Nebraska Medicaid Work Rules Implemented as Patient Loses Coverage

Shortly after doctors diagnosed Eli McCreary with kidney cancer, a local hospital informed the 64-year-old Omaha resident that he no longer had Medicaid coverage and would have to pay out-of-pocket or face canceled appointments.

McCreary’s situation unfolded as Nebraska became the first state to enforce new Medicaid work rules, launching the mandate on May 1, 2026, ahead of a nationwide deadline of January 1, 2027.

Roughly 70,000 adult Medicaid recipients in Nebraska are subject to the policy, which mandates 80 hours a month of work, study, volunteering, or participation in a similar activity, unless an exemption or hardship exception applies.

said in December

State documents show Nebraska set aside $8.2 million over two years for private contractors to handle the administrative transition. Yet advocates report widespread confusion, jammed call lines, and notices that failed to reach vulnerable participants.

Average wait times at the state health department call center nearly doubled from May to July, shifting from 13 minutes to 26 minutes. In August alone, the center handled over 101,000 calls, marking a 66% surge from May figures.

For McCreary, the policy shift triggered immediate disruption. He had been scheduled to see a cancer specialist, but the appointment was canceled after his insurance coverage lapsed.

I had to wait until I got insurance again to even come back out here, McCreary said. Everything was delayed.

Nebraska Medicaid Work Rules Strain Coverage Ahead of January Rollout

Attorneys and policy professionals who work with people on Medicaid and other public benefit programs said that McCreary’s substance use treatment, lasting four months starting in November 2025, and other health conditions should have exempted him.

If I could work, I would work, McCreary told Human Rights Watch, Oxfam America, and Nebraska Appleseed. But I can’t…. I can’t walk around. I mean, I can’t breathe. I can’t walk very far.

State officials defend the rollout as an operational success. Jeff Powell, a spokesperson for the Nebraska Department of Health and Human Services, said state data indicates 86% of affected applicants met the requirement or qualified for an exclusion, while 93% of existing enrollees maintained their coverage.

The Congressional Budget Office estimates that new Medicaid work requirements could increase the number of uninsured Americans by 4.8 million by 2034.