This makes it the first state to enforce these rules under the federal One Big Beautiful Bill Act (OBBB Act), moving ahead of the national 2027 deadline.
The policy targets the “expansion population”—typically adults aged 19–64 who do not have a disability and are not pregnant.
The state started notifying roughly 70,000 enrollees earlier this year. While the rules are live, the actual impact will be phased in during individual renewal periods starting for those whose coverage ends July 31, 2026.
Nebraska has become the first state to implement the federal Medicaid work requirements, mandated under President Trump's tax and spending bill that passed last summer. https://t.co/epS91hxfzy pic.twitter.com/muboTgC49s
— ABC News (@ABC) May 3, 2026
Rules went into effect May 1 for new applicants and renewals. Nebraska is the national test case for the OBBB Act; roughly 70,000 residents could be affected.
https://apnews.com/article/medicaid-work-requirements-nebraska-94555d7d5e739789c46b52f52f737f1b
Enrollees must complete 80 hours of work, school, or volunteering per month.
Failure to report or qualify for an exemption within 30 days of a request leads to loss of coverage.