Nebraska is set to implement new Medicaid work requirements, putting the state months ahead of a federal deadline and affecting tens of thousands of residents. The new rules affect adults enrolled through Medicaid expansion, which covers about 72,000 Nebraskans aged 19 and 64. The requirements include maintaining coverage by at least 80 hours per month, earning a minimum of $580 per month or qualifying for an exemption. Individuals who fail to meet these requirements risk losing their benefits. The changes were approved under the One Big Beautiful Bill Act, which allows for the state to be the earliest adopter of stricter eligibility rules. However, advocacy groups warn that the accelerated rollout could leave many beneficiaries unprepared and at risk of losing coverage.