OMAHA, Neb. (AP) — Nebraska on Friday will become the first state to enforce work, volunteer or education requirements for new Medicaid applicants, eight months before the federally mandated requirements kick in.

Advocates worry that the state is launching so rapidly that key details remain unresolved and some people who are eligible for coverage will lose it.

State officials say they’re prepared, training staff and sending letters, emails and texts to people who could be impacted.

Health policy experts, advocates and other states will be watching closely.

“It can be used as a lesson for other states, both where things go well and where things don’t go well,” said Jennifer Tolbert, deputy director of KFF’s Program on Medicaid and the Uninsured.

The law is expected to leave some without insurance

The work requirement is part of a broad tax and policy law that President Donald Trump signed last year. Nebraska Republican Gov. Nebraska Gov. Jim Pillen announced in December that the state would implement it eight months before it was required, saying the aim was “making sure we get every able-bodied Nebraskan to be a part of our community.”

The state had one of the lowest unemployment rates in the U.S. in February: 3.1%

The federal policy won’t apply to all Medicaid beneficiaries, just those who are enrolled under an expansion that most states chose to make to allow more low-income people to get healthcare coverage.

Under the change, many Medicaid participants ages 19 through 64 will have to show that they work or do community service at least 80 hours a month, or are enrolled in school at least half-time. They’ll also have their eligibility reviewed every six months rather than annually, so they could lose coverage faster if their circumstances change.

Exceptions will be made for people who are too medically frail to work or in addiction treatment programs, among others.

An Urban Institute report from March estimated that the changes would mean about 5 million to 10 million people fewer people nationally would be enrolled in Medicaid than would have been otherwise.

Choices states make about how to run their programs are expected to be a major factor in exactly how many people lose coverage.

“The higher the administrative burden, the more likely people are found noncompliant and disenrolled,” said Michael Karpman, who researches health policy at Urban.

Nebraska plans to use data to help determine who qualifies

Not everyone who has coverage will need to submit proof that they’re working.

The state says it will first match enrollees with other data it has to see if participants are working or exempt. The state says it has that information for most of the roughly 70,000 people enrolled in Medicaid through the expansion.

That leaves between 20,000 and 28,000 who would have to provide more information, plus an average of 3,000 to 4,000 new enrollees each month.

At first, they will just need to show that they met the requirements in just one month of the previous 12. The time frame will shift to six months in 2027.

There’s some flexibility. For instance, instead of showing they work 80 hours in a month, someone could instead provide records that demonstrate they earned at least $580, the amount someone earning minimum wage would make in 80 hours.

People who don’t submit requested information within 30 days of being asked could have their applications denied or lose coverage they already have.

The change is causing worry and confusion

Bridgette Annable, who lives in southwest Nebraska, received a letter saying she must meet the work requirements or lose the benefits that pay for her insulin and diabetic supplies.

The 21-year-old mother now has a part-time job, despite being advised against it to protect her mental health. She’s worried about her ability to keep working.

“I am working 30 to 25 hours a week — as much as my employer can provide,” Annable said. “Although I call out of work often due to fibromyalgia pain and bipolar episodes that leave me too tired to leave the house. I have enough energy to take care of my daughter and do some cleaning, but that’s about it.”

Amy Behnke, the CEO of the Health Center Association of Nebraska, said that staff members who help people enroll with Medicaid and their clients have a lot of questions, including some that the state hasn’t yet answered.

Some examples: Apprenticeship programs are supposed to count for work requirements, but does that apply only to those certified by the state’s labor department? There’s an exemption for people who travel to a hospital for care, but there’s not clarity on how far the journey must be.

KFF’s Tolbert noted that the state issued its 295-page list last week of conditions that could qualify someone as medically frail. “We don’t know if it’s a comprehensive list,” she said.

“The speed at which we are choosing to implement work requirements hasn’t left a lot of space for really meaningful communication,” Behnke said.

And Nebraska could have to make changes after the federal government provides guidance that is expected in June.

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Mulvihill reported from Haddonfield, New Jersey.

The Nebraska Department of Health and Human Services (DHHS) announced today that it is submitting a request to the U.S. Department of Agriculture (USDA) to expand the state’s Supplemental Nutrition Assistance Program (SNAP) Healthy Choice Waiver to include candy as an ineligible purchase. Once approved, the restriction will take effect November 1, 2026.

“DHHS continues to strengthen our Healthy Choice Waiver by adding candy to the list of items ineligible for purchase with SNAP benefits,” said Shannon Grotrian, Director of the Office of Economic Assistance (OEA). “This step supports healthier SNAP purchasing decisions and reflects the Department’s commitment to improving health outcomes for Nebraskans.” 

The change builds on the current Healthy Choice Waiver, which already prohibits the purchase of soda and energy drinks, a policy that took effect January 1, 2026.

Excessive consumption of sugar can contribute to a range of serious health conditions, including heart disease, obesity, type 2 diabetes, kidney disease, non-alcoholic fatty liver disease, and dental decay. Research from the USDA has shown that SNAP participants have a higher prevalence of obesity than both income-eligible and higher-income nonparticipants.

That same study found that SNAP participants, on average, consume more added sugars and fewer fruits and vegetables than non-participants. Another study from the University of Minnesota found that restriction of sugary foods led to an increase in healthier purchases and a decrease in sugary food purchases.

Prior to the implementation date, educational information will be sent to SNAP participants, retailers, and community members outlining the changes. Additional information including the definition of candy, will be shared in the following weeks on the SNAP Healthy Choice Waiver webpage at https://dhhs.ne.gov/Pages/Healthy-Choices-Waiver.aspx. This will include frequently asked questions (FAQ), information on healthy alternative purchases, and other community resources.

The University of Nebraska–Lincoln expects to confer a record 3,800-plus degrees during commencement exercises May 8-9.

Pinnacle Bank Arena, 400 Pinnacle Arena Drive, will host a ceremony for students earning graduate and professional degrees, 3 p.m. May 8, and two ceremonies for those earning bachelor’s degrees, 9 a.m. and 3 p.m. May 9. Doors open to the public at 1:30 p.m. May 8 and 7:30 a.m. and 1:30 p.m. May 9. A College of Law ceremony will take place at 2 p.m. May 9 at the Bob Devaney Sports Center, 1600 Court St., with doors opening to the public at 1 p.m.

Interim Chancellor Katherine S. Ankerson will preside over the ceremonies. The morning undergraduate ceremony will feature graduates in the Colleges of Business, Education and Human Sciences, Fine and Performing Arts, Journalism and Mass Communication, and Public Affairs and Community Service. The afternoon undergraduate ceremony will feature graduates in the Colleges of Agricultural Sciences and Natural Resources, Architecture, Arts and Sciences, and Engineering.

DeMoine Adams, motivational speaker and former Husker football student-athlete, will deliver the keynote address, “The Power of People,” during the morning undergraduate ceremony. Nebraska Builder Awards will be given to College of Architecture alumni and university supporters Scott W. Killinger and Richard L. Youngscap during the afternoon undergraduate ceremony.

Adams is the founder and CEO of The Game Plan — Ready, Set Perform, a Lincoln-based leadership and motivational speaking business that aims to inspire people to lead with purpose and be winners in the game of life. He also recently served for five years as CEO of TeamMates Mentoring, co-founded by legendary Husker football coach Tom Osborne. A first-generation college graduate, Adams holds a Bachelor of Arts in political science and Master of Arts in educational psychology from Nebraska.

A native of Pine Bluff, Arkansas, Adams was a standout Blackshirt defensive end and helped lead the Huskers to a Big 12 championship and national championship Rose Bowl appearance. He also earned Academic All-American and All-Big 12 honors. He went on to play professionally in the National, Canadian and Arena football leagues.

A native of Hebron, Nebraska, Killinger earned a Bachelor of Architecture from the University of Nebraska in 1961 and a Master of Architecture from the University of Pennsylvania in 1966. He has since built an international career as an architect, educator and civic leader. He is principal and founding partner of Kuang Xing International, a 50-person architecture, landscape and urban design practice based in Beijing and Philadelphia, and a founder of the Killinger Center for Urban Studies in China, which has strong ties to the University of Nebraska–Lincoln. He has taught and lectured at the university and served as the interim dean of the architecture college in 2015-16. He has also taught and lectured at Harvard University, the University of Pennsylvania, Savannah College of Art and Design, and leading Chinese universities.

A longtime advocate for his alma mater, Killinger served on the College of Architecture’s Professional Advisory Council from 2004-2015 and as a trustee of the University of Nebraska Foundation since 2012. In 2008, he received the distinguished Alumni Master award from the Nebraska Alumni Association. He is also a member of the NU Foundation’s Burnett Society for sustained philanthropic giving.

Youngscap is a lifelong Nebraskan, earning a Bachelor of Architecture from the University of Nebraska in 1961. His early career was marked by a commitment to thoughtful urban development and land conservation. In 1965, he acquired 16 acres in southeast Lincoln to protect it from high-density urban sprawl — a decision that led to the creation of Firethorn Golf Club, one of Nebraska’s most celebrated golf venues. In the 1990s, he recognized the potential of Nebraska’s Sandhills region, an ancient seabed with unique natural features ideal for golf. Partnering with architects Bill Coore and the PGA’s Ben Crenshaw, he developed the Sand Hills Golf Club, which opened in 1995. The course, celebrated for its minimalist design and harmonious integration with the natural landscape, has consistently been ranked among the top courses in the world.

In 1997, Youngscap received the Dr. Herbert H. Davis Memorial Award from the Nebraska Golf Hall of Fame. In 2019, he was honored with the Virgil A. Parker Special Recognition Award by the Nebraska Golf Association for his contributions to golf in Nebraska.

To maintain a secure environment, the commencement venues enforce a clear-bag policy that limits the size and type of bag that may be brought inside. Details are available here. To avoid inconveniences, guests and graduates are encouraged to arrive early and travel light.

No tickets are required for the ceremonies. All seating is on a first-come, first-served basis.

The public may sit in any non-reserved seats in Pinnacle Bank Arena other than on the main floor, which is set for graduates, faculty and dignitaries. Accessible seating is available on the concourse level in Sections 106, 107, 110, 112, 114, 117 and 118. Beverage stands will be open. Open captioning for people with hearing impairment will be provided through the ribbon screens at the corners of the arena concourse level. Guest services and first aid will be on Level 3 at Gate 112.

Paid parking, including accessible spaces, is available in Haymarket area garages and on the street. Additional information can be found here.

A drop-off area for mobility-restricted guests will be available on the south side of the U.S. Post Office building, 700 R St., directly east of Pinnacle Bank Arena.

Graduating students are to check in no later than 2:20 p.m. for the graduate and professional degree ceremony, 8:20 a.m. for the morning undergraduate ceremony and 2:20 p.m. for the afternoon undergraduate ceremony. Graduates should enter the south lobby, off R Street. A graduate-only entrance sign will be posted. Participants should bring their graduation regalia, as well as their NCard, or a photo ID and NU ID number, for check-in. Graduates will be given a name/number card to find their place in the processional lineup. They should bring this card to the stage to receive their diploma. Limited coat room space will be available, so graduates are encouraged to leave personal items with family or friends.

Guest parking for the College of Law ceremony is available in Lot 58, east of the Devaney Center. Guests should enter the venue via the north ramp. Accessible parking is also available east of the building. Attendants can direct guests to accessible seating. Limited guest services will be available.

Law graduates should park in Lot 57, just south of The Ice Box; enter through the Francis Allen Training Complex, northwest of the Devaney Center; and proceed to the track area. They should check in no later than 1:15 p.m. Graduates should bring their gown, tam and hood, as well as any honor cords or medallions. Personal items should be left with family or friends or in a locked vehicle. Graduates will return their robes in the track area following the ceremony.

Those participating in the Family Traditions Ceremony should arrive at 12:30 p.m. and follow signs to the main level of the Devaney Center, near the Athletic Training Office. The ceremony will begin at 12:45 p.m. and conclude in time for graduates to report for lineup.

The graduate and undergraduate ceremonies are expected to last about two-and-a-half hours, and the College of Law ceremony is expected to last 90 minutes to two hours. Graduates and their guests are asked to stay for the entire ceremony.

The commencement livestreams can be accessed here. The ceremonies also will be broadcast live on Spectrum channel 1303, Allo channel 23 and Kinetic channel 1080.

Additional information on May commencement is available here or by emailing commencement@unl.edu. For more information on the College of Law ceremony, contact Paige Debrie at 402-472-5117 or pdebrie2@unl.edu.