Nebraska Medicaid Costs $8.2 Million
State spent millions on contractors to enforce work rules, but call wait times doubled and one cancer patient lost coverage.
By Nikolai Patterson ·
Nebraska spent $8.2 million on private contractors to implement new Medicaid work requirements that took effect May 1. State documents obtained via a public records request show the funds paid two firms, Public Consulting Group and Covendis, for staffing and information technology support. The state launched the rules eight months before most other states, aiming to be the first under the One Big Beautiful Bill Act.
Eli McCreary, a 64-year-old Omaha resident, received a call from CHI Health informing him he had lost Medicaid coverage due to unmet work requirements. McCreary, who was diagnosed with kidney cancer in June, said he had been battling drug addiction and other chronic conditions. A representative told him, 'You're required to do work to stay on. And you haven't fulfilled your work requirement.'
McCreary canceled a CT scan and delayed a specialist appointment, saying he missed his window of opportunity for another month. He asked, 'I don't understand what job I can get. I can't walk. I can hardly breathe.' Attorneys noted that his four months of substance use treatment starting in November 2025 and his serious medical conditions should have exempted him from the rule.
Jeff Powell, a spokesperson for the Nebraska Department of Health and Human Services, said the rollout has been very successful. He cited state data showing 86% of affected applicants met the requirement or qualified for an exclusion. However, advocates argue that confusion and long wait times have hindered compliance. Average call center wait times doubled from 13 minutes in May to 26 minutes in July. Nebraska received more than 101,000 calls in August, a 66% increase from May.
The state budgeted for these costs because it operates its own Medicaid eligibility system rather than outsourcing to large vendors. Powell said contracted staff are used when hiring state employees is impractical due to time constraints. Public Consulting Group consultant Latanya Michaux praised the implementation, saying, 'I really cannot brag enough about how well Nebraska handled this requirement.'
Sarah Maresh, program director at Nebraska Appleseed, called the contractor costs shocking. She stated, 'When you put in complicated policies like this, there are large corporations making money behind the scenes.' The documents list at least six contractors costing over $250,000 each, with one individual earning more than $1.8 million. Powell noted that funding requests may not reflect actual expenditures.
The Congressional Budget Office estimates the Medicaid changes will leave 5.3 million more people uninsured by 2034. Work requirements will soon apply in over 40 states. McCreary said he was in despair when he received the call from the hospital. 'This cancer ain't going to stop just because I ain't got insurance,' he said. 'It's going to keep working on me.'
