Norfolk woman joins Medicaid lawsuit A federal rule led to termination of cancer patient's full coverage Nebraska cancer patient part of national Medicaid lawsuit

LINCOLN - A Nebraska woman who lost Medicaid coverage in the midst of cancer treatment is challenging the federal rule that required the state to cut her off.

Mary Shaw of Norfolk joined four plaintiffs from Connecticut and Delaware in a class-action lawsuit against the U.S. Department of Health and Human Services. They are seeking a temporary injunction to block the rule, which was issued in the waning days of President Donald Trump's administration and remains in place.

The suit alleges that, because of the rule, Medicaid benefits have been terminated to hundreds of thousands of people nationwide in violation of the Coronavirus Response Act of 2020.

The act provided additional federal Medicaid funding to states on the condition that they continue coverage for Medicaid patients throughout the COVID-19 public health emergency. The emergency was declared Jan. 27, 2020, and has been extended multiple times. It is expected to continue into next year.

"The requirement to keep people on Medicaid during the ongoing crisis was adopted precisely because Congress recognized the severe threat, not just to individuals but to public health, from ending health insurance to vulnerable, low-income people," said Sheldon Toubman, litigation attorney at Disability Rights Connecticut, one of the groups behind the suit.

According to the lawsuit, Shaw originally qualified for Medicaid after Nebraska extended coverage to low-income single adults. The coverage, which began in October 2020, allowed her to see a dentist and get physical therapy so she could walk again following a previous hip surgery.

Medicaid also covered the beginning of treatment on her right shoulder for a recurrence of squamous cell carcinoma, a type of skin cancer, in December 2021.

But, based on the "interim final" federal rule, Nebraska Medicaid officials terminated Shaw's full Medicaid coverage in January, the month she turned 65 and got on Medicare.

The rule, issued on Nov. 6, 2020, required states to reduce or eliminate Medicaid coverage for people who were deemed to have "minimum essential coverage" through special, limited Medicaid programs that help with some Medicare costs.

Shaw now qualifies for such a program. It pays her Medicare Part B premiums but does not cover co-pays and deductibles or health needs not included under Medicare.

Medicare is a federal health insurance program for people age 65 or older and some people with disabilities. Patients typically use supplemental insurance or Medicaid to help with out-of-pocket costs and to cover additional services. Medicaid is a state-federal program for low-income people.

As a result, the suit said, Shaw, who lives on about $1,252 per month in Social Security, has had to forgo medical care for her emphysema and for post-surgical care of her shoulder. She also has not sought treatment for an apparent new cancer on her leg because she cannot afford treatment.

"Between all of the services that are covered under Medicaid but not covered at all under Medicare and the doctor visits which are covered by Medicare but now require coinsurance that she cannot afford, the loss of Medicaid has been devastating to her," the lawsuit said.

Three Connecticut women filed the original case Aug. 3 in U.S. District Court in Connecticut. Shaw and a Delaware woman were added through an amended complaint, filed Aug. 26, along with the motion to pursue the case as a nationwide class action. A hearing on the request for temporary injunction is set for Sept. 27.

Nebraska Appleseed has been working with the groups representing the plaintiffs, which include Disability Rights Connecticut, Justice in Aging, The National Health Law Program and the law firm Stinson LLP.

[email protected], 402-670-2402, twitter.com/stoddardOWH