CMS touts Nebraska being first to launch Big Ugly Bill Medicaid work reporting requirements by misspelling the name of the state.

As of March 2025, around 72,000 Nebraska residents were enrolled in Medicaid via the ACA's expansion of the program. Last summer, after Congressional Republicans passed their Big Ugly Bill, I warned people against assuming that the gutting of Medicaid wouldn't hit until after the 2026 midterms: Over at The New Republic, Greg Sargent has taken this thinking one step further, noting that by delaying so much of the ugliness of the new law until 2027 or beyond... Republicans know how unpopular all this will be. So they’ve structured the bill so the tax cuts land immediately, while many of the Medicaid cuts get going in 2027 and 2028. That’s meant to spare them in the midterms. But there’s a wrinkle here worth appreciating. Those policies will start hitting right when JD Vance’s bid to succeed Trump is getting underway. For Vance—perhaps the most prominent evangelist for Trumpism’s supposed promise for the working class—to have to defend all of that carnage while running for president could yet prove a form of poetic justice. Again, this is a fair statement, as far as it goes. However, while I'm not an expert on any of the non-healthcare provisions, when it comes to the sections related to healthcare policy, a whole lot of the ugly will actually hit well before the midterms.