LINCOLN — Some state lawmakers expressed frustration Friday that State Department of Health and Human Services officials skipped a legislative hearing about Medicaid expansion.

The hearing, before the Appropriations and Health and Human Services Committees, was to study the department’s plan for creating a two-tier system to cover the 94,000 people eligible for Medicaid under the expansion.

The coverage is slated to start in October 2020, almost two years after voters passed a ballot measure requiring the state to expand coverage to more low-income Nebraskans.

State Medicaid Director Matthew Van Patton sent a letter to the committee members saying he had a prior commitment in Omaha and could not appear at the hearing. The department did not send anyone else to speak.

State Sen. Adam Morfeld of Lincoln, who introduced the interim study resolution, labeled the department’s failure to appear “despicable” and “completely unacceptable.” Sen. Machaela Cavanaugh of Omaha said she was troubled as well.

“I’m concerned about how we are supposed to work with the department if the department doesn’t show up to talk to us,” she said.

Asked why no one else spoke for HHS, spokeswoman Julie Naughton said the department has provided numerous updates and communications related to Medicaid expansion, including monthly reports required by state law and previous briefings for the HHS Committee. The department has information on a website,

Naughton also noted that the hearing was not required as part of the federal approval process for the planned two-tier system.

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As outlined in April, the two-tier expansion program would have different benefits and more stringent requirements than traditional Medicaid.

The basic level of coverage would not include dental, vision or over-the-counter medications. To qualify for the prime level of coverage, people would have to work, care for a family member, volunteer, look for work, attend college or take part in an apprenticeship to get full benefits.

HHS officials said the two-tier program would cover newly eligible people, as well as about 25,000 working-age adults without disabilities who have been on traditional Medicaid.

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. Noncitizens are not eligible now and would remain ineligible under expansion.

Nebraska is in the process of getting federal approval to undertake the expansion. To implement the two-tier system and its work requirements, the state will have to get a waiver from the federal government.

Morfeld, who led the petition drive to put Medicaid expansion on the ballot, expressed frustration about the length of time needed to launch the two-tier system.

He said the delay is costing Nebraska federal funds and resulting in deaths of people who must wait for coverage. He also said he has concerns that HHS is not moving quickly enough to meet the October 2020 start date.

But in his letter, Van Patton said work on the expansion “is currently underway and on schedule.”

“Launching an expanded Medicaid program that is right for Nebraska takes time to do well,” he said. “We remain focused on the established work plan and project timeline with a set go live of October 1, 2020.”

He said the department will hold public hearings on the state’s expansion plan on Oct. 29 in Scottsbluff, Oct. 30 in Kearney, Nov. 7 in Norfolk and Nov. 12 in Omaha.

A lawsuit challenging the timeline of the expansion was filed Thursday in Lancaster County. Nebraska Appleseed filed the suit on behalf of two people who could benefit from the expansion. It mirrors a case filed earlier with the Nebraska Supreme Court. The high court refused the case, saying it does not normally take up matters that could be filed in lower courts.

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Martha Stoddard keeps legislators honest from The World-Herald's Lincoln bureau, where she covers news from the State Capitol. Follow her on Twitter @StoddardOWH. Phone: 402-473-9583.

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