Medicaid Work Requirements

Starting May 1, 2026 members and applicants eligible under Medicaid expansion will have to meet work requirements to keep or get Medicaid coverage. This is a requirement of HR1 (the One Big Beautiful Bill Act). There are a list of people who be exempt from these requirements. 

Who will these work requirements affect, and who is exempt?

People that Medicaid expansion applies to are Medicaid members who:

  • Are between age 19 and 64
  • Are not pregnant
  • Do not have a disability
  • Are not enrolled in Medicare
  • Meet income limits (earn up to 138% of the federal poverty level or about $22,025 per year for one person or $45,540 for a family of four)
  • Are U.S. citizens or meet immigration rules

Of the individuals that fall under the criteria above, people who may not need to complete work requirements are: 

  • Individuals under the age of 26 and those who aged out of foster care
  • Individuals who are a member of a federally recognized Native American tribe, an Urban Indian, a California Indian,                                                                                     or if an individual receives services through the Indian Health Service (IHS)
  • Individuals who are a parent or caretaker of a child age 13 or younger
  • Individuals who are caring for a person with a disability

How Nebraska Medicaid Determines Exemptions

For individuals who have Medicaid now:

Nebraska Medicaid will review about 90 days before the end of a member’s eligibility period. If qualifying medical conditions or treatment indicators are identified, the individual will be treated as exempt without needing to take additional action. If Nebraska Medicaid does not have medical claims with qualifying medical conditions, the individual will need to submit the Individual Declaration Form, where there will provide basic information about their medically frail condition or SUD treatment provider.

For New Applicants:

Individuals may self-declare that they are medically frail or enrolled in an SUD treatment program by filling out the Individual Declaration Form. Individuals will be asked to provide basic information about their medically frail condition or SUD treatment provider. No additional documentation is required at this time.

 

For more information, please go to the NE DHHS webpage. There is also a video there to help explain the work requirements. 

 

Want to share your story about how this affects you? Or have other feedback? Please contact us.