Nebraska is set to become the first state to roll out new Medicaid work requirements authorized under legislation signed by President Donald Trump. The state’s Republican Governor Jim Pillen announced Wednesday that the policy will take effect May 1 and is expected to affect roughly 30,000 residents whose incomes are slightly above the traditional Medicaid threshold.
“We’re not here to take everybody to the curb,” Pillen said. He emphasized that the goal is “making sure we get every able-bodied Nebraskan to be part of our community.” The expansive tax and policy package Trump approved in July requires states to verify that many Medicaid recipients are working by 2027, while allowing states to adopt the requirement earlier if they choose.
Under the law, adults between the ages of 19 and 64 must work or complete community service for at least 80 hours per month, or be enrolled in school at least half time, in order to qualify for and maintain Medicaid coverage, reports the Associated Press.
The mandate applies only to individuals covered through Medicaid expansion programs, which extend eligibility to people with higher incomes. Forty states and the District of Columbia adopted expanded Medicaid income limits under former President Barack Obama’s 2010 healthcare overhaul.
As of May, Nebraska had approximately 346,000 Medicaid enrollees, including about 72,000 individuals in the expansion population, notes the outlet. Certain groups will be exempt, including disabled veterans, pregnant women, parents or guardians of children under 14 or of disabled dependents, individuals recently released from incarceration, people experiencing homelessness, and those undergoing addiction treatment. States may also grant temporary hardship exemptions at their discretion.
All Medicaid recipients covered through the expansion will be required to submit documentation at least twice a year verifying compliance with the work or education requirements. Failure to do so would result in the loss of coverage.
The new reporting schedule is twice as frequent as current Medicaid requirements for most enrollees, creating additional administrative demands for state agencies and, in some cases, requiring costly updates to computer systems.
Pillen said he does not anticipate increasing state staffing levels to manage the changes. According to estimates from the nonpartisan Congressional Budget Office, the policy would lower Medicaid spending by $326 billion over the next decade but would also leave about 4.5 million people uninsured each year beginning in 2027. Roughly 77 million Americans currently receive Medicaid coverage.