Revision History

Nebraska on May 1, 2026, became the first state to enforce Medicaid work requirements under the One Big Beautiful Bill Act, eight months ahead of the federal deadline. Roughly 70,000 expansion enrollees must now document 80 hours per month of work or qualifying activities to keep coverage, with researchers estimating between 25,000 and 41,000 could lose it — despite evidence from Arkansas and Georgia that such mandates reduce coverage without increasing employment.