Medicaid's new work rules start, risking coverage for millions

States are rolling out new Medicaid work reporting rules requiring enrollees to document at least 80 hours per month of work, school, or volunteering or qualify for exemptions. Nebraska has begun enforcing these rules, with some enrollees already facing coverage losses; nationwide, up to 7 million could lose coverage by 2028. Critics say exemptions are too narrow and clinicians will bear more burden evaluating medical exemptions, while CMS says it will consider public comments in ongoing rulemaking amid lawsuits and budget pressures.