Nebraska Roll-Out of Trump Medicaid Rules Is Chilling

Nebraska’s Medicaid work requirements are already costing people coverage. Plus, physicians face a mental health crisis as fear keeps many from seeking help.

Greetings, MindSite News readers, and happy Veterans Day!

In case you missed it a couple years ago, our editors remember their WWII veteran fathers. In today’s Daily, how Nebraska’s early rollout of new Medicaid work rules is hurting people, and the gaps that harm both patients and physicians in our nation’s health care system. Plus, how to navigate the anxiety that may bubble up when someone from your past reaches out. 

But first, Brooklyn artist and centenarian George Ford tells ABC-7 New York about some of his inspiration for growing up to illustrate Black children in picture books — right after his daily workout.

Nebraska’s early launch of new Medicaid work rules offers troubling preview

Omaha, Nebraska (Photo: John Matychuk via Unsplash)

Republican lawmakers claimed that changes to Medicaid work rules contained within President Donald Trump’s so-called One Big Beautiful Bill Act, wouldn’t impact citizens’ existing coverage. Early results show otherwise. While most states will enforce the new rules beginning in January 2027, Nebraska launched them on May 1, 2026. 

Soon after, Eli McCreary, then 64, was told by his local hospital in Omaha that he had lost coverage for failing to meet the bill’s monthly work requirements and would have his upcoming appointments canceled unless he paid out-of-pocket. Noting that he had heard of the new work rules, McCreary told KFF Health News that he didn’t realize they might apply to him. He was just a few months removed from substance use treatment and was navigating diabetes, chronic obstructive pulmonary disease and a new kidney cancer diagnosis. “I don’t understand what job I can get,” he said. “I can’t walk. I can hardly breathe. I can’t move around. What job am I going to get?”

McCreary was forced to cancel a CT scan and other tests, including a cancer-related appointment with a doctor who travels back and forth to Omaha every month. “I missed my window of opportunity with him for another month,” he said, recalling the despair he felt from the ordeal. Though he was eventually able to reschedule, the cancer had grown significantly by the time he had his right kidney removed in early November.

Attorneys and policy experts working with Medicaid enrollees added that McCreary should have never been in that position because the law exempts people with serious medical conditions or substance use disorders. But Nebraska health officials say their records show McCreary experienced “no lapses in coverage.” He received Medicaid through the Affordable Care Act expansion, and people covered under that expansion were subject to work rules under the new law. But officials claimed that he actually aged out of Medicaid and into Medicare at age 65 before the new requirement could apply to him. Still, many people are confused about which rules apply to them – McCreary, who was a driver for an asphalt services company before his health deteriorated, said he may have missed letters notifying him of the shift.

Nebraska health officials claim that the rollout of changes to Medicaid “has been very successful,” pointing to state data showing that 93% of existing enrollees kept their coverage. But groups that serve Nebraska’s low-income and working families say that the rollout has been full of missteps, largely tied to poor training of an overburdened staff. Amid the state’s refusal to hire additional workers to support the rule changes, average Medicaid call center wait times doubled between May and July, leaving some callers on hold for hours. People who work “just don’t have time to be sitting on the phone,” said Kenny McMorris, who runs the Charles Drew Health Center in North Omaha. 

By August, roughly 1,100 Nebraskans had been denied benefits due to the work requirements, mostly for not responding to information requests. Nebraska’s total Medicaid enrollment has also fallen by about 4,600 people since May, a reduction of 1.4%.

Nebraska’s experience may offer a preview of what’s coming in the rest of the country. Next year, work requirements will reach millions of Medicaid enrollees in more than 40 states. The Congressional Budget Office has estimated that the policy will leave 5.3 million people uninsured by 2034. Democrats, who will take control of Congress in January, have pledged to repeal the Medicaid changes within their first 100 hours, though President Trump could veto the effort.

Many doctors suffer from life-threatening mental strain but fear seeking help

Dr. Shikha Jain worked incredibly hard to become a triple board-certified hematologist and oncologist, and she loves caring for her patients. Still, the UI Health physician told Chicago Health, “I think about leaving medicine on a weekly basis.” She’s far from alone. Many physicians say that our existing health care system keeps them from putting patients first while making it risky to address their own mental health needs. Emergency rooms across the country are overflowing with patients who delay care because they lack insurance or a primary care doctor or, in recent years, fear immigration enforcement. ER doctors are thus left to absorb the consequences of every gap in access, treatment and follow-up. Insurance denials, staffing cuts and private equity buyouts only deepen the strain.

“To have an insurance company tell me that I don’t know what I’m prescribing or that this patient should not be getting a certain medication is incredibly frustrating.” Jain said. Insurance companies are also insulated from the moral pain of sitting with a patient and explaining that a necessary treatment has been denied. “They don’t have to have those hard conversations. We do,” she added.

Many physicians experience that tension as moral injury, a term first used to describe the trauma of Vietnam veterans who served in a system at odds with their values. It often goes hand in hand with burnout, which, according to American Medical Association President Dr. Willie Underwood III, climbed to 63% during the pandemic and still stands at 42% years later. In a 2025 survey cited by Chicago Health, 35% of physicians reported considering leaving medicine since the start of that year. 

Another study published last year in the Journal of Psychiatric Research found that 14% of health care workers reported suicidal thoughts in the past year, 6% said they had made a plan and 3.5% reported attempting suicide. More than 300 physicians die by suicide each year, placing them at greater risk than the general population.

Yet fear for their careers keeps many doctors from seeking help. Applications for licensure ask about mental health diagnoses in the same section as felony convictions, fueling stigma and fear according to Dr. Stefanie Simmons, an ER physician and chief medical officer of the health worker advocacy nonprofit Dr. Lorna Breen Foundation. Breen was a New York City emergency medicine physician, spent the early months of the pandemic caring for hundreds of COVID patients amidst massive shortages of beds, respirators and supplies, and contracted the virus herself. She died by suicide later in 2020. Her family founded the organization that year, saying Breen feared that seeking mental health care could cost her the career that she loved.

Now, the foundation along with the AMA and state medical boards, is pushing to change those questions on the licensure application for one simple query: “Are you currently impaired in your duties for any reason?” As of May 2026, 74 licensing boards, including the medical boards in 44 states, made the change. Hospitals ask similar questions when they credential doctors, but more than 1,400 hospitals, freestanding ERs and surgery centers, as well as over 2,000 urgent care centers, have confirmed that they no longer do so.. Illinois’ Department of Public Health is also expected to update its required credentialing language this fall.

There are also other barriers to mental well-being for health workers. Therapy rarely fits around overnight calls and unpredictable shifts, and some doctors avoid using their workplace mental health benefits for fear the records will follow them into credentialing reviews. Jain says health systems need to back up their encouragement with protected time, affordable treatment and clear confidentiality protections, so the message to doctors becomes: “We will make it possible for you to get help.”

In other news…

Trump’s post-midterm revenge fantasies and a key failure by Democrats. As psychiatrist Bandy Lee predicted, Trump has gotten increasingly threatening as his losses mount. Trump’s behavior stems from a “pathological drive for destruction,” she told MindSite News this spring. And his AI video fantasies about having UFC fighters attack reporters asking Trump questions at a press conference only underscore his unwellness. Meanwhile, the Democrats missed their first chance to impeach Secretary of Defense Pete Hegseth after 11 of them missed the vote, which Democratic Rep. Sydney Kamlager-Dove (CA) called “shameful.” Here is the full list of Democrats who managed to miss their first, and crucial, line of business. – Diana Hembree. 

When the past comes calling. Thanks to social media, almost anyone from our past can find us, whether it’s an ex, an old classmate or a coworker from our very first job. But seeing an old name pop up can stir up more than nostalgia. In conversation with health and science journalist Jancee Dunn, therapist Terri Cole told the New York Times that a blast from the past can be unsettling, even when the relationship was positive, because it can pull us right back into who we were then. Her advice? Take a beat before responding. 

Cole and other experts also encourage getting curious with yourself. What was your gut reaction when you saw the name? Do you miss the person, or the version of yourself you were when you still knew them? If you feel inclined to reply, determine if that impulse is due to loneliness, guilt or real interest. And don’t hesitate to do a little social media sleuthing to figure out why they’re reaching out now, psychologist and author Guy Winch added. Learning that an ex recently finalized a divorce, for example, might change how you respond. And if you’d rather not reconnect at all, Cole says, that’s okay too. You don’t have to answer every call.

The name “MindSite News” is used with the express permission of Mindsight Institute, an educational organization offering online learning and in-person workshops in the field of mental health and wellbeing. MindSite News and Mindsight Institute are separate, unaffiliated entities that are aligned in making science accessible and promoting mental health globally.

Creative Commons License

Author

Courtney Wise Randolph is the principal writer for MindSite News Daily. She’s a native Detroiter and freelance writer who was host of COVID Diaries: Stories of Resilience, a 2020 project between WDET and Documenting Detroit which won an Edward R. Murrow Award for Excellence in Innovation. Her work has appeared in Detour Detroit, Planet Detroit, Outlier Media, the Detroit Free Press, Michigan Quarterly Review, and Black in the Middle: An Anthology of the Black Midwest, one of the St. Louis Post Dispatch’s Best Books of 2020. She specializes in multimedia journalism, arts and culture, and authentic community storytelling. Wise Randolph studied English and theatre arts at Howard University and has a BA in arts, sociology and Africana studies at Wayne State University. She can be reached at info@mindsitenews.org.

Five years. 1500 stories. Help us cover what comes next.
All gifts matched through Dec. 31.

Close the CTA