What share of Nebraska Medicaid applicants lost coverage under early work rules?

Among 4,089 new applications subject to work requirements processed from May to August 2026, 14% were denied for not meeting the rules — mostly for not responding to information requests (84% of those denials). Among 7,280 renewals processed July to mid-August, 7% lost coverage, again mostly for non-response. Figures are from Nebraska’s September 2026 Medicaid Advisory Committee materials as analyzed by KFF.

How does Nebraska verify Medicaid work requirements and medical frailty?

Nebraska uses available data plus self-declaration forms, with optional short-term hardship exceptions. Federal interim rules allow self-attestation through 2027 for most criteria; starting January 2028, states generally must request documentation when they lack data, except that medical frailty rules are changing separately. KFF notes CMS has notified Nebraska it must change its medical-frailty verification process.

Who is excluded from Nebraska’s Medicaid work requirements?

Exclusions include pregnant and postpartum people, American Indian and Alaska Native enrollees, parents or caretakers of children under 14 or of disabled individuals, veterans with a disability, certain incarcerated people, some SNAP participants, and people who are medically frail. States must check exclusions before assessing qualifying activities.

Nebraska: 14% of work-rule applicants denied early

Nebraska’s early Medicaid work rules denied 14% of subject new applicants and cut 7% of renewals through mid-August 2026. Most losses were non-response to paperwork; CMS has told the state to change medical-frailty checks.

policy · nebraska · medicaid · work-requirements · medical-frailty

Hurstbergn, Wikimedia Commons, CC BY 4.0

Direct Support News desk · September 29, 2026 · Updated September 30, 2026 · 1 min read

Nebraska’s first months of early Medicaid work requirements produced measurable denials — mostly from unanswered paperwork, not proven noncompliance. On Sept. 29, KFF published early outcomes from Nebraska’s September Medicaid Advisory Committee meeting covering applications and renewals processed through mid-August 2026.

Nebraska began enforcing work rules for expansion adults on May 1, 2026, ahead of the nationwide Jan. 1, 2027, start. Among 4,089 new applications that needed a work-requirement determination, 46% met qualifying activities (mostly 80 hours of work or $580 monthly household income), 39% qualified for an exclusion, 2% used a short-term hardship exception, and 14% were denied. Of those denials, 84% were for non-response to information requests; only 16% were affirmatively found noncompliant.

Among 7,280 renewals subject to the rules, 34% met qualifying activities, 57% were excluded (medical frailty 39% of exclusions; parents/caregivers 31%), 2% used hardship exceptions, and 7% lost coverage — 92% of those for non-response. Nebraska currently relies on data matches plus self-declaration forms. KFF notes CMS has told the state it must change its medical-frailty verification process, and that documentation rules tightening after 2027 could raise future losses.

Why this matters for providers and DSPs

Caretakers of people with I/DD and enrollees who may be medically frail are exactly the households that lose coverage when notices go unanswered. Provider agencies and supports coordinators in early-adopter states (Nebraska, Montana, Arkansas) should help families track 30-day declaration deadlines and document exclusions — not advise on eligibility, but make sure paperwork does not silently end the coverage that pays for community supports.

Common questions

What share of Nebraska Medicaid applicants lost coverage under early work rules?: Among 4,089 new applications subject to work requirements processed from May to August 2026, 14% were denied for not meeting the rules — mostly for not responding to information requests (84% of those denials). Among 7,280 renewals processed July to mid-August, 7% lost coverage, again mostly for non-response. Figures are from Nebraska’s September 2026 Medicaid Advisory Committee materials as analyzed by KFF.
How does Nebraska verify Medicaid work requirements and medical frailty?: Nebraska uses available data plus self-declaration forms, with optional short-term hardship exceptions. Federal interim rules allow self-attestation through 2027 for most criteria; starting January 2028, states generally must request documentation when they lack data, except that medical frailty rules are changing separately. KFF notes CMS has notified Nebraska it must change its medical-frailty verification process.
Who is excluded from Nebraska’s Medicaid work requirements?: Exclusions include pregnant and postpartum people, American Indian and Alaska Native enrollees, parents or caretakers of children under 14 or of disabled individuals, veterans with a disability, certain incarcerated people, some SNAP participants, and people who are medically frail. States must check exclusions before assessing qualifying activities.

Sources

Early Medicaid Work Requirement Insights From Nebraska · September 29, 2026 · KFF analysis of Nebraska MAC meeting data on May–August 2026 work-requirement outcomes