Nebraska will roll out Medicaid work requirements in May, making it the first expansion state to implement these provisions under HR 1.
Here are four notes leading up to Nebraska’s launch:
1. Medicaid expansion states must implement community engagement requirements by the start of 2027. However, some states can begin earlier through a waiver or state plan amendment. As of Jan. 14, a handful of other states are awaiting CMS approval for waivers, such as Montana, Iowa, Arizona, Ohio and South Carolina, according to KFF. Nebraska used a state plan amendment.
2. While Nebraska is leading the pack with work requirements following HR 1, Georgia and Arkansas are the only two states that have tried Medicaid work requirements before. CMS pulled back approval for Arkansas’ requirements in 2021, but Georgia fought to maintain its requirements and ultimately secured a temporary extension through the end of 2026.
3. For Nebraska Medicaid expansion members, the state’s Department of Health and Human Services will verify work requirement execution during renewal. The department will start reviewing status for members with annual eligibility periods ending July 31 or later, and current members must have fulfilled the requirements for at least one month since their latest renewal. People applying for Medicaid May 1 or later must fulfill the requirements in the month leading up to their application.
4. Over 70,000 Nebraskans were set to receive notifications regarding the work requirements, according to December reporting from Nebraska Public Media. Of those, 30,000 will need to demonstrate compliance, Republican Gov. Jim Pillen estimated.
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