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Nebraska on Friday became the first state to implement Medicaid work requirements, eight months ahead of the federal deadline mandated in President Donald Trump’s “big, beautiful bill.” The move is expected to strip coverage from around 25,000 residents who qualified for the program under the Affordable Care Act’s Medicaid expansion, according to the Urban Institute, a nonpartisan research group. An estimated 72,000 Nebraskans will be subject to the policy, which applies to “able-bodied” adults ages 19 to 64. (Lovelace Jr., 5/1)

Voters in seven states bucked their conservative leaders to expand Medicaid at the ballot box. Now officials in six of them are deploying tactics to make the upcoming implementation of work requirements especially strict, which could dramatically reduce the number of people covered. (Ollstein, 5/3)

Health systems aiming to scale hospital-at-home programs are using health equity as a rallying point in their efforts to convince more state Medicaid programs to pay for the care. Providers argue states that don’t pay for in-home acute care are denying poor patients the same care options offered to patients covered by private insurance and Medicare. They also say states could be missing opportunities to identify social determinants of health that can negatively affect patient outcomes and drive up Medicaid spending. (Eastabrook, 5/1)

Agriculture Secretary Brooke Rollins this week attributed a multimillion-person drop in the number of participants receiving food stamps through the Supplemental Nutrition Assistance Program to the tamping down of fraud and an improved economy. But experts discount those factors, saying the primary driver of the decrease was more likely new legislation that changed how the program runs. (Goldin, 5/1)

The bipartisan reauthorization would add five more years to the Rural Community Hospital Demonstration, a payment model for "tweener" rural hospitals. (Muoio, 5/1)

U.S. Sens. Catherine Cortez Masto (D-NV) and Ted Budd (R-NC) on Thursday introduced the Veterans Protection from Fraud Act of 2026, a bipartisan proposal aimed at increasing criminal penalties for individuals who deliberately target veterans in fraud schemes. The bill would impose a sentencing enhancement of up to 10 years in prison for defendants convicted of fraud offenses that intentionally target veterans. Lawmakers say the measure is designed to deter increasingly common scams that exploit veterans’ benefits, financial stability, and trust in government institutions. (Fuller, 5/1)

Hundreds of thousands of Americans have switched to health insurance that covers a lot less of their care this year. Republicans hope a lot more will follow them. The shift since January was driven by GOP lawmakers’ decision at the end of December to reduce the help the government provides to people who don’t get insurance through work, but instead buy it in the Obamacare marketplace. The reduction in those subsidies sent Obamacare customers searching for plans that cost less. (Hooper, 5/3)