Nebraska to enforce federal Medicaid work requirements early in May 2026

Nebraska became the first state to announce that it will begin enforcing federal Medicaid work requirements early starting May 1, 2026. KFF Policy reported that the state is using a state plan amendment to start the mandates ahead of the national deadline. [1]

The federal 2025 reconciliation law requires states to condition Medicaid eligibility for adults in the Affordable Care Act expansion group on meeting work requirements starting January 1, 2027. However, states have the option to implement the rules sooner through a state plan amendment or an approved Section 1115 waiver, according to KFF Policy. [1]

Medicaid is a United States government program that provides health insurance for adults and children who have limited income and resources. The program is partially funded and primarily managed by individual state governments, which have broad authority in determining eligibility and benefits while the federal government sets baseline standards. [2]

Two other states also plan to implement the work requirements before the mandatory January 2027 deadline. KFF Policy reported that Montana plans to start enforcing its requirements on July 1, 2026. [1]