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Nebraska Modifies Its Privatized Medicaid; Iowa's Called "A Disaster"

Jan 4, 2017

Effective January 1st, Nebraska has made modifications in the administration of its Medicaid program by private insurance companies.   

All Nebraska Medicaid recipients who did not pick one of the available plans by December 1st were automatically enrolled in one.  Molly McCleery, Staff Attorney for the Health Care Access Program at Nebraska Appleseed, stresses that recipients who are not happy with their plan have 90 days to change.   

“I think we are probably going to see a lot of people who didn’t select a plan before December 1st be automatically enrolled in a plan and then maybe realize that their doctor isn’t covered or that it’s not the plan that they would want, and then they have to switch plans within the first 90 days.”

A recent Des Moines Register editorial calls Iowa’s privately managed Medicaid program, now less than nine months old, “a disaster.” Claiming Iowa’s Medicaid  costs had been among the lowest in the country, it says the state recently agreed to pay $127 million more than anticipated in state and federal funds – while recipients complain of being denied services and providers of not being reimbursed.

McCleery says with profit margin a factor, a similar scenario could play out in Nebraska.

“There are certain categories of coverage where it is just not a super profitable endeavor, and so the only way that companies can turn a profit is either by figuring out how to do better preventive care on the front end to save money later or to figure out what services can be cut or what efficiencies can be created.”

For more information, the website is neheritagehealth.com or neappleseed.org.