Nebraska Implements First Medicaid Work Requirements Ahead of Federal Deadline

Nebraska began enforcing Medicaid work requirements on May 1, 2026, eight months before the federal deadline. The rule targets adults 19-64 in the state’s Medicaid expansion who are not pregnant, parents of children under 14, or otherwise exempt. Enrollees must log 80 hours per month of work, volunteering, schooling or training, or earn $580 monthly (the federal minimum-wage benchmark). Exemptions include pregnancy, caregiving and “medically frail” status, defined by a 300-page list of medical codes. Nebraska will cross-check Medicaid claims and credit-agency data; otherwise, individuals must self-attest or submit paperwork, with no new staff. The expansion covers about 70,000 adults. The Urban Institute projects up to 25,000 could lose coverage; the Center for Budget and Policy Priorities estimates 28,000-41,000 at risk, and the state has not disclosed how many enrollees will be auto-verified versus required to submit forms. KFF notes 60-72 % already meet the rule, leaving roughly 30-40 % who may need to act. The CBO projects 4.8 million nationwide Medicaid beneficiaries could lose coverage over the next decade.

Straight Arrow NewsKTVT - Dallas - Fort Worth NewsCNNNPRNebraska becomes 1st state to implement Medicaid work requirementsNBC NewsHealthCareDiveWashington TimesNew Tang DynastyAs Medicaid work requirements go into effect Friday, Nebraska DHHS and advocates disagree on how implementation will go

Gov. Jim Pillen called the policy a “hand-up” that will boost independence. CMS Administrator Dr. Mehmet Oz praised Nebraska’s early start, saying the state is “working out the kinks.” Medicaid Director Drew Gonshorowski said agency’s top priority is communication. Spokesperson Jeff Powell said grants cover costs and no additional staff are needed.

As Medicaid work requirements go into effect Friday, Nebraska DHHS and advocates disagree on how implementation will go

Advocacy groups warn the rushed rollout and a 300-page exemption list will generate losses. Sarah Maresh of Nebraska Appleseed called the effort a “rush job” that could cause widespread disenrollment. Allie Gardner of the Center on Budget and Policy Priorities flagged difficulty navigating medical-code list. Adam Gaffney warned that documentation burdens will disproportionately affect disabled enrollees. Schmeeka Simpson, a Medicaid recipient who works three jobs, fears losing coverage despite meeting the requirement. Crystal Schroer said the policy “made my depression way worse” because of uncertainty about exemption eligibility.

HealthCareDive

• “Welfare should be a hand up, not a hand out, and this will encourage able-bodied adults to join the workforce — and ultimately help these folks know that their contributions to our state make a difference,” — Jim Pillen, Governor of Nebraska

New Tang Dynasty

• “Our top priority is making sure members clearly understand changes to the program and how to maintain their coverage,” — Drew Gonshorowski, Nebraska Medicaid Director

NPR

• “A vast majority of Nebraskans are working or would meet an exemption, but it is the red tape that's what causes the problems and really causes people to lose coverage,” — Sarah Maresh, Healthcare Access Program Director, Nebraska Appleseed

As Medicaid work requirements go into effect Friday, Nebraska DHHS and advocates disagree on how implementation will go

• “It is not easy being sick, and it’s especially hard to navigate bureaucracies and document exemptions like chronic illness,” — Adam Gaffney, Assistant Professor of Medicine, Harvard Medical School

NBC News