Lawsuit Filed to Ensure Access to Benefits in the Medicaid Expansion Program

Lawsuit Filed to Ensure Access to Benefits in the Medicaid Expansion Program

Nebraska officials chose to enact an unlawful tiered benefits system, violating Initiative 427

LINCOLN, NE — On February 25, Nebraska Appleseed and the National Health Law Program (NHeLP) filed a lawsuit on behalf of Nebraska Medicaid enrollees who face unnecessary barriers accessing services under the Medicaid expansion tiered benefits program. Through this lawsuit, we are striving to ensure Initiative 427 is implemented the way that Nebraska voters intended.

Nebraska Appleseed Health Care Access Program Staff Attorney, Sarah Maresh, issued the following statement:

“Comprehensive health care coverage is a vital part of leading vibrant, fulfilling lives. In 2018, Nebraska voters approved Medicaid expansion so that our family members, friends, and neighbors could finally access quality, equitable, affordable health care. However, the Nebraska Department of Health and Human Services (DHHS) elected to implement an unlawful tiered benefits system that has created barriers and burdens for enrollees and violates Initiative 427.

With coverage beginning last October, community members are ecstatic to finally be able to see a doctor without worrying about receiving a high bill they cannot afford. However, we’ve also heard of the frustration and confusion caused by the unnecessary complexities of the tiered benefits system. Medicaid expansion must include access to crucial health care services like dental, vision, and over-the-counter drug coverage for all enrollees without barriers. 

DHHS has a legal responsibility to honor the vote of Nebraskans who chose a healthier future for our state by passing Initiative 427 in November of 2018. This lawsuit seeks to fully implement the will of Nebraska voters and undo the unlawful actions of the Department.”

National Health Law Program Managing Attorney – North Carolina, Sarah Somers, issued the following statement:

“Following the lead of dozens of other states, Nebraskans voted to expand their Medicaid programs to include thousands of people who previously did not have access to affordable, quality health care. 

The approved legislation prohibits Nebraska from imposing additional obligations on those who enroll in the expansion. The experiences of other states that have imposed similar burdens show that they deprive people of the coverage they need and put heavy financial and administrative burdens on the state.”


The National Health Law Program (NHeLP) advocates, educates, and litigates at the federal and state level to protect and advance health care access and the civil rights of low-income people and other underserved groups.


Nebraska Appleseed is a nonprofit organization that fights for justice and opportunity for all Nebraskans. We take a systemic approach to complex issues – such as child welfare, immigration policy, affordable health care, and poverty – and we take our work wherever we believe we can do the most good, whether that’s in the courthouse, at the Capitol, or in the community.

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