Nebraska to Launch Medicaid Work Requirements in May: 4 Key Points

Nebraska will introduce Medicaid work requirements in May, becoming the first expansion state to implement these provisions under HR 1.

Here are four key points ahead of the rollout:

1. Medicaid expansion states must implement community engagement requirements by the beginning of 2027. However, some states can start earlier through a waiver or state plan amendment. As of Jan. 14, several states—including Montana, Iowa, Arizona, Ohio and South Carolina—are still awaiting CMS approval for waivers, according to KFF. Nebraska moved forward using a state plan amendment.
2. While Nebraska is taking the lead on work requirements under HR 1, only Georgia and Arkansas have previously attempted similar measures. CMS withdrew approval for Arkansas’ requirements in 2021, while Georgia pushed to retain its program and ultimately secured a temporary extension through the end of 2026.
3. For Nebraska Medicaid expansion members, the Department of Health and Human Services will verify compliance with work requirements during the renewal process. The department will begin reviewing eligibility for members whose annual coverage periods end July 31 or later. Current members must complete the requirements for at least one month since their most recent renewal. Applicants seeking Medicaid on or after May 1 must meet the requirements in the month prior to applying.
4. More than 70,000 Nebraskans were expected to receive notifications about the work requirements, according to December reporting from Nebraska Public Media. Of those, around 30,000 will need to show compliance, as estimated by Republican Gov. Jim Pillen.

At the Becker’s 5th Annual Fall Payer Issues Roundtable, scheduled for November 2–3 in Chicago, payer executives and healthcare leaders will gather to discuss value-based care, regulatory changes, cost management strategies and innovations shaping payer-provider collaboration.