OMAHA, Nebraska — A vow of poverty by more than 20 elderly nuns isn’t enough to qualify for Medicaid in Nebraska.

The state cut Medicaid benefits earlier this year for the Sisters of Mercy, one of the oldest Roman Catholic religious orders in Nebraska, the Omaha World-Herald reported.

The nuns are appealing the decision through the state Department of Health and Human Services, which administers the federal health care program to low-income and disabled residents. Some of the 21 affected nuns have received restored benefits.

The Sisters of Mercy manage a shrinking, aging population and growing retirement obligations. The group applied for Medicaid for elderly nuns in 2016 after selling property, reducing staff and making other cuts.

Some state senators backed a bill guaranteeing the sisters’ benefits, but the legislation never made it out of committee.

Some state officials suggested the sisters tap into currently restricted patrimony funds. Patrimony is an individual fund often distributed charitably according to a sister’s wishes after her death. Neither a sister nor the organization can access the fund because of the vow of poverty.

A nun would have to appeal to the Vatican and renounce her sacred vows to use patrimony funds for health care.

The state fears that expanding Medicaid to cover the Sisters of Mercy could prove costly if other people also qualify. Ignoring the sisters’ patrimony requires accounting for tithing in income qualification reviews of Medicaid recipients of all faiths, state officials said. Doing so could cost Nebraska $3 million annually by adding more than 300 Medicaid recipients by 2020.

Sen. Sara Howard of Omaha disagreed, saying that relatively few people besides the sisters would qualify under the proposed bill’s terms.

The sisters are hopeful they can make their case because the group in other states has received Medicaid.