Nebraska man with kidney cancer loses Medicaid coverage

Eli McCreary, 64, received a call from a CHI Health hospital in Omaha while battling a new diagnosis of kidney cancer. Staff told him he had lost his Medicaid coverage and would need to pay out of pocket to keep his appointments. McCreary, who also suffers from diabetes and chronic obstructive pulmonary disease, said he was confused by the sudden change in his status.

A call center representative informed McCreary that his benefits now required him to work. “You’re required to do work to stay on,” McCreary recalled the representative saying. “And you haven’t fulfilled your work requirement.” This mandate stems from a new rule in Nebraska that requires adult Medicaid recipients to prove they are working or participating in similar activities for 80 hours a month, unless they qualify for an exemption.

The state began enforcing these work requirements on May 1, eight months before most other states are scheduled to implement similar rules. Nebraska Governor Jim Pillen praised the move, calling it a key reform delivered by the federal administration. State officials reported that 93% of existing enrollees kept their coverage, but advocates argue the rollout has created confusion and longer wait times.

McCreary canceled a CT scan and delayed a visit with a specialist who travels to Omaha. “I missed my window of opportunity with him for another month,” he said. He noted that his physical condition made employment difficult, asking, “I can’t walk. I can hardly breathe. I can’t move around. What job am I going to get?” He had previously worked as a driver for an asphalt company until his health declined.

Nebraska spent $8.2 million over two years on contractors to administer the new Medicaid rules. Public Consulting Group and Covendis were hired to provide staffing and information technology support. Sarah Maresh, a program director with Nebraska Appleseed, described the costs as shocking. She noted that large corporations profit while state agencies struggle with inadequate training and staffing levels.

Call center wait times in the state nearly doubled between May and July, rising from 13 minutes to 26 minutes. The department received over 101,000 calls in August, a 66% jump from May. Kenny McMorris, CEO of the Charles Drew Health Center, said many working patients lack the time to navigate the phone system. McCreary eventually reached a call center, but it was for a different program, and the state had no record of him contacting the health department directly.

Attorneys suggest that McCreary’s recent substance use treatment and other medical conditions should have exempted him from the work requirement. The federal law allows exemptions for people with serious medical conditions or substance use disorders. McCreary prefers handling matters by phone or in person and does not have an account on the state’s online portal. He believes he may have missed mailed notices about his coverage.