Nebraska Medicaid Rules Leave 64-Year-Old Cancer Patient Uninsured

A 64-year-old Omaha man with kidney cancer says he was told by a hospital that he was no longer covered by Medicaid, forcing him to cancel diagnostic tests and delay treatment until he could pay out-of-pocket.

Eli McCreary received the news from a local hospital operated by CHI Health shortly after his June cancer diagnosis. He said a hospital representative informed him that his coverage had lapsed and that his scheduled appointments would be canceled unless he paid directly. McCreary, who also manages diabetes and chronic obstructive pulmonary disease, described a situation where he was physically unable to work due to his condition.

Nebraska became the first state to enforce Medicaid work requirements under the One Big Beautiful Bill Act on May 1. The new rules require about 70,000 adult recipients to prove they are working or participating in similar activities for 80 hours a month, unless they qualify for an exemption. The federal law, signed by President Donald Trump, aims to reduce federal Medicaid spending by more than $900 billion over the next decade, according to the Congressional Budget Office.

State officials report that the implementation has been largely successful. Jeff Powell, a spokesperson for the Nebraska Department of Health and Human Services, cited data showing that 86% of affected applicants met the requirement or qualified for an exclusion, and 93% of existing enrollees kept their coverage. Governor Jim Pillen praised the federal administration for delivering what he called a key reform, speaking alongside a videoed-in appearance by Mehmet Oz, the federal official overseeing Medicare and Medicaid.

However, advocates and clinics serving low-income Nebraskans describe a system marked by confusion and administrative strain. They point to poor training and inadequate staffing as primary causes for errors in enrollment. Sarah Maresh, a program director with Nebraska Appleseed, called the administrative costs shocking, noting that large corporations are profiting from the policy changes.

State documents obtained through a public records request detail $8.2 million in contractor costs over two years to manage the Medicaid changes. The funds were allocated to two firms: Boston-based Public Consulting Group and Atlanta-based Covendis. These companies helped increase agency staffing and manage information technology systems. Nebraska submitted these figures to federal regulators to secure funding, though Powell noted that the requests may not reflect actual expenditures.

Call center data reveals a spike in demand following the May rollout. Nebraska received more than 101,000 calls in August, a 66% increase from May. Average wait times at the state health department call center nearly doubled from May to July, rising from about 13 minutes to 26 minutes. Kenny McMorris, CEO of the Charles Drew Health Center in North Omaha, said roughly half of his facility’s 13,385 patients are on Medicaid, with 42% subject to the work requirements. He noted that working patients often lack the time to spend hours on the phone.

McCreary’s case illustrates the gaps in the system. He called for help but reached a private call center for SNAP accounts rather than the state’s AccessNebraska line. The worker told him he was required to work to stay on Medicaid and that he had not fulfilled that requirement. Attorneys and policy experts state that McCreary’s four-month substance use treatment and other health conditions should have exempted him from the work mandate. The federal law includes exemptions for individuals who are too sick to work, including those with serious medical conditions or substance use disorders.

CHI Health spokesperson Taylor Miller declined to answer specific questions about McCreary’s experience. She stated in an email that the organization is committed to helping patients understand their coverage and access to care, including financial assistance resources. McCreary said he eventually resolved the issue but missed a one-month window for a cancer-related appointment with a specialist. He noted that he does not use the state’s online portal, preferring phone or in-person interactions, and said he may have missed mailed notices about his coverage status.