π Nebraska First State to Enforce Medicaid Work Rules Under OBBBA Nebraska became the first U.S. state to implement Medicaid work requirements on May 1, 2026, under the Trump administration's One Big Beautiful Bill Act, which became law in July 2025. Most adults without dependents must now document at least 80 hours per month of work, education, or approved activity to keep coverage. All states must comply by January 1, 2027. Human Rights Watch, Oxfam America, and Nebraska Appleseed report that large numbers of Nebraskans are already losing coverage. One interviewee, Eli McCreary, 64, said he lost Medicaid while undergoing kidney cancer treatment β his specialist appointment was canceled and care delayed until coverage was restored. A state eligibility worker described the rollout as "rushed and confusing," citing poor training, vague guidance, and unprepared software systems. The OBBBA affects nearly 20 million adults without dependents across 40 states and Washington, D.C. who rely on expanded Medicaid under the Affordable Care Act. Source
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π Nebraska First State to Enforce Medicaid Work Rules Under OBBBA
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