Nebraska is set to become the first state in the nation to enforce Medicaid work requirements established through President Trump’s budget legislation. Beginning Aug. 1, approximately 200 state residents will lose their coverage for failing to meet the new guidelines, according to the state’s Medicaid director Drew Gonshorowski. The state accelerated its implementation timeline, moving ahead of the federal deadline of Jan. 1, to roll out the requirements.
Under the new federal rules, approximately 20 million people across 44 states must work or volunteer for at least 80 hours per month, attend school, or participate in job training to maintain their Medicaid benefits. Certain populations, including people with disabilities, individuals with serious illnesses, parents of young children, and caregivers, are exempt from the requirements. Gonshorowski stated that Nebraska expects about 70,000 residents to be subject to the work requirements, with an estimated 30,000 potentially losing coverage by 2028.
Proponents of the policy, including state officials, contend that work requirements will help recipients achieve economic stability and move out of poverty. The Medicaid director cited potential federal savings of $325 billion over a 10-year period. However, critics point to prior research indicating that previous work requirement policies failed to increase employment rates and often resulted in coverage loss for individuals who were unaware of the rules or unable to navigate administrative requirements.
Nebraska determined it could verify compliance for approximately three-quarters of affected individuals through its own eligibility system without requiring additional member outreach. The state conducted an extensive outreach campaign including written notices, text messages, emails, and broadcast advertising. Despite these efforts, advocates have raised concerns about the clarity of state communications, and testing of the state’s Medicaid help line revealed extended wait times and accessibility issues. Gonshorowski indicated his team is meeting regularly with federal officials to improve outreach and communication processes.
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