OMAHA —Nebraska became the first state to implement Medicaid work requirements under President Donald Trump’s One Big Beautiful Bill Act, launching the rules May 1, eight months ahead of most states. Approximately 70,000 adult recipients must complete 80 hours of work or qualifying activities monthly unless exempt. State officials say the rollout has been successful, with 93% of existing enrollees retaining coverage, while healthcare advocates report staffing shortages, inadequate training and difficulties accessing benefits. Congressional Democrats plan to pursue repeal of the requirements in January, although a potential presidential veto could prevent the changes.

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