Nebraska Medicaid History and Facts

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Initial Medicaid Implementation: Nebraska began their state’s Medicaid program in July 1966 replacing the existing state programs that provided medical assistance. Nebraska was one of the first states to adopt Medicaid legislation following the passage in 1965. The state initially under budgeted for the Medicaid program implementation and had to request approximately $750,000 from the legislature to meet the demands in 1969.

Key Medicaid Political Issues: One provision of the Affordable Care Act required all states to extend coverage of foster kids through Medicaid up till the age of 26. The state struggled with implementing this provision of the law and faced criticism in the media and among advocates. The state began its managed care program in 1995 in the Eastern portion, or most populous portion, of the state. In 2010 the state expanded the program to seven additional counties. In 2013 the state transitioned behavior health services to a managed care contract statewide.

Medicaid Expansion Implementation: Nebraska held several votes on Medicaid expansion in the legislature and at one point had majority support to pass Medicaid expansion in the legislature but the bill failed because of the requirement to need 2/3rds of the legislature to pass. In November of 2018 Nebraska voters will vote whether to expand Medicaid through a proposition. The effort to put the proposition on the ballot faced a legal challenge from the state’s Republican leaders but was ultimately allowed to proceed by the courts. Prior to the expansion of Medicaid, the state did not cover childless adults at any level and covered parents up to 63% of the federal poverty level.

General facts about Nebraska Medicaid:

Medicaid program name: Medicaid

CHIP Program name: Kids Connection

Separate or combined CHIP: Combination

Medicaid Enrollment: 245,000 (2018 estimate)

Total Medicaid Spending: $2.1 billion (FY 2017 estimates)

Share of total population covered by Medicaid: 13%

Share of Children covered by Medicaid: 30% (estimate)

Share of Medicaid that is Children and Adults: 73%

Share of Spending on Elderly and people with disabilities: 69%

Share of Nursing Facility Residents covered by Medicaid: 50% (estimate)

FMAP: 52.58%

Expansion state: No

Number of people in expansion: N/A

Work Requirement: No


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