Nebraska - #2 (tie)
Ranking: Health Insurance Freedom
Health Insurance
-1
from 2014
Analysis
Like other Great Plains states, Nebraska has usually had very good regulatory policy. It benefited from the commodity boom, federal farm subsidies, and its own policy regime during the 2000s and early 2010s, posting one of the highest growth rates in the country. However, it has lagged Colorado, Wyoming, and Iowa since 2011.
Nebraska is relatively fiscally decentralized but relatively high-taxed, with somewhat lower-than-average state tax revenues (about 5.1 percent of adjusted personal income, a drop from 6 percent in FY 2006) and higher-than-average local tax revenues (5.1 percent of income). Nebraskans do not have much choice of local governments, limiting the benefits of this approach—the state has only 0.44 effective competing jurisdictions per 100 square miles. Debt, assets, and public employment are about average, while government GDP share is higher than average.
Nebraska does very well on the most important regulatory policy category, land-use and environmental freedom. However, it has not done much to check eminent domain for private gain. On labor policy it is above average because of a right-to-work law and flexible workers’ compensation funding rules, but it enacted a high minimum wage in 2014. Health insurance freedom is extensive, with few mandated benefits outside the ACA essential benefits and with a light touch on managed care. Nebraska does a little better than average in keeping occupational licensing in check, and in 2015 nurse practitioners gained full practice authority. The state has long had one of the best civil liability systems in the country. The state has a certificate-of-need law for hospital construction.
