In September 2003, the Nebraska Department of Health and Human Services System contracted with The University of Nebraska Medical Center to examine the characteristics of the uninsured in Nebraska and to suggest strategies for extending health insurance coverage to Nebraskans without health insurance. This contract was issued as part of the U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA) State Planning Grants Program.

In order to examine the characteristics of the uninsured in Nebraska and to develop policy recommendations, the University of Nebraska Medical Center conducted a household telephone survey of 3,750 Nebraskans and 13 focus groups across the six health planning regions in the State. The household survey was conducted from March 10 through May 8, 2004, and the focus groups were conducted from June 3 through July 27, 2004. The purpose of the household survey was to determine the characteristics and location of the uninsured in the State. The purpose of the focus groups was to improve understanding of the experience of the uninsured in Nebraska and to understand the factors small employers consider when deciding whether to offer health insurance to their employees.The Nebraska Health Insurance Policy Coalition used the results of the household survey and the 13 focus groups to develop public and private strategies to improve availability, accessibility, and affordability of health care services to Nebraskans. In May 2005, UNMC conducted 9 additional focus groups to solicit reactions to the strategies proposed by the Coalition.

In the fall of 2006, we conducted a three-part study designed to assess the prospects for providing affordable health insurance benefits through small businesses. This study included (1) a mail survey of 158 small businesses with 50 or fewer employees located in three geographic regions—Lancaster County, Tri-cities area (which consists of Hall, Adams, and Buffalo counties), and Scotts Bluff County—in Nebraska; (2) telephone interviews of 373 employees in the same three geographic regions who work for businesses with 3 to 500 employees; and (3) an assessment of the gap between the cost that small employers and their employees are able to afford for health benefits and the cost of products currently available for small business to offer their employees. The findings from this study can be used to develop strategies that would work toward closing the gap that currently exists between self-reported affordability and the cost of current health insurance coverage options available to small businesses and their employees.