LINCOLN — A lawsuit challenging Nebraska's plans for expanding Medicaid to about 94,000 people will be refiled in district court after the Nebraska Supreme Court refused to take the case.
Last week, the high court denied Nebraska Appleseed's bid to make its arguments directly to the state's top court.
In written minutes, the court explained that it is "primarily an appellate tribunal for purpose of reviewing matters tried in lower courts" and it does not ordinarily consider cases that could be filed first in a lower court.
James Goddard, Appleseed's economic justice director, said Monday that he hopes to refile in Lancaster County District Court this week and wants to keep the case moving quickly.
"We are going to do everything we can to push it along as soon as possible," he said.
Two weeks ago, Appleseed asked the Supreme Court to order state Medicaid officials to implement the voter-approved Medicaid expansion by Nov. 17. That would be almost a year earlier than the Nebraska Department of Health and Human Services plans to start offering the coverage.
The case was brought on behalf of Mellissa Ely and Gerald Brown, two Nebraskans with serious health conditions who need treatment. Both would gain coverage and care under the expansion.
The lawsuit argued that the delay in implementing expansion violated Initiative 427, the Medicaid expansion law approved by voters in 2018.
The law requires the state to cover additional low-income Nebraska adults, as allowed under the federal Affordable Care Act. It also requires state officials to maximize federal funding for the expansion.
But delaying the implementation of expansion means that the state will miss out on a period of time when the federal government would pay 93% of the cost of coverage. Under the ACA, the federal share will drop to 90% on Jan. 1.
Based on state estimates, the later start date would mean $149 million less in federal funding for the state.
HHS officials have announced plans to use a two-tier system to cover the newly eligible group. Under the plan, those people would have different benefits and requirements than other Medicaid patients. To get full coverage, they would have to work, care for a family member, volunteer, look for work, attend college or take part in an apprenticeship.
Following federal approval of the expansion itself, the state will have to seek federal approval of a waiver to adopt the two-tier program. That process can take several months.
Currently, single adults and couples without minor children cannot qualify for Medicaid, no matter their income level. Also barred are parents and disabled people with incomes higher than the current Medicaid cutoff.
Expansion would allow those groups to gain Medicaid coverage if their incomes are below 138% of the federal poverty level — $16,753 for a single person or $34,638 for a family of four. Non-citizens are not eligible now and would remain ineligible under expansion.