A Nebraska cancer patient faced canceled medical appointments and distress after being told he lost his Medicaid coverage under the state’s new work requirements. Eli McCreary of Omaha learned of the change shortly after his kidney cancer diagnosis, highlighting early complications in the state’s implementation of federal policy shifts.
Rollout of New Rules in Nebraska
Nebraska became the first state to enforce Medicaid work requirements on May 1, moving eight months ahead of most other states under the One Big Beautiful Bill Act championed by President Trump. Governor Jim Pillen and federal officials praised the rapid implementation, with state data indicating that 86% of affected applicants and 93% of existing enrollees maintained their coverage.
However, health clinics and advocacy organizations reported widespread confusion, inadequate staffing, and poor training during the rollout. Approximately 70,000 adult Medicaid recipients in Nebraska face the mandate to prove they work or participate in similar activities for 80 hours a month, unless exempted.
State documents obtained by KFF Health News via a public records request revealed that Nebraska budgeted $8.2 million over two years for private contractors, including Public Consulting Group and Covendis, to support agency staffing and IT administration. While consulting representatives praised the state’s execution, local advocates criticized the heavy reliance on corporate consultants and the lack of workforce additions.
Impact on Patients and Rising Call Wait Times
Average wait times at the state health department’s call center doubled from 13 to 26 minutes between May and July, with advocates noting some enrollees waited hours. Internal state documents showed that most denials among applicants resulted from unsubmitted paperwork rather than direct work violations.
McCreary, who also battles diabetes, chronic obstructive pulmonary disease, and a history of substance addiction, recounted being told by a hospital that his Medicaid was canceled due to unmet work requirements. Although he previously worked as an asphalt driver, his severe health conditions should have qualified him for exemptions under federal law.
Jeff Powell, a spokesperson for the Nebraska Department of Health and Human Services, disputed that McCreary lost coverage due to work requirements, stating instead that he experienced no coverage lapses and aged out of Medicaid into Medicare. Powell also stated the state had no record of McCreary calling the health department.
Federal policy experts project that similar work requirements across more than 40 states next year will leave 5.3 million more people uninsured by 2034. McCreary eventually rescheduled his medical procedures and underwent surgery in early November to remove his right kidney after the cancer had grown.
