Nebraska has become the first state in the nation to implement new work requirements for Medicaid recipients, eight months ahead of the Trump administration's deadline. 

Federal officials say they're trying to add accountability to social service programs, but healthcare advocates say there's a pile of unaddressed administrative issues. 

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Forty-three states must impose new Medicaid work requirements by January 1st, 2027. Nebraska Appleseed's Health Care Access Program Drector Sarah Maresh said people are going to lose access to their health insurance and coverage with no time to plan. 

"And what that means," said Maresh, "is that there's going to be more families who either can't go to the doctor because of cost, or they are going to the doctor but likely aren't getting things that are super important for healthcare coverage, like preventative screenings."

Maresh said that also means an increase in emergency room visits by people who are uninsured, which she says is the most expensive and least helpful form of healthcare.

Joan Alker, executive director and co-founder of the Center for Children and Families at Georgetown University, said Medicaid work requirements don't lead to higher rates of employment. She said she also has major concerns about what the rollout is meant to look like. 

"States are already on a tight timeframe to implement this policy effectively," said Alker. "Indeed, we do not still have federal guidance available for the states, but yet Nebraska has plunged ahead without these final federal rules available."

The new eligibility rules require Medicaid recipients to work, volunteer or actively search for work for at least 80 hours a month. Montana is scheduled to implement the new requirements in July, and Iowa will do so in December.