Nebraska faces challenges as first state to impose Medicaid work requirements under GOP bill

Nebraska on Friday is set to become the first state to impose Medicaid work requirements under the GOP’s One Big Beautiful Bill Act, racing ahead of the national deadline by eight months. 

Nebraska’s experience will be a key test for Republicans who been championing work requirements, as it could be an indicator of what the rest of the country will face when the policy takes effect nationwide. 

The only two states that have enacted similar rules— Arkansas and Georgia— found they did not increase employment, caused tens of thousands of people to lose coverage and cost the states millions of dollars.  

In Nebraska, Medicaid advocates and health policy experts fear similar coverage losses as people get buried under a blizzard of red tape. The law’s implementation timeline was already compressed, and they said Nebraska’s decision to rush ahead will be disastrous. 

For instance, the state just this week released hundreds of pages with key details about who will qualify for a “medically frail” exemption.  

“Unfortunately, when we have a rush job, we usually see bad results, and this is shaping up to be the case,” said Sarah Maresh, the program director for health care access at the nonprofit Nebraska Appleseed. 

Work requirements have been a priority for President Trump and congressional Republicans since his first term.    

The GOP’s tax and spending megabill used work requirements to partially pay for its nearly $3 trillion price tag. The Congressional Budget Office estimated nearly 5 million people will lose their Medicaid over the next decade as a result, including many who are already working. 

GOP officials argue work requirements are needed to root out waste fraud and abuse in the Medicaid program, and they will only target the “able-bodied” people who should be working but choose not to.   

Nebraska Gov. Jim Pillen (R) has said he wants to promote self-sufficiency. 

“It’s a key piece of giving the discipline for our families to be successful. It’s a key piece of self-worth. It’s a key piece of mental health and........

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