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Nebraska just became America’s healthcare policy laboratory.
On May 1st, they flipped the switch on Medicaid work requirements, 7 months ahead of the federal deadline.
72,000 Nebraskans now need to prove 80 hours of monthly work to keep their healthcare.
Here’s what nobody’s talking about:
65% of affected Medicaid adults in Nebraska already work or attend school. They’re not sitting idle, they’re juggling multiple part-time jobs without benefits, caring for elderly parents, or managing chronic conditions that make steady employment difficult.
The math is sobering:
• 25,000 Nebraskans could lose coverage
• Nationally: 5.2 million could lose Medicaid by 2034
• 4.8 million could become completely uninsured
But here’s the real challenge: States still don’t have federal guidance on who qualifies as “medically frail” for exemptions. Work verification systems aren’t fully built. The infrastructure needed to track compliance doesn’t exist yet.
🔍 Think about this:
When someone loses Medicaid coverage, they don’t stop needing insulin. They don’t stop having asthma. They just stop getting treatment until they show up in your emergency room.
As healthcare leaders, we need to prepare for what’s coming. Montana starts July 1st. Iowa follows in December. By 2027, this could be nationwide.
The question isn’t whether work requirements change behavior.
It’s whether we’re ready for the surge of uninsured patients who will flood our emergency departments when preventive care disappears.
Nebraska is running the experiment. The rest of us better be taking notes.
♻️ Repost if healthcare access shouldn’t depend on employment status
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Author:
Jonathan Govette is a seasoned healthcare and technology executive with more than two decades of experience building, scaling, and advising digital health companies. He is the Co-Founder and CEO of Oatmeal Health, an AI-driven Lung Cancer Screening and Diagnostics company focused on expanding access to early detection for underrepresented populations, particularly patients served by Federally Qualified Health Centers and value-based health plans.
With a background in engineering, product development, and strategic partnerships, Jonathan has founded and led multiple health technology ventures across clinical care delivery, regulated medical software, and AI-enabled diagnostics. His work sits at the intersection of medicine, technology, and health equity, with a consistent focus on translating complex clinical problems into scalable, real-world solutions.
Jonathan has spent much of his professional life dedicated to improving outcomes for marginalized and underserved communities. He has designed and implemented frameworks that align clinical quality, reimbursement, and technology to sustainably advance health equity at scale. This mission is deeply personal and informs his leadership philosophy and long-term vision for healthcare transformation.
In addition to his operating experience, Jonathan is an author and long-time writer in the healthcare domain, with over 20 years of published work covering digital health, medical innovation, and healthcare systems. He is a frequent mentor to early-stage founders and regularly advises startups on product strategy, partnerships, and go-to-market execution in regulated healthcare environments.
Before entering industry full-time, Jonathan nearly pursued a career in medicine with an early path toward cardiothoracic surgery, an experience that continues to shape his clinical perspective and respect for frontline care delivery.
CEO | Oatmeal Health | AI Lung Cancer Startup | Engineer | Writer | Almost Became a Doctor (Cardiac Thoracic Surgeon) | 3x Health Tech Founder | Startup Mentor | Follow to share what I’ve learned along the way.
