LINCOLN, Neb. — Nebraska has begun ending Medicaid coverage for some adults who did not document enough work, education, volunteer service or other qualifying activity, making the state the first to remove beneficiaries under work rules enacted during President Donald Trump’s second term.
The state began applying the requirements May 1 to adults covered through Medicaid expansion and started checking compliance for coverage periods ending July 31 or later. Nebraska officials said roughly 200 people were expected to lose coverage Aug. 1 after failing to meet or document the standard.
Covered adults generally must complete 80 hours of qualifying activity during a month. Paid employment, education, job training, volunteering, caring for a person with a disability and certain other activities can count. Exemptions are available for some people, including those with specified medical conditions or other qualifying circumstances.
Supporters say the rules connect public benefits with employment and community participation. Health-policy researchers and patient advocates warn that eligible people can lose coverage because their schedules change, they work multiple jobs, they do not receive notices or they have difficulty submitting paperwork.
The Nebraska rollout is being watched nationally because federal law requires broader state implementation. People affected by a termination may have appeal rights or be able to restore coverage after supplying documentation, but the process and deadlines vary by case.
Sources: NPR, Nebraska Department of Health and Human Services and The Associated Press. NPR report published July 31, 2026.
