Nebraska is First in the Nation to Pursue Medicaid Work Requirements

Governor Jim Pillen was recently joined by Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, and Nebraska Department of Health and Human Services (DHHS) CEO Steve Corsi in announcing that Nebraska is the first state in the nation to pursue work requirements for Medicaid expansion members. At the news conference, Governor Pillen signed a letter to CMS, detailing Nebraska's intent to implement requirements by May 1, 2026. The new work requirements are the result of HR1, known as the One Big Beautiful Bill. Among its key provisions is a requirement that able-bodied adults in the Medicaid expansion population engage in work or other qualifying activities as a condition of receiving Medicaid benefits.Governor Pillen praised the Trump administration for passage of the OBBB and emphasized that the policy will promote long-term independence and stronger community ties.“These requirements will help Nebraskans achieve greater self-sufficiency through employment and other meaningful activities," said Governor Pillen. “Working not only provides purpose but helps people become active, productive members of their communities. Nebraska will be ready to move forward with these requirements prior to the federally mandated start of Jan. 1, 2027." Under the new rules, able-bodied adults ages 19–64 in the Medicaid expansion population will be required to participate in work, approved work programs, community service, or educational activities for at least 80 hours per month, unless they qualify for an exemption. “Across the nation, our goal is to support people engaged in meaningful work, involved in their communities, and connected to the support that sets them up for long-term success," said CMS Administrator Dr. Mehmet Oz. “Nebraska is leading the way as the first state to launch its community engagement requirements, and we congratulate Governor Pillen and his team for their commitment to helping more Nebraskans move toward greater independence and opportunity. CMS will be working together with Nebraska and its 50 counterparts to ensure every program is implemented smoothly, responsibly, and in compliance with federal law." Most importantly, children in working households benefit from more stable routines, improved educational outcomes, and stronger examples of workforce participation. Higher employment rates are also linked to lower crime rates, increased civic engagement, and a stronger economy.DHHS CEO Steve Corsi said not only will these changes help more Nebraskans move toward economic stability; it will also help Nebraska's businesses and economy. “Employment provides financial stability, fosters personal growth, and will help Nebraska's small businesses in need of workers," said Corsi. “These new requirements move Nebraska forward by encouraging greater economic and social participation."Current Nebraska Medicaid members will be assessed for the new requirements during their regularly scheduled renewal after the implementation date. Individuals applying for Medicaid on or after May 1, 2026, will need to provide verification of their community engagement activities or qualifying exemption. Of particular note:The rule changes apply to able-bodied adults ages 19-64 in the Medicaid expansion population.Medicaid expansion includes individuals 19-64 with low incomes who receive health coverage through Nebraska Medicaid.Eligibility is based on income up to 138 percent of the federal poverty level (in 2025 for a single person was $21,610, or for a family of four was $44,380).Work requirement activities are requirements that Medicaid expansion members and applicants must meet in order to receive coverage through Nebraska Medicaid.Qualifying work requirement activities include employment, attendance at school, participation in an apprenticeship, participation in an approved work program, or volunteering.Nebraska Medicaid will use available data to verify compliance during application and renewal. If verification cannot be completed, members will be responsible for submitting documentation. Individuals found non-compliant will receive notice and have 30 days to meet the requirement or claim an exemption before denial or disenrollment. Exemptions:Certain individuals are excluded from this requirement, including:People who are disabledPeople who are currently in foster carePeople through age 25 who aged out of foster careMembers of recognized Native American tribesPregnant womenParents or guardians of children up to age 13Caregiver of an individual with disabilitiesDisabled veterans (with a 'total' disability status)People who are medically frailPeople compliant with work requirements under the SNAP or TANF programsPeople receiving treatment for a substance use disorderPeople who are incarcerated or have been within the last 90 daysPeople who qualify for Medicare Part A or Part BIndividuals seeking assistance with employment opportunities may use the Nebraska Department of Labor's NEworks job service at neworks.nebraska.gov or download the NEworks mobile app from the App Store or Google Play.DHHS will send a notice by mail, email, or text to beneficiaries who must participate in community engagement (or have an exemption). More information regarding the requirement can be found at dhhs.ne.gov/workrequirements.

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