Effective May 1, 2026, Nebraska became the first state to enact Medicaid work requirements under H.R. 1. While states are required to implement work requirements effective January 1, 2027, Nebraska opted to implement early; as such, this is a valuable opportunity for states to learn lessons about Medicaid work requirements.
Hilltop researchers Morgan Henderson, Danielle Barefoot, Leigh Goetschius, and Alice Middleton used publicly available, monthly enrollment data from the Centers for Medicare & Medicaid Services to examine the impact of work requirements in Nebraska. This latest brief uses newly available data through July 2026 and updates Hilltop’s analysis released last month. Hilltop continues to find evidence that the number of individuals determined eligible for Medicaid at application in Nebraska has fallen significantly since work requirements began in May 2026, with an estimated 25% reduction.
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