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Legislation

Four states start Medicaid work requirements early, and Nebraska enrollment stalls

Federal

Issue

Medicaid work-requirement implementationTaking effect

Next: · IHAWP community-engagement requirements begin

Nebraska (May 1), Montana (July 1), Arkansas (July 1) and Iowa (December 1) are starting Medicaid work requirements before the January 1, 2027 deadline. In May, Nebraska health centers saw zero new Medicaid enrollees, down from about 15 a month, before termination checks began.

Georgia's Pathways enrolled about 16,183 people in three years, about 5% of its potential population.

Key points

  • Nebraska saw 0 new Medicaid enrollees in May, down from about 15 a month, before any termination checks began.
  • Georgia's Pathways program enrolled only about 5% of its potential population in three years, the one real-world benchmark for January 2027.
  • Oregon's guidance restates a future federal exclusion for specified community-clinic services; it is not a current or universal visit exemption and supports no outcome forecast.

Sources for this story

Georgetown CCF / CBPP / KFF

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Cite this analysis

FQHC Talent. (2026, June 10). Four states start Medicaid work requirements early, and Nebraska enrollment stalls. Source: Georgetown CCF / CBPP / KFF. Retrieved November 11, 2026, from https://www.fqhctalent.com/intel/medicaid-work-req-state-implementation-map-june-2026