finance
Nebraska Becomes First State to Enforce Medicaid Work Requirements, Ahead of 2027 Federal Deadline
Nebraska became the first U.S. state to roll out Medicaid work requirements on Friday, affecting an estimated 72,000 residents. The policy, mandated under President Donald Trump's bill, requires able-bodied adults to prove 80 hours of work or exemptions monthly. Around 25,000 enrollees could lose coverage, advocates warn, amid concerns over bureaucratic hurdles.
Apr 29, 4:34 PM·4m read7 sources
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Nebraska on Friday implemented Medicaid work requirements, becoming the first state to do so eight months ahead of the federal deadline of January 1, 2027. The policy, mandated in President Donald Trump’s bill, applies to able-bodied adults ages 19 to 64.
An estimated 72,000 Nebraskans are subject to the requirements, with around 25,000 residents who qualified for Medicaid under the Affordable Care Act’s expansion expected to lose coverage, according to the Urban Institute.
New Medicaid enrollees in Nebraska must submit proof of work hours or exemption beginning Friday. People already on Medicaid have until at least the end of July to provide such proof. Those who do not submit information within a month of notification may be denied or lose coverage, according to the Nebraska health department.
To maintain eligibility, individuals must show they work, volunteer, or perform community service at least 80 hours a month, or are enrolled in school or an apprenticeship at least half the time. Beginning next year, Nebraska will review Medicaid eligibility every six months, up from once a year. The Trump administration is not expected to release official guidance on the requirements until June.
Pregnant women, parents of young children, and people with disabilities are exempt from the requirements. People diagnosed with certain medical conditions also qualify for exemptions. In late April, Nebraska released a nearly 300-page list of diagnoses qualifying as medically frail for exemption, spanning thousands of medical codes.
Nebraska’s website states health officials will review medical claims data about 90 days before the end of an enrollee’s eligibility period to automatically exempt those with qualifying conditions. People without automatic exemption must file their own form declaring a listed condition. “It’s not super straightforward.
