely because they still cannot find whether they are in the expansion group or another Medicaid category on their online portals, Medicaid cards, or notices. The only way they can know for sure is to try calling a caseworker, which has also been fraught with issues. On top of that, the incredibly complex Medicaid work reporting requirements have not been clearly and thoroughly communicated to Nebraskans, leading to further confusion. Nebraskans need additional, clear, simple, and targeted outreach from DHHS to explain the work requirements and the impact.
- Call Center Issues: Throughout the last three months, many Medicaid enrollees have been experiencing issues with the call center. Enrollees are having to wait a long time (often over an hour) and are being disconnected. For weeks, the language lines were not working correctly and may not have been working at all.
- Caseworker Issues: State caseworkers have not been adequately trained on the Medicaid work requirements and at times do not provide accurate information. We have heard DHHS caseworkers at times cannot answer basic questions or have given incorrect information. The impacts have not been limited to the Medicaid expansion group. In one particularly troubling example, an enrollee was erroneously told by a DHHS worker that she was going to lose Medicaid because the worker believed she wouldn’t meet the work requirements or an exemption. She scheduled a major medical procedure to manage health conditions on an emergency basis because she thought she would have no health care coverage. After spending more than an hour on the phone with multiple DHHS workers and her lawyer, she ultimately found out that she is not in the expansion category, so the work requirements do not even apply to her.
- Outstanding Questions: How far does someone have to travel to qualify for the travel-based temporary hardship exemption? Will secondary and tertiary diagnosis codes be used to help determine medical frailty? Providers and advocates have been trying to get answers to these, and many more questions, for months. We still need answers.
- No Data: Even though the state has spent the last three months denying low-income Nebraskans’ applications for health care coverage for failing to prove that they meet work requirements or an exemption, the state has not shared even the most basic information with the public about how this is impacting Nebraskans, such as how many Nebraskans have been denied coverage under this new rule.
We fear that these are signs of more issues to come, and we need your help. We want to hear from you! If you know anyone who has any experience with medicaid work requirements, please reach out to our Community Assistance Line or reach out to anyone on our health care access team.
