Month four of Medicaid work requirements in Nebraska has followed a familiar path – filled with confusion, long call wait times, policy questions gone long-unanswered, and a lack of public data. We know coverage loss can have far reaching consequences. We heard from one individual who found out he lost his Medicaid coverage after the hospital called him to cancel his appointments in the midst of cancer treatment. His managed care organization told him it was because of the work requirements.
On August 13th, Governor Pillen announced that Nebraska’s Medicaid Director resigned, to the surprise of many. While this is an unfortunate time for a change in leadership, our concern remains the same – Nebraska is not equipped to implement the work requirements. We continue to consistently see significant issues with the implementation of the work requirements since our update last month. A few notable updates include:
- Mass Confusion: Due to our state’s poor outreach, we continue to hear from folks in Nebraska who are confused about whether the work requirements apply to them, and there is still no way for folks to find that out on their own. In August, we’ve seen how far this confusion continues to stretch – some think they have to meet work requirements so their children can keep Medicaid, even though only adults in the expansion group must meet the work requirements to keep their coverage. We continue to hear from folks who think they were terminated because of Medicaid work requirements before August 1 even though existing enrollees were not supposed to have lost coverage until August 1.
- Call Center Issues: Many Medicaid enrollees have been experiencing issues with the call center. We have continued to hear that folks are having to wait over an hour to speak with someone. While the state data was slow to reflect this, recent state data updated on August 14 showed a significant increase in call center volume and wait times, with 30,000 more calls and an additional 15 minutes call wait times on average just since April of this year.
- Outstanding Policy Questions: Despite recent meetings with advocates, many significant operational questions remain unanswered, including how far someone has to travel to qualify for the travel-based temporary hardship exemption and how the medically frail process squares with the new federal guidance.
- Scant Public Data: The state has still not shared even the most basic work requirement termination and denial numbers. We only recently learned at the end of July through a Tradeoffs interview that our Medicaid Director expected about 200 people to lose coverage at the beginning of August. The state has not released any data to verify that and has not shared any other information about denials and terminations publicly, despite many requests. The state has also not responded to public records requests asking for this same simple data. So far, the state has only committed to comply with the federal Centers for Medicare & Medicaid Services reporting requirements and our state statute passed this year that requires annual reporting on certain work requirement metrics by December 1st.
We know Medicaid work requirements are bad policy for Nebraskans, and our state’s haphazard implementation is only making things worse. We want to hear from you! If you know anyone who has any experience with or questions about Medicaid work requirements, please reach out to our Community Assistance Line or reach out to anyone on our health care access team.