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 individual/family health coverage runs from November 1 through January 15 in Nebraska.
Outside of open enrollment, a qualifying event is generally necessary to enroll or make changes to your coverage. But there are some exceptions, such as the ongoing enrollment opportunity for Native Americans and subsidy-eligible applicants with household income up to 150% of the poverty level. People who are eligible for Medicaid/CHIP can also enroll anytime.
In Nebraska, consumers may be able to buy affordable individual and family health insurance by enrolling through the ACA marketplace (HealthCare.gov). More than 90% of consumers who enrolled in 2022 coverage through HealthCare.gov received premium subsidies.
Nebraskans may also find affordable coverage through Medicaid if they’re eligible. See Medicaid eligibility guidelines in Nebraska.
Short-term health insurance is also a lower-cost coverage option in Nebraska, where seven insurers offer short-term plans.
There are four insurers offering plans statewide in Nebraska’s exchange for 2023:
- Blue Cross Blue Shield of Nebraska (new for 2023)
- Medica
- Oscar
- Ambetter from Nebraska Total Care
Bright Health is no longer offering plans after the end of 2022, but Blue Cross Blue Shield of Nebraska is new to the exchange for 2023. So the number of participating insurers for 2023 was unchanged at four.
Read more about Nebraska exchange carriers and insurance rates.
For 2023, Blue Cross Blue Shield of Nebraska is new to Nebraska’s exchange, and Bright Health has left the exchange. For the other three insurers, average pre-subsidy premiums increased by an average of 2.6% for Medica and 8.8% for Oscar, and decreased by an average of more than 10% for Ambetter (Nebraska Total Care).
Read more about average premiums in Nebraska’s exchange since 2014.
During the open enrollment period for 2022 coverage, 99,011 people enrolled in health plans through Nebraska’s health insurance. This was by far a record high (similar to nationwide enrollment), driven largely by the affordability enhancements provided by the American Rescue Plan.
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%. And Nebraska’s uninsured rate has likely dropped since Medicaid expansion took effect in late 2020.
As of 2022, there were nearly 94,000 people enrolled in private health insurance plans through the marketplace in Nebraska. 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 96% of those enrollees were 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.
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 was 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 (roughly 55,000 had enrolled by the end of the first year that the program was in place). The federal government is paying 90% percent of the costs associated with Medicaid expansion.
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 nearly 367,000 as of August 2022. About 29% of those enrollees had selected a Medicare Advantage plan instead of Original Medicare, while the other 71% were enrolled in Original Medicare. There are pros and cons to 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.
