Nebraska Gov. Pillen and CMS Administrator Oz announce first state Medicaid work requirements for May 2026

Nebraska Gov. Jim Pillen and CMS Administrator Mehmet Oz hold a joint press conference on December 17, 2025, announcing Nebraska will implement Medicaid work requirements on May 1, 2026 — eight months before the January 2027 OBBBA deadline. Nebraska is the first state to announce early implementation using the state plan amendment mechanism created by the OBBBA, bypassing the Section 1115 waiver process. The requirements apply to approximately 72,000 Medicaid expansion enrollees ages 19-64 who must complete 80 hours per month of qualifying activity. Oz says "We're connecting these individuals on Medicaid who want Medicaid, free insurance, with options around jobs." Advocates immediately raise concerns about the rapid timeline, lack of new staff, and a $19 million cut to the Nebraska DHHS budget.