LINCOLN — The two-tier Medicaid system that officials are proposing as a way to cover more low-income Nebraskans would be unique to the state.

The Heritage Health Adult system would include work, wellness and personal responsibility requirements, many of which have been tried by other states. However, the combination of requirements and the penalties for failing to meet requirements would be new.

As outlined by state officials, people would not get dental, vision and over-the-counter medication coverage if they fall short on any of the requirements. But they could still keep physical, medical and prescription drug coverage. Reviews would be done every six months to determine compliance.

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