Nebraska’s Accelerated Medicaid Requirements Stir Concerns Among Residents and Experts
In a bold move, Nebraska has become the first state to implement stringent Medicaid work requirements, a decision that has sparked a wave of concern among residents and healthcare professionals. While the state government aims to reduce program costs, many fear the new requirements could leave vulnerable populations without essential medical coverage.
Cheri Stollar, a dedicated mother of five, has relied solely on Medicaid for healthcare coverage throughout her life. Despite pursuing higher education and juggling multiple jobs, she has been unable to break free from the grip of poverty. “I hate the myth that people who need these resources are lazy,” Stollar remarked. “I think access to medical care is vital for everyone. You shouldn’t only be able to take care of your medical needs if you have money.”
The updated Medicaid guidelines, propelled by the One Big Beautiful Bill Act, demand that able-bodied enrollees between the ages of 19 and 64 log at least 80 hours of employment, volunteering, or educational activities each month. This applies to individuals who are not pregnant, do not have disabilities, meet immigration criteria, and earn less than 138% of the federal poverty level, roughly $22,000 annually for a single person or $45,500 for a family of four. Further details on these requirements can be found on the Nebraska DHHS website.
Stollar, who also serves as a mental healthcare provider, noted that 85% of her patients depend on Medicaid. The new eligibility criteria have already resulted in the loss of two clients, highlighting the sweeping impact on low-income families. “I feel like it’s like kicking people when they’re down,” she said. “People are already struggling. I don’t understand. I just don’t understand the reasoning.”
The expedited implementation of these requirements, initiated by Governor Jim Pillen on May 1, has drawn national attention. “Nebraska is proud to be the model for fellow states implementing Medicaid Work Requirements,” Pillen stated, emphasizing the need for able-bodied adults to contribute if they can work.
Healthcare advocates, however, warn of the potential consequences. Drew Gonshorowski, Director of Medicaid and Long-Term Care, indicated that the first wave of disenrollments would affect approximately 200 Nebraskans. Yet, Sarah Maresh from Nebraska Appleseed expressed concerns that this number could eventually rise to 40,000, as disenrollments are set to continue monthly. Maresh noted, “For 61 years, Medicaid has been a lifeline for millions of Nebraskans and our hospitals in our state. Nebraskans just can’t afford this.”
The implementation has been fraught with confusion, particularly around exemptions and eligibility criteria. Megan Word from the American Cancer Society Cancer Action Network highlighted the challenges faced by cancer patients under the new rules. An Interim Final Rule mandates that, starting in 2028, patients must demonstrate their inability to work due to medical conditions, a requirement that is currently lacking clear guidance.
Angela Lindstrom from the Health Center Association of Nebraska reported significant delays in communication with DHHS due to a state budget crisis. This has left many applicants in limbo, with some, like a pregnant woman who was wrongly denied coverage, facing dire consequences.
State Senator John Fredrickson voiced concerns over the state’s capacity to handle the increased administrative burden, stating, “This is landing on top of a system that’s already really struggling.” The accelerated timeline, he noted, was a choice, not a necessity, underscoring the urgency of addressing these challenges to safeguard access to vital healthcare services.
