# Nebraska reviews new federal Medicaid work rule, declines to delay implementation  
**Published:** 2026-06-05T10:15:57.000Z  
**Source:** [Nebraska Examiner](https://nebraskaexaminer.com/briefs/nebraska-dhhs-reviewing-federal-rule-on-medicaid-work-requirements-declines-call-to-press-pause/)  
**AI-generated:** yes (claude-haiku-4-5-20251001)  
**Canonical:** https://lincolne.news/article/nebraska-reviews-new-federal-medicaid-work-rule-declines-to-delay-implementation

LINCOLN, Neb. — Nebraska's Department of Health and Human Services is reviewing new [federal guidance on Medicaid work requirements](https://www.cms.gov/newsroom/fact-sheets/medicaid-community-engagement-requirement-certain-individuals-interim-final-rule-comment-period-cms) released this week but says it has no plans to delay the state's early enforcement of the policy.

The federal government unveiled an interim final rule Monday that [details how states should implement work requirements](https://nebraskaexaminer.com/briefs/nebraska-dhhs-reviewing-federal-rule-on-medicaid-work-requirements-declines-call-to-press-pause/) for Medicaid recipients. The rule, released by the Centers for Medicare and Medicaid Services, is nearly 400 pages and [available for public review](https://public-inspection.federalregister.gov/2026-11094.pdf), with most states required to comply by January 1, 2027.

Nebraska, however, became the first state to enforce the requirements when the policy took effect May 1, eight months ahead of the federal deadline. Roughly 25,000 of the 72,000 adults enrolled through Medicaid expansion will eventually face work requirements to maintain coverage.

The federal rule requires certain adults between ages 19 and 64 to document 80 hours monthly of work, volunteering, school or approved programs, or earn at least $580 monthly. Exemptions apply to pregnant women, people with disabilities, veterans with total disability ratings, and parents or caretakers of young children.

Collin Spilinek, a spokesperson for Nebraska's Department of Health and Human Services, said the agency is reviewing the new guidance "to determine what changes, if any, will be necessary to make." He added the state has successfully managed implementation with "no issues" and has received federal grants to support the effort.

But [Nebraska Appleseed](https://neappleseed.org/), a nonprofit advocacy group, argues the federal rule is more onerous than Nebraska's current requirements and creates additional hurdles for people with disabilities and serious medical conditions. The rule requires individuals with medical needs to "prove" they cannot work to qualify for exemptions, the organization contends.

"This federal rule adds major and punitive new restrictions that will directly hurt Nebraskans, especially those with serious medical needs and disabilities," said Sarah Maresh, Appleseed's health care access program director. The organization urged the state to "press pause" and join other states in waiting until January 2027 to implement requirements.

"People's lives are on the line," Maresh said.

Federal estimates project significant coverage losses. The Congressional Budget Office estimates 4.8 million people nationally will become uninsured over the next decade due to work requirements. In Arkansas, when similar requirements were implemented in 2018, approximately 18,000 people lost coverage due to administrative and paperwork barriers before a federal judge halted the program in 2019.

Spilinek said there are "no plans" to delay Nebraska's implementation. The state's medical frailty definition for exemptions and compliance verification systems are already operational.

In April, Drew Gonshorowski, director of the state's Division of Medicaid and Long-Term Care, emphasized the policy's goal was to support member coverage sustainability. "Our commitment here is to ensure that our members receive coverage long term," [Gonshorowsk told KETV](https://www.ketv.com/article/nebraska-set-to-roll-out-new-medicaid-work-requirements/71169063).

## Sources

- [Nebraska Examiner](https://nebraskaexaminer.com/briefs/nebraska-dhhs-reviewing-federal-rule-on-medicaid-work-requirements-declines-call-to-press-pause/)
- [Centers for Medicare and Medicaid Services interim final rule on work requirements](https://www.cms.gov/newsroom/fact-sheets/medicaid-community-engagement-requirement-certain-individuals-interim-final-rule-comment-period-cms)
- [Federal Register document for public review](https://public-inspection.federalregister.gov/2026-11094.pdf)
- [Nebraska Appleseed advocacy organization](https://neappleseed.org/)
- [KETV interview with state Medicaid director](https://www.ketv.com/article/nebraska-set-to-roll-out-new-medicaid-work-requirements/71169063)

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This article was generated by AI (claude-haiku-4-5-20251001) based on source material from Nebraska Examiner, enriched with 3 web searches. The original source is available at https://nebraskaexaminer.com/briefs/nebraska-dhhs-reviewing-federal-rule-on-medicaid-work-requirements-declines-call-to-press-pause/.