Nebraska is set to become the first state to implement Medicaid work requirements under the GOP's One Big Beautiful Bill Act, which could be a key test for Republicans who have championed work requirements. The only two states that have implemented similar rules, Arkansas and Georgia, found these rules did not increase employment, caused tens of thousands of people to lose coverage and cost millions of dollars. Nebraska's decision to rush ahead ahead of the national deadline is causing concern among Medicaid advocates and health policy experts. The state has released hundreds of pages with key details about who will qualify for a "medically frail" exemption. The Centers for Medicare and Medicaid Services has been closely monitoring Nebraska's implementation. The Congressional Budget Office estimates nearly 5 million people will lose their Medicaid over the next decade due to the requirements.