❓WHAT HAPPENED: New Medicaid work requirements will be implemented in Nebraska, becoming the first U.S. state to reform the system under a federal law signed earlier in 2025.
👤WHO WAS INVOLVED: Governor Jim Pillen (R), Nebraska’s Department of Health and Human Services, and Administrator of the Centers for Medicare and Medicaid Services (CMS) Dr. Mehmet Oz.
📍WHEN & WHERE: Nebraska, with implementation notifications starting January 2026 and full rollout by May 2026.
💬KEY QUOTE: “This is a hand up, not a handout. It’s a key piece of giving the discipline for our families to be successful.” – Governor Pillen
🎯IMPACT: Approximately 72,000 Nebraskans could be affected.
The State of Nebraska will be the first U.S. state to bring itself into compliance with new Medicaid work requirements implemented under President Donald J. Trump’s One Big Beautiful Bill Act. Able-bodied adults who are between the ages of 19 and 64 must now provide documentation showing 80 hours of employed work or community service every month to qualify for benefits under Nebraska’s Medicaid expansion. Alternatively, they must be enrolled in school at least part-time to maintain coverage.
Signed into law by President Trump on July 4, 2025, the legislation mandates that states adopt Medicaid work requirements by 2027 but allows for earlier implementation. Nebraska is the first state to announce its compliance.
The new work requirements will impact an estimated 72,000 of Nebraska’s 346,000 Medicaid recipients, with the former falling under the higher-income expansion population affected by the federal rule. Those exempt from the work requirements include disabled veterans, pregnant women, primary caregivers of minor children or disabled dependents, those recently incarcerated, homeless, or those currently receiving addiction treatment.
“We’re not here to take everybody to the curb [but we’re] making sure we get every able-bodied Nebraskan to be part of our community,” Governor Jim Pillen (R) said, announcing the changes. He continued: “This is a hand up, not a handout. It’s a key piece of giving the discipline for our families to be successful. It’s a key piece of self-worth. It’s a key piece of mental health and stability.”
Dr. Mehmet Oz, Administrator of the Centers for Medicare and Medicaid Services (CMS), supported the initiative, saying, “So, there actually is work to do. We just got to get it to people who are struggling to find their way with the job opportunities that can allow them to get back on their feet and get back into full employment.”
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