Why Is This Happening? (The Big Picture)
In July 2025, the U.S. Congress passed a new law called H.R. 1, the “One Big Beautiful Bill Act.” This law was signed on July 4, 2025.
That law made big changes to Medicaid all across the country. Each state can choose when to start some of those changes.
The work requirements will start in Nebraska on May 1, 2026.
The Four Waves of Changes
Wave 1
May 2026: Work Requirements Begin
Some Medicaid members will need to show they are working or doing a similar activity for at least 80 hours per month. That is about 20 hours per week. Qualifying activities include: working a job, going to school, apprenticeship, approved work programs, community service, or volunteering.
Wave 2
May 2026: More Frequent Check-Ins
Medicaid may contact you more often to confirm you still qualify.
If Medicaid contacts you, you must respond within 30 days. If you do not respond, you could lose your coverage.
Wave 3
2027: Changes to Retroactive Coverage
Right now, Medicaid can sometimes pay for medical bills from up to 3 months before you enrolled.
Starting in 2027, this “retroactive coverage” will be reduced. If you think you need Medicaid, sign up as soon as possible. Do not wait.
Wave 4
2028: Small Costs for Some Visits
Starting in 2028, some Medicaid members may need to pay a small amount for certain services.
The cost could be up to $35 per visit for some types of care. More details will be shared as this gets closer.
What Counts as “Work”?
For the May 2026 work requirement, these activities all count toward your 80 hours per month:
-
Working a job full-time or part-time
-
Going to school or a college program
-
A job apprenticeship or trade program
-
An approved workforce training program
-
Community service or volunteering