As states face stricter Medicaid work requirements, Nebraska is an early test

By — Hannah Grabenstein Hannah Grabenstein Leave your feedback Share Copy URL https://www.pbs.org/newshour/nation/as-states-face-stricter-medicaid-work-requirements-nebraska-is-an-early-test Email Facebook Twitter LinkedIn Pinterest Tumblr Share on Facebook Share on Twitter As states face stricter Medicaid work requirements, Nebraska is an early test Nation Jun 5, 2026 5:00 PM EDT The Health Center Association of Nebraska usually enrolls about 15 people each month in Medicaid. In May, after Nebraska became the first state to enact President Donald Trump's stricter work requirements, the organization enrolled none. WATCH: Who will be affected by Trump administration's Medicaid, SNAP work requirements That drop-off in new Medicaid enrollees is unheard of for the organization, said CEO Amy Behnke, whose nonprofit supports and advocates for the state's community health centers. She believes people aren't coming in because they assume, with these new work requirements, they're not eligible for Medicaid or "they think it's going to be too overwhelming or cumbersome to try to keep coverage." Trump's big tax and funding bill, or "One Big Beautiful Bill Act," signed into law last summer, established "community engagement requirements" for people with low incomes or disabilities who receive health insurance through Medicaid. The federally mandated requirements won't affect all Medicaid recipients, but millions of enrollees in 43 states , including Washington, D.C., must now prove they're working, volunteering or going to school for at least 80 hours a month or risk losing their benefits at the start of 2027. Nearly all of these states expanded Medicaid under the Affordable Care Act. Experts told PBS News they worry the new requirements could result in hundreds of thousands of otherwise eligible enrollees losing health coverage. Educate your inbox Subscribe to Here’s the Deal, our politics newsletter for analysis you won’t find anywhere else. Nebraska enacted new requirements on May 1, eight months ahead of the Jan. 1, 2027, deadline. New applicants have to prove that they're meeting the work requirements or qualify for an exception in the month immediately prior to enrollment, Behnke said. The state said the change will not apply to Medicaid enrollees whose yearly renewal is in May or June of this year. The first group of re-enrollees affected will be those whose yearly renewal is set for the end of July. The changes come as the administration says it's targeting fraud and waste in federal health programs. After the Centers for Medicare & Medicaid Services issued new guidance in early June on how states ought to implement the work requirements, Dr. Mehmet Oz, head of CMS, said the stricter rules will restore a "perverted" Medicaid system. "If you're sitting at home, which is true for the millions of people who are able-bodied on Medicaid, on average you're spending 6.1 hours watching television or just hanging around," he said, appearing to cite an America