Nebraska's Rushed Medicaid Work Rules Told a Cancer Patient He Had Lost Coverage
The state started enforcing the requirement May 1, eight months before most states, and call-center waits have doubled as some 1,100 people were denied by August.
When Eli McCreary, a 64-year-old Omaha man, was diagnosed with kidney cancer in June, a CHI Health hospital told him he had lost his Medicaid coverage and that his appointments would be canceled unless he paid out of pocket. A call center told him, "You're required to do work to stay on." He had surgery in early November to remove his right kidney, according to KFF Health News, which reported the case with NPR.
McCreary's case shows what happens when a new federal policy is put into practice quickly. Nebraska began enforcing Medicaid work requirements on May 1, 2026, about eight months before most states. Roughly 70,000 adult enrollees are subject to the rule and must show 80 hours of work or a similar activity each month unless they qualify for an exemption.
The state budgeted $8.2 million over two years for contractors, including Public Consulting Group of Boston and Covendis of Atlanta. Strain is visible in the call data. Average call-center waits nearly doubled between May and July, from about 13 minutes to 26. August brought more than 101,000 calls, a 66% jump from May.
The state's numbers paint a different picture. The health department says 86% of affected applicants met the requirement or qualified for an exclusion, and 93% of existing enrollees kept coverage. About 1,100 people had been denied by August, mostly for not responding to requests for information. Total Medicaid enrollment has fallen by about 4,600, or 1.4%, since May.
The state disputes McCreary's account. Spokesperson Jeff Powell said he had "no lapses in coverage" and aged into Medicare before the requirements applied to him. Advocates counter that his substance-use treatment and health conditions should have earned him an exemption in the first place.
The stakes are national. The Congressional Budget Office estimates the policy will leave 5.3 million more people uninsured by 2034, and work requirements take effect in more than 40 states next year. Democrats, who won the House in last week's midterms, plan to try to repeal the changes in January, but a Trump veto could block them. Until then, Nebraska is the test case for how many eligible people get caught by the paperwork.
The Nebraska experience will be closely studied by other states, many of which are using the same kind of contractor-run verification systems. Critics say the real risk is not people who fail to work but people who work and still lose coverage because they miss a notice or cannot get through on the phone. Supporters of the requirement say it encourages employment and that most affected people are keeping their coverage, as the state's figures show.
