Key state official opposes task force to oversee voter-approved Medicaid expansion

Key state official opposes task force to oversee voter-approved Medicaid expansion
Adam Morfeld

LINCOLN — Nebraska’s top Medicaid official argued Friday against creating a special task force to oversee how his agency carries out the voter-approved Medicaid expansion.

Matthew Van Patton, the Department of Health and Human Services Medicaid director, told lawmakers that the proposed panel would not help and could even hinder work on expanding Medicaid coverage to an estimated 94,000 low-income Nebraskans.

But State Sen. Adam Morfeld of Lincoln, who introduced Legislative Bill 631, said Van Patton’s testimony and his responses to questions illustrated the need for outside oversight.

“There were a lot of questions and, to be honest with you, I didn’t hear a lot of answers,” he said. “There’s a lot of things that we don’t know about, and it’s a big system.”

Morfeld led a petition drive to get a Medicaid expansion question on the ballot. Voters approved the measure, known as Initiative 427, in November. The measure requires HHS to file a Medicaid plan amendment with the federal government by April 1.

The filing would serve as formal notification that Nebraska plans to offer Medicaid coverage to new groups of people, as allowed under the federal Affordable Care Act.

It also must spell out the state’s plans for those groups and its timeline.

Van Patton told members of the Legislature’s Executive Board that HHS is on track to meet that April 1 deadline. But he said there is no date set to start enrolling any of the newly eligible people.

He said there are many pieces that need to be completed, including amending the contracts with the managed care organizations that administer most Medicaid services and making any necessary changes in computer systems.

At the same time, he said the state is working to decide what services to cover for the expansion group. Nebraska currently covers 13 health services required by the federal government and 19 health services that the federal government considers optional.

Van Patton would not say whether the newly eligible Medicaid recipients would be provided those same services.

“Our intent at this point is that they are, the coverages will remain intact,” he said.

But he added that “access to those different components for this population may be structured differently, it may be tiered.”

Supporters of LB 631 said the troubles that followed other major Medicaid projects illustrate the need for oversight during the expansion effort.

Andy Hale, testifying for the Nebraska Hospital Association, said errors made during a 2014 revamp of the Medicaid payment system cost hospitals more than $12 million a year. The switch to new managed care organizations in 2017 left health care providers of all types struggling to get paid accurately and on time.

Under Initiative 427, the newly eligible include single adults and couples without minor children who cannot qualify for Medicaid now.

Also included are parents and disabled people with incomes higher than the current Medicaid cutoff.

Citizens who make up to 138 percent of the federal poverty level — $16,753 for a single person or $34,638 for a family of four this year — will be eligible. Noncitizens would not be eligible.

Omaha tries again to gain help from the state to pay for sewer project

Omaha sewer project. City officials made another attempt on Friday to persuade state lawmakers to earmark some state funds to the massive $2 billion to $3 billion sewer separation project mandated in the Omaha metropolitan area.

State Sen. Brett Lindstrom of Omaha introduced Legislative Bill 242, which would earmark a portion of the state sales taxes paid on sewer bills in the Omaha area to the sewer project.

The huge endeavor has already increased sewer fees from $12 per month to $51 per month over the past nine years and is projected to raise such fees to $77 per month by 2026, according to Omaha City Councilwoman Aimee Melton. That’s an “extreme hardship” for many families, Melton said.

LB 242 would funnel $2 million to $3 million a year to the Omaha area that would help relieve those high bills, she said.

Several proposals have been made in the past eight years to provide state aid to Omaha for the project, which was mandated by the Environmental Protection Agency to stop raw sewage from overflowing into the Missouri River and Papillion Creek during heavy rains, a problem that was occurring about 50 times.

In 2014, lawmakers earmarked about $1 million a year from a state water fund to aid the Omaha project.

#MeToo lawsuits. The statute of limitations would be removed for civil lawsuits arising from a sexual assault under LB 249, which was heard by the Judiciary Committee on Friday.

Currently, such lawsuits cannot be filed more than 12 years after a plaintiff’s 21st birthday. In 2017, lawmakers removed a similar statute of limitations on civil lawsuits involving sexual assault of a child, and LB 249 was portrayed as the next logical step.

Advocates for the bill, sponsored by Sen. Sara Howard of Omaha, said that recent revelations about sexual assaults brought by the #MeToo movement cast a new light on the subject and that allowing such lawsuits to proceed, even years later, can help empower a sexual assault victim and aid in their healing.

Title X funding. Gov. Pete Ricketts applauded a new federal regulation on Title X funding issued by the Trump administration on Friday.

The rule is similar to controversial language included in last year’s state budget that was used to cut off the Title X funding that had been going to Planned Parenthood in Nebraska.

The governor had recommended putting the same language in the new state budget, which is being crafted by the Legislature’s Appropriations Committee.

He called it “appalling” when committee members voted last week not to include the language in their preliminary budget proposal.

Despite the federal changes, Ricketts said Friday that he would continue working “to ensure that our budget and Title X funding continues to reflect our pro-life values.”