Nebraska is becoming the first state to implement a Medicaid work requirement signed by Trump

ABC NewsLiveVideoShowsShopInterest Successfully AddedWe'll notify you here with news aboutTurn on desktop notifications for breaking stories about interest? OffOnStream onNebraska is becoming the first state to implement a Medicaid work requirement signed by TrumpMany people applying for Medicaid in Nebraska will soon have to prove that they're working, volunteering or in schoolByGEOFF MULVIHILL Associated Press and MARGERY A. BECK Associated PressApril 28, 2026, 12:00 AM1:19FILE - Nebraska Gov. Jim Pillen, speaks during a news conference at the Department of Agriculture to rollout the USDA'S National Farm Security Action Plan in Washington, July 8, 2025. (AP Photo/Manuel Balce Ceneta, File)The Associated PressOMAHA, Neb. -- Nebraska on Friday will become the first state to enforce work, volunteer or education requirements for new Medicaid applicants, eight months before the federally mandated requirements kick in. Advocates worry that the state is launching so rapidly that key details remain unresolved and some people who are eligible for coverage will lose it.State officials say they're prepared, training staff and sending letters, emails and texts to people who could be impacted.Health policy experts, advocates and other states will be watching closely.“It can be used as a lesson for other states, both where things go well and where things don’t go well,” said Jennifer Tolbert, deputy director of KFF's Program on Medicaid and the Uninsured.The work requirement is part of a broad tax and policy law that President Donald Trump signed last year. Nebraska Republican Gov. Nebraska Gov. Jim Pillen announced in December that the state would implement it eight months before it was required, saying the aim was “making sure we get every able-bodied Nebraskan to be a part of our community.”The state had one of the lowest unemployment rates in the U.S. in February: 3.1%The federal policy won't apply to all Medicaid beneficiaries, just those who are enrolled under an expansion that most states chose to make to allow more low-income people to get healthcare coverage.Under the change, many Medicaid participants ages 19 through 64 will have to show that they work or do community service at least 80 hours a month, or are enrolled in school at least half-time. They'll also have their eligibility reviewed every six months rather than annually, so they could lose coverage faster if their circumstances change.Exceptions will be made for people who are too medically frail to work or in addiction treatment programs, among others.An Urban Institute report from March estimated that the changes would mean about 5 million to 10 million people fewer people nationally would be enrolled in Medicaid than would have been otherwise. Choices states make about how to run their programs are expected to be a major factor in exactly how many people lose coverage.“The higher the administrative burden, the more likely people are found noncompliant and disenrolled,” said Michael Karpman, who researches health policy at Urban.Not everyone who has coverage will need to submit proof that they're working.The state says it will first match enrollees with other data it has to see if participants are working or exempt. The state says it has that information for most of the roughly 70,000 people enrolled in Medicaid through the expansion.That leaves between 20,000 and 28,000 who would have to provide more information, plus an average of 3,000 to 4,000 new enrollees each…

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