Nebraska Medicaid: A Cancer Patient Loses Coverage Under New Work Rules
A 64-year-old man diagnosed with kidney cancer was told to work 80 hours a month to keep his benefits, a situation advocates say highlights administrative confusion in the state’s rollout.
By Anthony Foster ·
Eli McCreary, a 64-year-old resident of Omaha, canceled a scheduled CT scan and other tests at a CHI Health hospital after staff told him his Medicaid coverage had lapsed. The hospital, part of CommonSpirit Health, said it would cancel his appointments unless he paid out-of-pocket. McCreary, who was diagnosed with kidney cancer in June, also suffers from diabetes and chronic obstructive pulmonary disease. He said he could not walk or breathe easily, making the requirement to work seem impossible.
McCreary called a help line and was told that he was required to work to stay on Medicaid. A representative told him he had not fulfilled his work requirement. He had completed a substance use treatment program in March, but attorneys say that condition, along with his other illnesses, should have exempted him from the new rules. McCreary missed a follow-up appointment with an oncologist who travels to Omaha, delaying his care by a month.
Nebraska became the first state to enforce Medicaid work requirements under the One Big Beautiful Bill Act on May 1. The rules mandate that adults work or participate in similar activities for 80 hours a month unless they qualify for an exemption. About 70,000 adult recipients in the state are subject to these changes. State officials said the rollout has been successful, with 86% of affected applicants meeting the requirement or qualifying for an exclusion.
Advocates dispute the state’s assessment. They cite poor training, inadequate staffing, and confusing systems. Kenny McMorris, CEO of the Charles Drew Health Center in North Omaha, noted that roughly half of the center’s 13,385 patients are on Medicaid, with 42% of those subject to the work requirements. He said patients often lack the time to navigate complex phone systems while working.
Nebraska spent $8.2 million over two years on contractors to implement the changes, according to state documents. The funds were used to hire staff from Public Consulting Group and Covendis. Sarah Maresh, a program director at Nebraska Appleseed, called the costs shocking, noting that large corporations benefit from the complex policies. The state said it used contractors when hiring state employees was impractical or uneconomical.
Call center wait times at the Nebraska Department of Health and Human Services nearly doubled between May and July, rising from 13 minutes to 26 minutes. The state received more than 101,000 calls in August, a 66% increase from May. Most denials among applicants were due to unsubmitted paperwork, a result the state described as expected. McCreary said he may have missed letters about his coverage because he prefers to handle matters by phone or in person rather than using the state’s online portal.
Taylor Miller, a spokesperson for CHI Health, said the system is committed to helping patients understand their coverage and access financial assistance. Jeff Powell, a spokesperson for the health department, confirmed McCreary was eligible for Medicaid under the Affordable Care Act, which places him in the group subject to work requirements. Powell said the state has no record of McCreary calling the department’s main call center, AccessNebraska, though McCreary believes he did. The governor’s spokesperson did not respond to requests for comment.
The Congressional Budget Office estimates the policy will leave 5.3 million more people uninsured by 2034. In Nebraska, the next step is for the state to continue processing the remaining enrollees. The Department of Health and Human Services plans to maintain the current enforcement schedule through the end of the fiscal year. McCreary is currently waiting to determine if his coverage will be reinstated or if he must pay for his ongoing cancer treatment.
