With Nebraska set to lead the nation on Medicaid work rules, providers say patients and hospitals may not be prepared

LINCOLN, Neb. (KOLN) — In just under three weeks, Nebraska will become the first state to implement new work requirements for individuals on Medicaid — a full eight months ahead of the federal deadline.

But not everyone appears to be ready.

“There’s a lot of uncertainty with our hospitals,” said Nebraska Hospital Association President and CEO Jeremy Nordquist. “They know that there’s going to be a lot of folks who come in who just don’t know what they need to do to comply with the new regulations.”

In December, Gov. Jim Pillen announced Nebraska would be the first state to put these work requirements in place.

These work requirements came out of President Donald Trump’s One Big Beautiful Bill last year, and will require able-bodied adults ages 19 to 64 to work or volunteer at least 80 hours a month, unless they have a qualified exemption.

At the time, flanked by Centers for Medicare and Medicaid Administrator Dr. Mehmet Oz, Pillen called it a hand up, not a handout.

But just weeks before the deadline, one clinic CEO says, “everybody’s just kind of guessing right now.”

Bluestem Health CEO Brad Meyer told 10/11 on Monday it currently has about 8,400 Medicaid patients and estimates 10% to 15% of those will eventually be disenrolled, based on what happened in states like Arkansas when trying to implement similar requirements.

But they won’t know the real impact — especially financially — until 2027.

“Right now, we just don’t know what the impact is going to be,” Meyer said. “But looking at other states who have tried it, we’re estimating that it could potentially cost us between $400,000 and $600,000 per year.”

Ultimately, while he doesn’t anticipate clinic closure, it may force Bluestem Health to cut back on the services it provides.

“We’re trying everything we can to try to recruit new patients to help offset those that will no longer have insurance. But whenever your uncompensated care goes up, you have loss of revenue on one side and then more patients who are uninsured on the other side,” Meyer said. “We’ll still be here to serve them, it’s just in what capacity it has in a year or two down the road, I just don’t know.”

Nordquist added that about 30% to 40% of the 70,000 Nebraskans on Medicaid will need to have their hours verified manually, adding another layer of work for the state, and a concern about Nebraskans being wrongfully disenrolled.

At the end of the day, Nordquist added the state’s 92 hospitals are here to serve Nebraskans, but he offered some suggestions for those preparing for the May 1 deadline.

“Make sure your contact information is updated on the state portal so they can contact you when they need to re-verify for your coverage. Right now it’s every 12 months, but starting in 2027, that’s going to go to every six months. That’s another federal policy change,” Nordquist said. “So it’s really important that folks that rely on Medicaid keep their contact information current with the state and stay in touch on that regard.”

The Nebraska Hospital Association created a website — MedicaidNebraska.com — to try and help impacted Nebraskans navigate the new work requirements.

Learn more at News Channel Nebraska.