Nebraska rolls out Medicaid work requirements, putting thousands at risk of losing coverage

Nebraska on Friday became the first state to implement Medicaid work requirements, eight months ahead of the federal deadline mandated in President Donald Trump’s “big, beautiful bill.”The move is expected to strip coverage from around 25,000 residents who qualified for the program under the Affordable Care Act’s Medicaid expansion, according to the Urban Institute, a nonpartisan research group.

Nebraska on Friday became the first state to implement Medicaid work requirements, eight months ahead of the federal deadline mandated in President Donald Trump’s “big, beautiful bill.”

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The move is expected to strip coverage from around 25,000 residents who qualified for the program under the Affordable Care Act’s Medicaid expansion, according to the Urban Institute, a nonpartisan research group. An estimated 72,000 Nebraskans will be subject to the policy, which applies to “able-bodied” adults ages 19 to 64.

States are not required to implement the work requirements until Jan. 1, 2027, and the Trump administration isn’t expected to release official guidance on how states should do so until June. Advocates for Medicaid say the rollout is unnecessarily rushed.