Medicaid Enrollment Trends
The CCF Enrollment Tracker uses the most recent monthly administrative data from state websites and the Centers for Medicare & Medicaid Services (CMS). State administrative data is often the quickest way to assess what is happening in a state’s Medicaid program.
Nebraska is one of 16 states where only CMS data – not state administrative data – is available for Medicaid adult expansion enrollment. Because this data lags by 6 months, tracking problems or rapid enrollment declines will be difficult without state-level transparency. For instance, Arkansas released several rounds of data – including enrollment – during its Medicaid work reporting rollout in 2018 and 2019. Read more here about ways states can collect and report data to monitor implementation and impact of work reporting requirements.
In Nebraska, the three Medicaid managed care organizations (MCOs) that enroll Medicaid expansion adults – often referred to as Heritage Health Adults – are:
- Nebraska Total Care (a subsidiary of Centene Corporation)
- UnitedHealthcare Community Plan of Nebraska
- Molina Healthcare of Nebraska
Medicaid managed care plans that enroll expansion adults will have timely data on how work reporting requirements impact enrollment. Plans receive disenrollment files and the state will no longer send monthly payments to the MCOs for those adults who lose their Medicaid eligibility. The MCOs will know who was disenrolled, where they live, and which providers or services they previously accessed.
Parents and Children
The overwhelming majority of parents should be exempt from work reporting requirements. Parents with income below the state’s “Section 1931” mandatory income eligibility level are not subject to work reporting requirements regardless of the age of their children. Section 1931 parents are a mandatory coverage group that all states must cover. Read more about this category here.
In Nebraska, parents with incomes below 58% of the poverty line are covered through the 1931 category (and therefore not subject to work reporting requirements). For a family of three, that’s an income below around $15,800 annually or $1,320 per month.
In addition to not applying work requirements to parents qualifying through 1931, H.R. 1 also exempts all parents and caretaker relatives with dependent children under age 14 from work reporting requirements if they qualify through Medicaid expansion. So all parents with a child under age 14 are exempt if their income is below 138% of the federal poverty line, whether they qualify by 1931 or by Medicaid expansion.
Additionally, any woman who is pregnant when she applies for Medicaid and becomes pregnant while covered by Medicaid is exempt from work reporting requirements. The exemption is extended through the entire postpartum period during which the woman is continuously eligible regardless of changes in circumstances. All states cover postpartum care for women whose pregnancy is covered by Medicaid for a full 12 months, except Arkansas.
Since many women in the adult expansion group become pregnant after enrolling, it will be critical for states to take steps to identify pregnant and postpartum women to ensure they receive continuous coverage and are excluded from work reporting requirements. Read more from CCF here about risks posed by H.R. 1’s new requirements for pregnant and postpartum women.
State Policy and Implementation Decisions
State Administration and Operation
Eligibility and Enrollment System Readiness
As states implement work reporting and six-month renewal policies, many may struggle to keep up with the administrative workload – workloads that already strain state systems and staff. Tracking metrics such as call center wait times, application processing times, and renewal outcomes can provide insight into system strain and a state’s readiness to implement data matching and other necessary system changes. Read more about these eight state-reported metrics in the report and the blog. See the 50-state tracker here, updated for the most recent quarter.
Click on the tabs below to see the different metrics.
State Websites and Consumer Information
Click here for more information about Medicaid from the Nebraska Department of Health and Human Services. State residents can apply or renew coverage through the online portal here.
Nebraska’s Medicaid work reporting requirements webpage includesoutreach notices and flyers, sample self-attestation forms, and details on how Nebraska Medicaid determines exemptions from work requirements for individuals who are medically frail.
Nebraska has a Medicaid Advisory Committee (MAC) made up of health professionals, Medicaid enrollees, hosts quarterly meetings with state agency officials. Recent MAC meetings discuss work reporting requirements and their impact on current enrollees and future applicants to Nebraska Medicaid.
Additional Resources
Nebraska Appleseed has a comprehensive Medicaid Work Requirements Resource Page for enrollees and other stakeholders, including up-to date information and contact information at Nebraska Appleseed to share problems, such as call center issues, online portal issues, call center or state staff being unable to provide enough or accurate information, notice issues or delays in Medicaid processing times, and/or people being confused or having difficulty navigating or understanding the work reporting requirements.