Nebraska health insurance

Two insurers offer 2020 coverage in Nebraska's health insurance marketplace; short-term health insurance plans are now available.

Health insurance in Nebraska

This page is dedicated to helping consumers quickly find health insurance resources in the state of Nebraska. Here, you’ll find information about the many types of health insurance coverage available. You can find the basics of the Nebraska health insurance marketplace and upcoming open enrollment period; a brief overview of Medicaid expansion in Nebraska; a quick look at short-term health insurance availability in the state; statistics about state-specific Medicare rules; as well as a collection of health insurance resources for Nebraska residents.

Nebraska’s health insurance marketplace

State legislative efforts to preserve or strengthen provisions of the Affordable Care Act

How hard has Nebraska tried to preserve the Affordable Care Act’s gains? See how Nebraska compares to other states.

Nebraska uses the federally facilitated health insurance exchange, but with a marketplace plan management model, which means the state oversees various aspects of the plans available for sale in the Nebraska health insurance marketplace.

Nebraska did not accept federal funding to expand Medicaid coverage under the Affordable Care Act. Both tend to be indicators of reluctance to the health reform law.

However, the state was already performing better than most in the nation as far as pre-ACA uninsured rates go, and once the law’s key provisions took effect, it continued to do so.

Prior ACA implementation, the uninsured rate in Nebraska was 11.3 percent, according to US Census data. By 2018, it had fallen to 8.3 percent, which was a little lower than the national average — despite the fact that the state hadn’t expanded Medicaid coverage.

Nebraska’s open enrollment period and dates

Open enrollment in Nebraska for 2021 health insurance plans  will run from November 1, 2020 to December 15, 2020. Prior to the open enrollment period, Nebraska residents with qualifying events can still enroll or make changes to their medical insurance coverage for 2020.

Medica is no longer the only insurer offering coverage through the Nebraska exchange. Bright Health joined the exchange statewide for 2020. Medica Imposed an average rate decrease of nearly 7 percent for 2020.

Enrollment in Nebraska’s health insurance marketplace reached a record high in 2020, which is fairly unusual for states that use HealthCare.gov (most have seen declining enrollment since 2016, although the COVID-19 pandemic is driving significant exchange enrollment growth mid-year in 2020, nationwide).

Read more about Nebraska’s health insurance marketplace.

Medicaid expansion in Nebraska

In 2018, voters in Nebraska approved a Medicaid expansion ballot initiative.  The state is in the process of expanding Medicaid eligibility, with the specifics submitted to the federal government for review in late 2019. But Medicaid plan enrollment in Nebraska won’t begin until August 2020, and the earliest available effective date will be October 2020 — nearly two years after voters approved the Medicaid expansion ballot initiative.

The Medicaid coverage expansion will mean coverage for about 86,000 Nebraskans, and the federal government will pay 90 percent of the cost.

Read more about Nebraska’s Medicaid expansion.

Short-term health insurance in Nebraska

Nebraska law limits short-term health insurance plans to terms of less than 12 months. That’s in line with the new federal rules on short-term health insurance plans.

The state does, however, require short-term health insurance plans sold in the state to be filed with the department of insurance, to cover state-mandated benefits, or comply with the state’s internal and external appeal requirements.

Read more about short-term health insurance coverage in Nebraska.

How has Obamacare helped Nebraskans?

Nebraska’s current senators, Republicans Ben Sasse and Deb Fischer, were not in the Senate in 2010 when the ACA was enacted. But both voted yes on all three ACA repeal measures that the Senate considered in July 2017: The Obamacare Repeal Reconciliation Act, the Better Care Reconciliation Act, and “skinny” repeal.

In the House, all three Nebraska Representatives supported the American Health Care Act (AHCA), an ACA repeal effort that passed the House in May 2017 but stalled when the Senate was unable to pass any of their versions of the bill.

Former Gov. Dave Heineman was also opposed to the ACA, calling it an “unaffordable, unsustainable, regulatory nightmare” Heineman ended his tenure and was replaced in January 2015 by Pete Ricketts.

Gov. Ricketts is also opposed to the ACA, and favors many of the reforms preferred by the GOP: tort reform, expanded HSAs, and tax credits to help purchase health insurance. He is opposed to Medicaid coverage expansion and had vowed to continue Gov. Heineman’s rejection of expanding the program, but voters circumvented the state legislature with a Medicaid expansion ballot initiative. And although Heineman’s administration is implementing a more complicated version of Medicaid expansion, and taking a long time to get it done, the process is moving forward.

Does Nebraska have a high-risk pool?

Before the ACA, individual health insurance was underwritten in nearly every state, which meant that pre-existing conditions could prevent a person from obtaining a policy, or could result in significantly higher premiums or policy exclusions. The Nebraska Comprehensive Health Insurance Pool (NCHIP) was created to give people an alternative if they were unable to obtain individual health insurance because of their medical history.

Now that the ACA has been implemented, all individual major medical health insurance plans are guaranteed issue, making high-risk pools largely obsolete, and NCHIP closed on December 31, 2013. The program is now only available for people who are under 65 and on Medicare due to a disability.

Medicare coverage and enrollment in Nebraska

350,756 Nebraska residents were enrolled in Medicare plans as of April 2020. Medicare beneficiaries in Nebraska can select a Medicare Advantage plan instead of Original Medicare; there are pros and cons with either choice.  About 15 percent of the state’s Medicare enrollees did so in 2018, which was well below the national average.

About 59 percent of the state’s Medicare beneficiaries are enrolled in stand-alone Medicare Part D plans, which provide prescription drug coverage.

Read more about Medicare plans in Nebraska, including the state’s rules for Medigap plans.

Nebraska health insurance resources

Nebraska’s state-based health reform legislation

Scroll to the bottom of this page for a summary of state-level Nebraska bills related to health reform.


Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

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