Group challenging Nebraska Medicaid rule

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By NATE JENKINS / The Associated Press

A legal advocacy group is formally petitioning the state to change a Medicaid rule it says is hurting poor working families in Nebraska.

The Nebraska Appleseed Center for Law in the Public Interest says a so-called “100-hour rule” is discouraging some poor parents from working, and unfairly prevents others from receiving health care. Under the rule, a low-income parent who would otherwise qualify for Medicaid is kept out of the program if he or she works more than 100 hours a month.

“The 100-hour rule discourages parents from returning to work and earning more family income,” said Erin Ching, a staff attorney with Appleseed. “It also treats two-parent families unfairly, since the rule does not apply to single parents.”

State officials say they don’t know how many more Nebraska families might get Medicaid if the rule was changed. The state Department of Health and Human Services received notice on Wednesday that the rule was being formally challenged. A spokeswoman said no one was available to answer questions about why the rule is needed.

A former state senator who was in the Legislature when it decided to keep the rule in the late 1990’s said the rule is an example of how Medicaid can be an inflexible, relying on concrete criteria and thresholds that can sometimes seem questionable.

“With a lot of these Medicaid rules, you get to a point where you fall off a cliff,” said former state Sen. Jim Jensen of Omaha, who was longtime chairman of the Legislature’s Health and Human Services Committee. “It’s too bad there isn’t some sort of phase-in."

Ching said about half of all states have a similar, 100-hour rule, but Nebraska is unusual in that the rule doesn’t apply across-the-board to all low-income people who qualify for public assistance.

The poorest parents — who get cash welfare payments because they meet low-income guidelines — can still get Medicaid even if they work more than 100 hours.

The current rule applies to parents who have low incomes and are considered “medically needy,” but make too much to qualify for the cash welfare, Ching said. They can only get Medicaid help if they work less than 100 hours a month.