Nebraska Medicaid work requirements left a 64-year-old Omaha cancer patient believing he had lost his health coverage, delaying his care by about a month, KFF Health News reported. Eli McCreary, diagnosed with kidney cancer in June 2026, said a hospital told him his Medicaid was gone and his appointments would be cancelled unless he paid out of pocket. Nebraska disputes his account.

Nebraska launched the rules on May 1, 2026, the first state to enforce them under President Donald Trump’s One Big Beautiful Bill Act, eight months before most states. About 70,000 adults must prove 80 hours a month of work or qualifying activity unless exempt. The state budgeted $8.2 million in contractor costs over two years. By August, about 1,100 people had been denied benefits, mostly for not answering information requests.

Key Points

• Eli McCreary, 64, of Omaha, says he was told he lost Medicaid coverage after the new rules took effect, and cancelled a CT scan and other tests, delaying a cancer appointment by about a month.
• McCreary, who also has diabetes and chronic obstructive pulmonary disease, said he could not walk or breathe well enough to work.
• Nebraska was the first state to enforce Medicaid work requirements under the One Big Beautiful Bill Act, launching the rules on May 1, 2026.
• About 70,000 adults must prove 80 hours a month of work or qualifying activity; as of August, about 1,100 had been denied benefits, mostly for unanswered information requests.
• The state says McCreary had no lapse and moved to Medicare at 65, while Democrats say they will seek repeal in their first 100 hours in office in January.

What Happened

McCreary was diagnosed with kidney cancer in his right kidney in June 2026. He also lives with diabetes and chronic obstructive pulmonary disease, which makes breathing difficult. A CHI Health hospital in Omaha, he said, told him he had lost Medicaid coverage and his appointments would be cancelled unless he paid himself.

When he called for help, he said, a call-centre representative told him: “You’re required to do work to stay on... And you haven’t fulfilled your work requirement.” He said he could not walk or breathe well enough to work. He cancelled a CT scan and other tests, delaying a cancer appointment by about a month. In early November, surgeons removed his right kidney.

Nebraska says he had no lapse in coverage and was disenrolled only after turning 65 and moving to Medicare. The state says it has no record of the call he describes.

Background: Why Nebraska Moved First

Medicaid is the joint federal-state programme covering tens of millions of low-income Americans. Republicans have long argued adults who can work should do so, or train, volunteer or study, to keep benefits. Democrats and health experts say paperwork alone will push eligible people off the rolls, including people too sick to work or unable to prove an exemption.

The One Big Beautiful Bill Act made work requirements national policy, with most states due to start in early 2027. Nebraska chose not to wait, launching on May 1, 2026, and becoming the first live test of whether the system works as promised.

Nebraska Medicaid Work Requirements: How the Rules Work

Adults must document 80 hours a month of work or a qualifying activity, such as a job, training, community service or education, or show they are exempt, for example because of a serious medical condition. People who do not answer the state’s information requests can lose benefits even if they worked the hours or should have been exempt.

That detail matters. As of August, about 1,100 Nebraskans had been denied benefits, and state documents obtained by KFF Health News show most were for unanswered information requests, not for failing to work. A federal judge in Boston recently blocked a narrowed definition of who counts as “medically frail” for exemptions, a ruling that limited how tightly the government can define the sickest patients out of protection.

Reactions and Quotes

McCreary’s own words are the most direct account of the human cost. He said the hospital told him his coverage was gone, and quoted the call-centre worker: “You’re required to do work to stay on... And you haven’t fulfilled your work requirement.” For a man who said he could not walk or breathe well enough to work, the message was that his illness did not count.

Nebraska has pushed back firmly. State spokesperson Jeff Powell called the rollout “very successful”, citing figures that 86 percent of affected applicants met the requirement or qualified for an exclusion and 93 percent of existing enrollees kept coverage. Critics ask what happened to the other 7 percent, and how many were people like McCreary.

Why It Matters

Nebraska is the live experiment. What happens there will shape the debate in every other state that must enforce the same rules. Medicaid covers people with low incomes, many in jobs without stable hours, paid sick leave or easy computer access. Proving 80 hours a month means keeping records, answering letters and understanding exemption forms, all while sick or working irregular shifts. The $8.2 million for contractors is money that does not go to doctors or medicine. People who lose Medicaid are also ineligible for subsidised marketplace coverage in most states.

What Happens Next

In Nebraska, the rollout continues. KFF Health News’ reporting will keep pressure on officials to explain the denials and show that sick people, or those who never received a letter, are not being cut off by mistake.

In Washington, Democrats in the new Congress say they plan to repeal the Medicaid changes in their first 100 hours in office in January, a direct challenge to a signature Trump policy, and the president could veto any repeal. McCreary has had his kidney removed; whether the month-long delay changes his outcome only his doctors can say.

His story has become the first human face of America’s new Medicaid work rules, and the first test of whether the system can tell the difference between someone who will not work and someone who cannot.

Frequently Asked Questions

What are Nebraska’s Medicaid work requirements?

Since May 1, 2026, about 70,000 adult recipients in Nebraska must prove 80 hours a month of work or qualifying activity, unless exempt.

Who is Eli McCreary?

Eli McCreary, 64, of Omaha, was diagnosed with kidney cancer in June 2026. He says he was told he lost Medicaid coverage, delayed tests, and had surgery in early November to remove his right kidney.

How many people have lost coverage under the Nebraska rules?

About 1,100 people as of August, most for not responding to information requests rather than failing to work, according to state documents obtained by KFF Health News.

What does Nebraska say about the rollout?

Spokesperson Jeff Powell called it “very successful”, citing 86 percent meeting the requirement or qualifying for an exclusion and 93 percent keeping coverage.

Could the Medicaid work requirements be repealed?

Democrats say they plan to repeal the changes in their first 100 hours in office in January, though President Trump could veto any repeal.

Sources: KFF Health News; Azat TV. Image: US News Pulse illustration.