OMAHA, Neb. (Azat TV) – A 64-year-old Nebraska cancer patient was told he had lost his Medicaid coverage after the state became the first in the nation to enforce stringent new work requirements under federal legislation, according to an NPR report published on November 9, 2026. Eli McCreary of Omaha, who was diagnosed with kidney cancer in June 2026, said he received a call from a CHI Health hospital informing him that he was no longer insured and that his medical appointments would be canceled unless he paid out of pocket.
McCreary, who also battles diabetes and chronic obstructive pulmonary disease, contacted a help center where he was told his Medicaid benefits now required him to maintain a job. “I don’t understand what job I can get,” McCreary said, noting that his health issues severely limit his mobility. Following the notice, McCreary canceled a scheduled CT scan and delayed a critical physician consultation.
Rushed Implementation and Contractor Costs
Nebraska launched the new work rules on May 1, 2026, rushing to become the first state to enforce provisions under President Trump’s signature One Big Beautiful Bill Act, eight months ahead of most other states. The rules require about 70,000 adult Medicaid recipients to prove they work or participate in qualifying activities for 80 hours a month, unless exempt.
State public records obtained by KFF Health News and cited by NPR reveal that Nebraska budgeted $8.2 million in contractor costs over two years to enact the Medicaid changes, employing firms such as Boston-based Public Consulting Group and Atlanta-based Covendis to increase administrative staffing. While state officials defended the rollout, health clinics and advocacy groups reported widespread confusion, inaccurate guidance, and administrative bottlenecks.
Escalating Stakes and Call Center Strain
State data highlighted significant strain on administrative infrastructure following the rollout. Average wait times at the Nebraska Department of Health and Human Services call center nearly doubled from roughly 13 minutes in May to 26 minutes in July, while August call volumes surged by 66% compared to May. Jeff Powell, a spokesperson for the state health department, defended the rollout as “very successful,” pointing to data indicating that 86% of affected applicants and 93% of existing enrollees retained or met coverage requirements.
However, advocacy organizations such as Nebraska Appleseed and the Charles Drew Health Center warned that complex reporting rules disproportionately harm vulnerable populations who lack the time or resources to navigate bureaucratic hurdles. Internal documents showed that the majority of initial application denials stemmed simply from unsubmitted paperwork, an outcome state administrators categorized as expected.
Political Context and Legislative Outlook
Governor Jim Pillen praised the administration for delivering the key reform, appearing alongside federal officials in December 2025 to champion the aggressive timeline. Conversely, congressional Democrats have stated their intention to repeal the Medicaid changes during their first 100 hours in office in January 2027, though political analysts note that a potential presidential veto could block legislative rollbacks. As federal and state leaders spar over the future of the program, patients like McCreary face immediate disruptions to critical health services.