Frequently asked questions about health insurance
coverage options in Nebraska
Nebraska utilizes the federally facilitated health insurance marketplace, 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, but residents use HealthCare.gov to enroll in plans through the exchange.
Read our guide to the Nebraska health insurance marketplace.
The open enrollment period for 2022 coverage ran from November 1, 2021 to January 15, 2022. Outside of open enrollment, a qualifying event is necessary to enroll or make changes to your coverage.
There are four insurers offering plans statewide in Nebraska’s exchange for 2022:
- Oscar (new for 2022)
- Ambetter from Nebraska Total Care (new for 2022)
Ambetter and Oscar are new for 2022. Bright and Medica already offered plans in 2021, and are continuing to do so for 2022.
Read more about Nebraska exchange carriers and insurance rates.
For 2022, Medica’s rates have increased by an average of about 10%, while Bright’s have increased by a little more than 1%. The entry of Ambetter and Oscar has created a lot of new competition, and has resulted in smaller premium subsidies for some enrollees due to lower benchmark premiums.
Both Bright Health and Medica reduced their average full-price premiums in 2021, by an average of about 2.6%. Medica’s average premiums also decreased the year before.
Enrollment in Nebraska’s health insurance marketplace/exchange reached a record high in 2020, which was fairly unusual for states that use HealthCare.gov. (Most saw declining enrollment from 2017 through 2020.)
For 2021, however, enrollment dropped about 2%, with 88,688 people signing up during the open enrollment period that ended in mid-December 2020. (In most states, there was a slight increase in enrollment from 2020 to 2021.)
Enrollment increased in 2021, however, as a result of the COVID/American Rescue Plan enrollment window that continued through August 15, 2021. 15,498 Nebraska residents signed up for coverage during the COVID-related enrollment window, which was more than double the normal enrollment volume during that time (a qualifying event would normally be necessary to enroll at that time of year, but that was not the case during the COVID/American Rescue Plan window in 2021).
Read more about Nebraska’s health insurance marketplace.
Although Nebraska did not establish its own exchange and waited until 2020 to accept federal funding to expand Medicaid (and only did so after voters passed a ballot initiative requiring it), 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%, according to US Census data. By 2018, it had fallen to 8.3%, which was a little lower than the national average — despite the fact that the state hadn’t expanded Medicaid coverage. The uninsured rate in Nebraska remained at 8.3% in 2019, although it increased again nationwide, to 9.2%. Nebraska’s uninsured rate likely dropped once Medicaid expansion took effect in late 2020.
As of 2020, there were nearly 87,000 people enrolled in private health insurance plans through the marketplace in Nebraska. That had dropped to a little over 83,000 by early 2021, but the drop was expected due to the expansion of Medicaid in late 2020 (people who were previously eligible for subsidies in the marketplace became eligible for Medicaid once the eligibility rules were expanded).
All of the marketplace enrollees have coverage for the ACA’s essential health benefits without having to worry about lifetime or annual benefit caps. And 94% of those enrollees are receiving premium subsidies that reduce their monthly premium costs.
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.
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 successful Medicaid expansion ballot initiative. Medicaid expansion took effect in Nebraska in October 2020.
In 2018, voters in Nebraska approved a Medicaid expansion ballot initiative. The state then began 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 didn’t begin until August 2020, with coverage effective in October 2020 – nearly two years after voters approved the Medicaid expansion ballot initiative.
The expansion of Medicaid was expected to provide coverage for about 86,000 Nebraskans. The federal government is paying 90% percent of the costs associated with Medicaid expansion. If the Build Back Better Act is enacted, this will increase to 93% for 2022 through 2025.
Read more about Nebraska’s Medicaid expansion.
Nebraska law limits short-term health insurance plans to terms of less than 12 months, and total duration, including renewals, of no more than three years. That’s in line with the 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.
Nebraska Medicare enrollment reached 360,231 as of September 2021. About a quarter of those enrollees had selected a Medicare Advantage plan instead of Original Medicare; there are pros and cons with either choice.
Read more about Medicare plans in Nebraska, including the state’s rules for Medigap plans.
- Nebraska Department of Insurance’s Affordable Care Act page — Includes information about rate review and approval, enrollment assisters, and health plan availability
- HRS Erase/Resolute — The federally-funded Navigator organization that can help Nebraska residents enroll in coverage through HealthCare.gov.
- Senior Health (SHIIP) — A local service for Medicare beneficiaries that can provide enrollment advice and help to educate Medicare beneficiaries about the resources available to them.
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.