No
H.R. 1 (the “One Big Beautiful Bill Act") was passed into federal law on July 4, 2025, and made many changes to the Medicaid program, including work requirements.
Starting May 1, 2026, Nebraska Medicaid will begin enforcing work requirements for new applicants and existing Medicaid members under Medicaid expansion. Some people enrolled in Nebraska Medicaid through Medicaid expansion may not have to complete work requirements (see list of exemptions below).
Who must meet Work Requirements?
Adults enrolled in Medicaid through Medicaid expansion (also known as Heritage Health) must meet work requirements unless they qualify for an exemption.
People enrolled through Medicaid expansion are Medicaid members who:
- Are ages 19–64
- Are not pregnant
- Do not have a disability
- Are not enrolled in Medicare
- Meet income limits (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
Work requirements only apply to people enrolled through Medicaid expansion, which began in Nebraska in 2020. Some people may qualify for work requirement exemptions, including for temporary hardships.
What are Work Requirements?
Work requirements are activities Medicaid members and applicants under Medicaid expansion must complete to get health insurance through Nebraska Medicaid.
Work requirement activities include:
- Working
- Attending school or an apprenticeship
- Participating in a work program
- Volunteering
Medicaid members and applicants must spend at least 80 hours in at least one qualifying month doing one of these activities or attending school or an apprenticeship at least half time. Or Medicaid members and applicants can combine any of these activities to get to 80 hours during a qualifying month.
Individuals can also meet work requirements if they are working and earn the federal minimum threshold in a qualifying month. This is the equivalent of 80 hours worked at the current federal minimum wage. This is currently about $580 per month.
When do Work Requirements Start?
Work requirements take effect on May 1, 2026.
For existing Medicaid members under Medicaid expansion, DHHS will check to see if they meet work requirements as part of their Medicaid renewal. DHHS will begin checking work requirements for members whose annual eligibility periods end on or after July 31, 2026. Existing members must have met work requirements for at least one month since their last renewal.
Individuals applying for Medicaid on or after May 1, 2026, must meet work requirements in the month before they apply.
Exemptions
Some Nebraska Medicaid expansion adults may not need to complete work requirements if they meet one of the following exemptions:
- Under age 26 and aged out of foster care
- A member of a federally recognized Native American tribe, an Urban Indian, a California Indian, or if you receive services through the Indian Health Service (IHS)
- A parent or caretaker of a child age 13 or younger
- Caring for a person with a disability
- A veteran with a total disability rating
- Medically frail. This can mean the individual has:
- Blindness or disability
- Substance use disorder
- A disabling mental health condition
- A serious and complex medical condition
- A serious physical, intellectual, or developmental disability
- In a household that gets supplemental nutrition assistance program (SNAP) or Temporary Assistance for Needy Families (TANF) benefits and are compliant under certain conditions with work requirements
- In a qualified drug or alcohol treatment program
- Incarcerated or recently released (within 90 days of a qualifying month)
- Pregnant or had Medicaid while pregnant and are up to 12 months postpartum
Other mandatory exceptions may apply.
Temporary Hardships
Some people enrolled in Nebraska Medicaid through Medicaid expansion also may not need to complete work requirements if they have one of the following temporary hardship reasons:
- They were hospitalized or in a nursing facility.
- They themselves or a dependent traveled to receive serious medical care that wasn't available in their community.
- They live in a county under a federal emergency.
- They live in a county with high unemployment (8 percent or 1.5 times the national unemployment rate).
Members and applicants will be required to complete and send a declaration form to DHHS for hardships related to hospitalization, nursing facility stays, and traveling to receive medical care. They can submit the declaration form to DHHS online, over the phone, by mail, or in person.
If a member or applicant lived in a county currently under a federal emergency declaration or in a county with a high unemployment rate, DHHS will verify if these hardships apply to them. Members cannot complete a declaration form for living in a county under a federal emergency or with high unemployment.
Reporting Work Requirement Information
The Department of Health and Human Services (DHHS) will use information it already has to determine if an applicant or existing member has met work requirements in a qualifying month or if they qualify for an exemption.
If DHHS does not have enough information to verify work requirements or an exemption, we will contact the individual and ask for more information. We will send the individual a notice describing the information we need from them and a declaration form they can use to send it to us. If DHHS requests additional information from an individual, they must submit the requested information within 30 days of receipt, or they may be denied Medicaid coverage or lose their Medicaid coverage.
Individuals should check their mail, email, and text regularly in case DHHS requests more information from them. If an individual does not receive a request from DHHS, then they do not have to send additional information about work requirements.
Reporting Changes to DHHS
Nebraska Medicaid members must report changes that impact their eligibility. This includes changes in income, home address, work status, and household size (such as marriage, divorce, pregnancy, or adoption). You can provide this information to DHHS in person, online, by phone, or through the mail.
If DHHS requests information from an individual or they need to report a change that affects their Medicaid eligibility, they can do so in the following ways:
- Phone Number: (855) 632-7633 (press option 3)
- Lincoln Phone Number: (402) 473-7000 (press option 3)
- Omaha Phone Number: (402) 595-1178 (press option 3)
- TTY Number: (402) 471-7256
- Fax: (402) 742-2351
- In person: at a local DHHS office
Work Requirement Resources