Nebraska Medicaid work requirement

Nebraska began enforcing the federal 80-hour requirement on May 1, 2026 through a state plan amendment - the first state in the country to do so. If you are a Nebraska expansion adult age 19-64, the rule applies to you NOW, not in 2027. Report your hours or claim an exemption on Heritage Health's schedule.

What this means for you

The federal 80-hour requirement is being enforced in Nebraska right now, not in 2027. If you are an expansion adult age 19-64, you must show 80 qualifying hours a month or claim an exemption to keep coverage. Run the 2-minute exemption check (most exempt people don't realize they are), keep proof of your hours, and respond to every notice from Heritage Health within 30 days.

The rule in one paragraph

Adults 19-64 covered through the ACA expansion group must show 80 hours a month of work, community service, or work programs — or half-time school enrollment, or at least $580/month in income — unless exempt. Compliance is checked at application and at renewals (at least every 6 months). Miss it and the state must give 30 days notice before coverage ends.

The 10 federal exemptions

• Under 19 or over 64
• Pregnant or postpartum
• Parent or caretaker of a child 13 or younger, or of a disabled person
• Medically frail or with special medical needs
• Veteran with a total disability rating
• American Indian / Alaska Native
• Already meeting SNAP or TANF work rules
• Recently released from incarceration
• In a drug or alcohol treatment program
• Short-term hardship

Check if I'm exempt — free

Do my hours count?

• Paid employment Counts
• Self-employment / gig work Counts
• Volunteering Counts
• School / training Half-time+
• Caregiving Exempts you instead
• Job searching Not federally

Full detail, including the $580/month income route and the seasonal-worker rule: what counts toward the 80 hours.

Sources

• H.R. 1 as enacted (Public Law 119-21), Congress.gov
• Medicaid.gov — official federal Medicaid site
• HealthCare.gov — marketplace coverage options
• KFF Medicaid policy tracking

Related state guides: Montana