Nebraska has enforced a Medicaid work requirement since May 1, 2026, and the first hard numbers point at an unexpected cause of lost coverage. Of the 557 applications the state denied between May and August, 84 percent were denied because the applicant never answered a request for more information, and only 16 percent because the person was affirmatively found not to meet the requirement, KFF reported on September 29. The federal requirement will reach every state on January 1, 2027, which makes Nebraska the closest preview of how the rule works in practice.
What KFF counted in Nebraska’s first four months
The analysis, written by KFF’s Amaya Diana, Anna Mudumala and Jennifer Tolbert, describes Nebraska as the first state to enforce the new rules. Nebraska processed 9,614 applications from May through August, and 4,089 of them were subject to the work requirement. Of those, 557 were denied, or 14 percent.
The 84 percent figure applies only to that group of 557 denials. KFF’s wording is that the denials were due to “non-response to requests for additional information,” while the remaining 16 percent were “affirmatively found to be noncompliant.” It is not a share of all applicants and it is not a national number.
Renewals moved differently. Nebraska processed 7,280 renewals in July and August, and 533 enrollees, or 7 percent, lost coverage. The 84 percent non-response split is reported for denied applications and should not be read as the reason behind those renewal losses.
Readers unsure whether the work requirement reaches their own coverage, or whether an exemption covers them, can turn to The SNAP & Medicaid Renewal Organizer, which sets out the new Medicaid work requirement and who is exempt.
See who is exempt from the Medicaid work requirement →
Who is exempt from Nebraska’s 80-hour test
For the person holding a Medicaid notice, the practical question is whether the rule reaches them at all. Under Nebraska DHHS’s requirements FAQ, the test is met by 80 hours of qualifying activity in a calendar month, by earning $580 in a month (the equivalent of 80 hours at the federal minimum wage), or by attending school or an apprenticeship at least half-time. The exemptions listed include parents and caretakers of children age 13 or younger, people caring for someone with a disability, members of federally recognized tribes, veterans with a total disability rating, people who are blind or have a disability, people in qualified drug or alcohol treatment, people who are pregnant or up to 12 months postpartum, people in SNAP or TANF who meet those programs’ work rules, and people who left jail within 90 days.
The 30-day clock behind the non-response denials
Nebraska’s notices carry a firm deadline. The state’s FAQ says: “You must submit the information within 30 days of getting the notice, or you may be denied or lose coverage.” Information can be sent through the iServe online portal, by mail, by phone, through a QR code in the notice, or in person at a local DHHS office. A person who is working or exempt but misses the window can still end up denied, which is the pattern KFF’s count shows.
The 84 percent figure counts missing replies. By itself it does not show how many of those applicants were meeting the 80-hour test, and KFF’s own framing is the narrower one: among denials, silence outnumbered findings of noncompliance by a wide margin. The state also began checking existing members, with first compliance checks scheduled for July 31, 2026.
Why pending disability claims complicate the exemption
Exemptions only help when they are documented, and KFF’s July 29 analysis of SSI applicants shows where that can stall. As of May 2026, about 862,000 people were waiting on initial disability determinations, and the average initial SSI and SSDI decision took 184 days. KFF’s authors, including Abby Sachar, Alice Burns, Amaya Diana and Jennifer Tolbert, wrote that the application process “can be a lengthy and complicated process, spanning months, if not years.”
The same analysis notes that the “medically frail” exemption is defined as a physical or mental health condition that impairs a person’s ability to meet community engagement requirements, and that the requirement is set to apply to Medicaid expansion enrollees and certain waiver participants starting January 1, 2027. Someone with a pending disability claim may therefore need to establish the exemption through the state’s own process rather than wait for a federal decision.
Keeping a Medicaid file answerable before January 1, 2027
The free official route is the state Medicaid agency that mails the notices. Nebraska’s version is the DHHS requirements FAQ, which lists the contact channels (phone (855) 632-7633, option 3; the iServe portal; mail to P.O. Box 2992, Omaha, NE 68103-2992). In any state, the agency named on the letter is the one that records the response.
What matters from Nebraska’s numbers is the paper trail. Enrollees who expect a request for information have the most to gain from knowing, before it arrives, which documents prove hours worked, school enrollment, caregiving or an exemption, and from noting the notice date so the 30 days can be counted from it. Responding through a channel that leaves a record, and keeping the confirmation, answers the exact failure KFF counted.
The date to hold is the notice date, not the start of the federal rule. In Nebraska’s first four months, 84 percent of the 557 denials came from silence, according to KFF’s September 29 analysis.
For households sorting through those documents, The SNAP & Medicaid Renewal Organizer pairs a summary of the new Medicaid work requirement and who is exempt with a renewal document checklist. It is a paid organizer that sits next to the state agency’s own process, not a replacement for it.
Click here to get The SNAP & Medicaid Renewal Organizer for the work requirement →
This article was produced with AI assistance and reviewed by The Financial Wire’s editorial team.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
