An adult in Nebraska who receives an ADC cash benefit is eligible under the mandatory rules at about 33% of the federal poverty level. The "medically needy spend down" option lets people who spend a large portion of their income for medical care (such as a nursing home or any medical care that is uninsured) qualify for some Medicaid services through "spending down" their income into this range. They pay part of their income for those services that Medicaid picks up the rest. All people in nursing homes are going to be either aged, blind or disabled (ABD). Most of the medically needy spend down occurs related to nursing home coverage.
This chart shows there are mandatory coverages for different ages of children but we have taken it optionally to 185% of poverty. Anything that’s pink was an optional choice, and anything in blue was mandated by the federal government.
This chart shows how eligibility has worked out over time, starting back in 1987 with about 90,000 people on Medicaid. As of the end of June, 2005, there were 199,632 people on Medicaid. The milestones are marked showing various changes made in eligibility. Cumulatively, those changes together with population changes, economic cycles, etc., have created the current level of the Medicaid population. The area labeled LB 8 shows when our state was in fiscal crisis and a number of people were taken off of Medicaid during a special session of the Legislature.
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