MEDICAID Expansion Work Requirements

Under a new law passed by Congress and signed by President Trump, Nebraska Medicaid expansion enrollees will have to meet work requirements or prove an exemption to get coverage. Governor Pillen is starting these requirements 8 months early on May 1, 2026.

Medicaid expansion is a specific type of Medicaid that provides health coverage to 70,000 Nebraskans between the ages of 19-64 who have income up to 138% of the federal poverty level (in 2026, about $22,000/year for an individual) and do not qualify for any other type of Medicaid.

Who is exempt?

You may not have to meet work requirements if you are pregnant, under the age of 26 and aged out of foster care, are a parent/guardian of a child under 14 or a person with disabilities, have a disability or serious/complex health condition, are medically frail, or have other special health needs. There are many other exemptions, including short-term exemptions like being hospitalized or in a nursing facility, traveling outside of the county for care, or being in counties with high unemployment or in a federal emergency.

How do you meet requirements?

If you must meet work requirements, you generally must complete at least 80 hours of qualifying activities in a qualifying month (but not every month). This may include full or part-time paid work, self-employment, a work program, school (at least half-time), or volunteering, among other things.

When does this start?

  • New applicants: Starting May 1, applicants who would qualify for Medicaid expansion must meet or prove an exemption to work requirements.
  • Existing enrollees: Starting May 1, DHHS will begin to assess anyone with renewals due on or after July 31 2026 for work requirements. During this time, DHHS may contact you for more information.

The work requirements are complicated and we’re continuing to learn more information. Ask questions, get local help, and stay up to date with this information and by reviewing updates from the Nebraska Department of Health and Human Services.

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