By Nebraska Department of Health and Human Services
LINCOLN, Neb. – Staff from the Centers for Medicare & Medicaid Services (CMS) visited Nebraska this week for two days of collaborative meetings with the Nebraska Department of Health and Human Services (DHHS) to advance implementation of the nation’s first Medicaid work requirement for Medicaid expansion members required by the Working Families Tax Cut (WFTC) Legislation. The new requirements will take effect in Nebraska on May 1, 2026.
The new work requirements are the result of HR1, also known as the One Big Beautiful Bill. Among its key provisions is a requirement that able-bodied adults in the Medicaid expansion population engage in work or other qualifying activities as a condition of receiving Medicaid benefits.
Last month, DHHS announced it would implement the requirements well ahead of the federally mandated deadline of Jan. 1, 2027, making Nebraska the first state in the nation to do so. During a joint press conference, CMS Administrator Dr. Mehmet Oz commended Nebraska’s leadership and reaffirmed CMS’s commitment to supporting the state through implementation.
“Nebraska has set a high standard for the rest of the nation by rolling out its Medicaid community engagement requirements eight months ahead of schedule,” Dr. Oz said. “I’m proud of how CMS and Nebraska’s health department have worked together to empower beneficiaries, safeguard taxpayer dollars, and build stronger communities for all Nebraskans.”
The two days of meetings focused on preliminary CMS guidance and Nebraska’s readiness for the May 1 implementation date. Since the announcement last month, DHHS issued federally required outreach notices to the nearly 70,000 Medicaid expansion members and published a dedicated work requirement web page and supporting resources.
Under the new rules, able-bodied adults ages 19-64 in the Medicaid expansion population will be required to participate in work, approved work programs, community service, or educational activities for at least 80 hours per month, unless they qualify for an exemption.
“When the opportunity arose to help Nebraskans become more self-sufficient through Medicaid Work Requirements in the One Big Beautiful Bill, Governor Pillen’s direction was clear,” said DHHS CEO Steve Corsi. “He wanted it done yesterday.”
This reform is expected to deliver meaningful benefits to Nebraskans. Research shows that work requirements are associated with higher and more stable incomes, increased workforce participation, and greater access to employer-sponsored benefits beyond government assistance.
Most importantly, children in working households benefit from more stable routines, improved educational outcomes and stronger examples of workforce participation. Higher employment rates are also linked to lower crime rates, increased civic engagement and a stronger economy.
“These meetings with CMS have been extremely valuable in clarifying what Nebraska needs to do to implement these requirements responsibly and effectively,” said Drew Gonshorowski, Director of the Division of Medicaid and Long-Term Care. “We’re working hand in hand with our federal partners and stakeholders across the state throughout this process.”
DHHS will continue working closely with CMS in the months ahead to ensure full federal compliance as the implementation date approaches.
For more information on the Medicaid work requirements, visit https://dhhs.ne.gov/WorkRequirements.