Nebraska Medicaid work rules strain coverage ahead of nationwide rollout

OMAHA, Neb. — Nebraska was the first state to implement new Medicaid requirements back in May, and the changes are already reshaping how residents keep their coverage.

For 26 years, Tanya Wilson has relied on Medicaid for her healthcare. She undergoes dialysis four times a week and says the paperwork to remain on Medicaid has become a burden.

"It's been a lot of work, from June, July and August they took us through the ringer, it was submitting paperwork after paperwork and finding different insurance companies that they accepted, it's been a lot," Wilson said.

Nebraska's new rules require certain Medicaid recipients to meet work requirements or qualify for an exemption. About 70,000 Nebraskans are subject to the requirements, according to Appleseed Nebraska.

"The state is extremely hard to get a hold of right now and we know that is posing barriers to folks proving that they meet the requirements," Sarah Maresh said.

Maresh told me more than 1,000 Nebraskans have lost coverage because of the requirements. Now the rule is facing legal challenges, as a judge in Boston blocked part of the Trump administration's efforts to narrow medical exemptions.

"When we have these really troubling policies that are essentially made to make people lose coverage it is just heartbreaking," Maresh said.

Roughly 330,000 Nebraskans rely on Medicaid, and the federal work requirements are set to take effect nationwide in January.

"I have spoken to folks who have said to me that Medicaid expansion has saved my life," Maresh said.

For Wilson, who has spent almost three decades relying on Medicaid, keeping her coverage means navigating what is now asked of her.

"Before May I did not have to because everything was taken care of now every six months they want updates," Wilson said.

While Wilson has not lost her coverage, her experience highlights the challenges some Nebraskans face and foreshadows what more Nebraskans could face come January.

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