What Does Nebraska’s 2025 Executive Order on Abortion Providers Really Do?

In November 2025, Governor Jim Pillen issued Executive Order No. 25-16, directing the Nebraska Department of Health and Human Services (DHHS) to review and, where appropriate, terminate Medicaid participation for providers involved in or affiliated with abortion services. The order doesn’t explicitly name Planned Parenthood, but it could affect organizations previously excluded from Medicaid in other states. Supporters see it as reinforcing Nebraska’s pro-life laws; critics warn it may restrict access to preventive and reproductive health care. This article explains what the order says, how it fits into Nebraska law, and what its effects may be for patients, providers, and future litigation.

Understanding Executive Order No. 25-16

Governor Pillen signed the order on November 6, 2025, citing Nebraska’s longstanding policy of protecting “the life, health, and welfare of pregnant women and unborn human life.”

The order instructs DHHS to:

• Terminate or deny Medicaid enrollment for any provider excluded from Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP) in another state.

• Consider sanctions against affiliates or associated persons of sanctioned providers.

• Review the eligibility of providers disenrolled elsewhere and decide whether they meet Nebraska’s standards for medical care and administration under 471 NAC 2.

• Add terminated entities to Nebraska’s Medicaid Excluded Provider list.

DHHS must bring its operations into compliance no later than November 28, 2025 .

The Legal Basis Behind the Order

The Governor grounded the order in a mix of state statutes, administrative regulations, and recent federal precedent, including:

• Neb. Rev. Stat. § 28-325, declaring Nebraska’s duty to protect unborn life;

• Neb. Rev. Stat. §§ 44-8402, 44-8403, 71-7606(3), prohibiting the use of taxpayer funds for abortion;

• 471 NAC 2, 005.01 and 005.04, which authorize DHHS to exclude or sanction Medicaid providers that fail to meet standards or have been terminated elsewhere;

• The federal One Big Beautiful Bill Act, Pub. L. 119-21 (2025), limiting federal funds for abortion providers; and

• The U.S. Supreme Court’s Medina v. Planned Parenthood South Atlantic, 606 U.S. ___ (2025), confirming that states may decide which providers qualify for Medicaid participation .

Together, these authorities give Nebraska discretion to deny Medicaid enrollment to abortion-affiliated providers, as long as the decision complies with federal Medicaid standards.

How This Order Could Affect Nebraska Health Care

Although the order doesn’t automatically cut off funding to any single organization, it signals that Nebraska intends to align its Medicaid rolls with other states’ exclusions.

If Planned Parenthood or similar providers have been terminated elsewhere for abortion-related activities, DHHS may now disenroll those affiliates in Nebraska.

Critics worry that such action could reduce access to contraception, STI testing, and cancer screening—particularly in rural counties with few reproductive-health providers.

Supporters counter that other community health centers and non-profit clinics can fill those roles without performing or promoting abortions.

Because implementation is left to DHHS discretion, actual impacts will depend on future rulemaking and enforcement. The order doesn’t bar all reimbursements automatically; it directs a review process that could result in exclusion where statutory grounds exist.

Implementation and Legal Outlook

DHHS agencies must comply by late November 2025, meaning provider reviews are likely underway.

Legal challenges may emerge if the disenrollment process affects patients’ ability to choose qualified Medicaid providers. Potential arguments could include claims under federal Medicaid’s “free-choice-of-provider” rule or equal-protection concerns, though the Medina decision narrowed those paths.

Future governors or legislatures could amend or rescind the order, but for now it stands as Nebraska’s most sweeping post-Dobbs executive action on reproductive health funding.

Frequently Asked Questions (FAQ)

Does Medicaid in Nebraska still cover abortion in limited cases?

Yes. Under both state and federal law, Nebraska Medicaid only covers abortion in cases of rape, incest, or when the mother’s life is in danger—a rule unchanged by Executive Order 25-16.

Does the order directly defund Planned Parenthood?

Not explicitly. The order doesn’t name Planned Parenthood, but if its Nebraska affiliates have been excluded from Medicaid in another state, DHHS may terminate their enrollment after review.

What happens to patients who used those clinics?

Patients can continue care at Medicaid-approved community health centers, federally qualified health centers, or county health departments, though service availability may vary.

When does the order take effect?

DHHS agencies must achieve compliance no later than November 28, 2025, though provider reviews may take place over several months.

Could the order be challenged in court?

Yes. Lawsuits could argue that the order violates Medicaid’s federal requirements or Nebraska’s Administrative Procedure Act if DHHS actions exceed its rulemaking authority.