The director of Nebraska's Medicaid program is stepping down in the middle of the state's effort to expand coverage under the federal health care law. Officials say Matthew Van Patton, the director of the Medicaid and Long-Term Care program, will leave his job effective Feb. 7. Van Patton had served in the job for almost two years and was a key leader in the effort to expand coverage for low-income residents. He was appointed by Republican Gov. Pete Ricketts, who strongly opposed measures to expand Medicaid in the Legislature but promised to follow the wishes of voters who approved it as a ballot measure in 2018.