No
Rescinding the Nebraska Sustainable Coverage Demonstration Waiver
After further review and consideration of stakeholder feedback, operational factors, fiscal considerations, and federal policy guidance, DHHS has determined that it will not proceed with submission of the Sustainable Coverage Demonstration application at this time. As a result, DHHS will not submit the demonstration application to CMS and no changes will be made to the current retroactive Medicaid eligibility policy at this time.
Program Update
Under the Section 1115 Sustainable Coverage Waiver, the State seeks to limit retroactive eligibility to the beginning of the month in which the individual applies for Medicaid. Via this waiver, Nebraska DHHS seeks to promote timely Medicaid enrollment and program sustainability. Individuals will be encouraged to apply for Medicaid immediately, whether or not they have an immediate need for care, which will promote continuity of coverage. Medicaid will align better with the commercial market, which does not have retroactive eligibility, making individuals more prepared should they transition to commercial coverage in the future. The change to retroactive eligibility will also encourage providers to work with individuals to complete Medicaid applications in a timely manner.
The Demonstration also seeks to promote program sustainability not only by limiting the start of coverage but also by promoting proactive healthcare management and efficient use of healthcare resources. Individuals with ongoing coverage are more able to maintain primary care and receive care in the most appropriate and efficient settings.
Importantly, the waiver does not seek to eliminate retroactive eligibility in its entirety. Individuals will remain eligible for coverage effective with the first day of the month of application. This will ensure that individuals do not face gaps in coverage due to potential delays in application processing.
The anticipated effective date for this waiver is October 1, 2026.
Program Information
Public Hearings
MLTC will hold public hearings to receive comments on the Section 1115 demonstration waiver application. The slides from the presentation are in the Program information section above.
- Wednesday, March 11, 2026 - 3:00pm-4:30pm
- Charles H. Gere Branch Library - 2400 S 56th Street Lincoln, NE 68506
- Meeting Recording
- Tuesday, March 17 - 11:00am-12:30 pm
- Legislative Hearing - Friday, February 27, 2026 - 1:30pm