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Nebraska Becomes First State to Enforce Medicaid Work Requirements on May 1, 2026

The mandate covers expansion adults at 80 hours a month with twice‑yearly reporting.

Overview

  • Gov. Jim Pillen announced the rollout alongside CMS Administrator Mehmet Oz, who voiced support for the policy.
  • State officials estimate about 30,000 Nebraskans will be subject to the new rules, and roughly 70,000 expansion enrollees will receive notices.
  • Exemptions include pregnant people, those who are disabled or medically frail, caregivers of young or disabled dependents, recently incarcerated people, people experiencing homelessness, and those in addiction treatment.
  • Nebraska plans no increase in state staffing despite added verification and IT demands created by the six‑month paperwork cycle.
  • The Congressional Budget Office projects large Medicaid savings nationally but millions more uninsured annually starting in 2027, with little expected employment gain.