Nebraska First to Enforce Federal Medicaid Work Rules

Nebraska on Thursday became the first state to enforce new federal Medicaid work requirements, mandating that certain adults complete at least 80 hours per month of work, volunteering, school attendance or participation in a work program to maintain coverage.

The requirements, established under H.R. 1, also known as the One Big Beautiful Bill and signed into law by President Donald Trump last year, apply primarily to low-income adults ages 19 to 64 enrolled through the Affordable Care Act's Medicaid expansion, including able-bodied individuals without dependent children. Participants can also meet the threshold by earning at least $580 per month. Compliance will be verified at application and at least every six months during renewal.

Several groups are exempt, including those deemed medically frail. This category covers individuals with disabling mental health conditions, substance use disorders, physical or developmental disabilities that limit daily activities, or serious medical conditions such as advanced heart disease, diabetes, chronic obstructive pulmonary disease or cancer. People ages 65 and older qualify automatically for exemption upon Medicare eligibility. The...