With Work Requirement Pending, Nebraska Medicaid Expansion Rolls On

Nearly two years after Nebraska voters approved a measure to expand Medicaid, the state on Aug. 1 began the process of enrolling eligible adults for coverage effective Oct. 1. Approximately 90,000 Nebraskans will be newly eligible for Medicaid under the Heritage Health Adult (HHA) program, which will leverage the existing Heritage Health managed care structure by enrolling adults into one of the state’s three contracted managed care organizations. Those MCOs are Nebraska Total Care (Centene), UnitedHealthcare Community Plan of Nebraska and Anthem, Inc.’s newly acquired Medicaid plan from WellCare.

The additional Medicaid lives in Nebraska will have a minimal impact to MCO earnings per share (EPS), according to Credit Suisse. “Assuming an even split of lives and a roughly $400 [per member per month payment], we estimate that CNC [Centene], UNH [UnitedHealth Group], and ANTM [Anthem] have a roughly $144 mln annual revenue opportunity from Nebraska Medicaid expansion,” wrote securities analyst A.J. Rice in a July 21 note. “Assuming a 2-3% net margin on these lives in 2021, relative to our 2021 EPS estimates, we calculate these additional Medicaid lives would have a 0.1% impact for CNC, 0.1% impact for ANTM, and a 0.0% impact for UNH.”

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Lauren Flynn Kelly

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.

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