Does Heritage Health Cover Home Birth in Nebraska? 2026 Coverage Reality: CNMs Cannot Legally Attend Home Births in Nebraska
No. Nebraska is the most restrictive state for home birth in the country. State law expressly prohibits Certified Nurse-Midwives from attending home deliveries: Neb. Rev. Stat. 38-613 says a CNM "shall not attend a home delivery." [1] Heritage Health (Nebraska Medicaid) covers CNMs but only in hospital and birth center settings. CPMs are not licensed in Nebraska and are not Medicaid-eligible. The legal barrier on home birth practice rather than the Medicaid coverage rule is what defines Nebraska's home birth landscape.
Nebraska is the country's most restrictive state for CNM-attended home birth. Statute expressly bars Certified Nurse-Midwives from attending home deliveries, [1] and a 2025 bill to lift the restriction stalled without becoming law. [4] Heritage Health (Nebraska's Medicaid program) covers CNM services in hospital and birth center settings as a federal mandate, [2] but the home birth setting is closed off by the practice statute. CPMs are not Medicaid-eligible. If you're on Heritage Health and want home birth, the legal barrier comes before the Medicaid question.
On this page
Sources cited (5)
- Neb. Rev. Stat. § 38-613
- Nebraska Total Care Heritage Health
- Social Security Act § 1905(a)(17)
- Unicameral Update, LB 676 (2025)
- Neb. Rev. Stat. § 38-1,118
Does Heritage Health cover home birth?
No. Nebraska's situation is structurally different from most states. The legal barrier comes before the Medicaid question: Neb. Rev. Stat. 38-613 states that a certified nurse-midwife "shall not attend a home delivery." [1] This makes home birth attended by a credentialed midwife unavailable in the state regardless of Medicaid coverage rules.
Heritage Health covers CNM services in hospital and birth center settings as a federal Medicaid mandatory benefit. [3] Heritage Health members can choose from hospitals or birth centers for delivery. [2] Home birth is not a covered or permitted place of service for CNMs in Nebraska.
For non-CNM midwives (CPMs, lay midwives), Nebraska's regulatory framework is also restrictive. CPMs are not licensed at the state level and cannot bill Heritage Health. Practicing a health profession without a state credential violates Nebraska's Uniform Credentialing Act, which carries criminal penalties. [5] Home births in Nebraska , when they occur , typically happen without licensed professionals present, with all expenses paid out of pocket.
Which midwife credentials does Heritage Health cover?
Nebraska Medicaid recognizes one midwifery credential, but with a unique legal restriction.
Certified Nurse-Midwives (CNMs) are licensed under Nebraska's Certified Nurse Midwifery Practice Act. CNM services are a federal Medicaid mandatory benefit. [3] However, Nebraska statute expressly bars CNMs from attending home deliveries, and it still requires a practice agreement with a collaborating physician. [1] CNMs can practice in hospital and birth center settings only.
Certified Professional Midwives (CPMs) are not state-licensed in Nebraska and cannot bill Heritage Health. A 2025 bill to create a CPM license (LB 374) was folded into the same stalled legislation as the CNM reform. [4]
| CREDENTIAL + SETTING | HERITAGE HEALTH COVERAGE | LEGAL STATUS |
|---|---|---|
| CNM in hospital | Yes (federal mandate) [3] | Legal |
| CNM in birth center | Yes (federal mandate) [3] | Legal |
| CNM at home (planned) | No [2] | Prohibited by statute [1] |
| CPM at home | No (not state-licensed) | No legal credential exists [5] |
What does Heritage Health cover for pregnancy?
Heritage Health covers full maternity care in permitted settings. [2] This includes prenatal visits, labor and delivery in hospitals and licensed birth centers, postpartum care, and newborn care. All three Heritage Health plans (Molina Healthcare of Nebraska, Nebraska Total Care, and UnitedHealthcare Community Plan) serve members statewide. Members can choose from hospitals or licensed birth centers for delivery.
For families wanting a home-birth experience while on Heritage Health, a CNM-staffed freestanding birth center is the closest legal alternative. Birth centers approximate the home birth model in a Medicaid-billable setting. Nebraska's birth center capacity is thin, though: the state's first freestanding birth center opened in Bellevue, near Omaha, and options outside the Omaha metro are limited. Confirm current in-network birth centers with your plan.
If a Nebraska family is determined to have a home birth despite the legal restriction, the practical reality is that they would need to do so without a credentialed birth attendant (which carries its own significant safety and legal risks) or travel to a neighboring state for prenatal care and birth (with cross-border Medicaid challenges).
What about advocacy to change Nebraska's home birth law?
Nebraska's home birth restriction has been the subject of midwifery community advocacy for years, and 2025 brought the closest attempt yet. LB 676, introduced by Sen. Ben Hansen, would remove the requirement that a CNM have a practice agreement with a collaborating physician and would eliminate the location restrictions that block home birth attendance. It advanced from General File on a 40-3 vote in April 2025, and a committee amendment would have folded in CPM licensure (LB 374) and Medicaid coverage of doula services (LB 701). [4] The amendment was rejected, the bill stalled on Select File, and as of mid-2026 none of it has become law. The statute barring CNM home delivery remains in force. [1]
If you're early in pregnancy in 2026 and considering home birth, the realistic options are:
Use a Nebraska freestanding birth center. This is the closest legal alternative to home birth and is covered by Heritage Health when the center is in network. Capacity is concentrated near Omaha, so confirm availability early.
Hospital-based CNM care. Heritage Health covers hospital-based CNM-attended birth.
Travel to a neighboring state. Some Nebraska families relocate temporarily to Iowa, Missouri, Kansas, or South Dakota for late prenatal care and home birth, though cross-border Medicaid coverage requires careful coordination and often does not follow you. Confirm with your plan before committing.
For a full guide to home birth midwives in Nebraska, including licensing, costs by region, and what to ask before hiring, see our Nebraska home birth midwife guide.
Bottom line: Nebraska is structurally different from every other state in this guide: statute expressly bars CNMs from attending home deliveries, [1] and the 2025 reform bill (LB 676) stalled without passing. [4] Heritage Health covers CNM services in hospital and birth center settings only. [2] CPMs are not state-licensed and cannot bill Heritage Health. The realistic options for a Nebraska Medicaid family wanting a home-birth experience are CNM-staffed birth centers, hospital-based CNM care, or relocation to a neighboring state for the pregnancy.
- Nebraska Revised Statutes. § 38-613. Certified Nurse Midwifery Practice Act. View source
- Nebraska Total Care. Medicaid: Heritage Health Plan. View source
- Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services. View source
- Nebraska Legislature, Unicameral Update. Bill to Broaden Practice Authority for Certified Nurse-Midwives Advanced. April 2025. View source
- Nebraska Revised Statutes. § 38-1,118: General violations; penalty. View source
▶ How we research and review this content Editorial standards
Every guide on Home Birth Partners is researched against primary sources (federal regulations, peer-reviewed clinical literature, and state-level licensing boards) and reviewed by a credentialed midwife before publication.
We update articles when source data changes, when state laws are revised, or at minimum every 12 months. The "Last reviewed" date in the byline reflects the most recent review.
If you spot an error or have a primary source we should add, email [email protected].