The Indiana Family and Social Services Administration is preparing to phase in work requirements for able-bodied Hoosiers ages 19-64 who participate in Medicaid’s Healthy Indiana Plan, starting Jan. 1, 2027.
The agency released new details this week about early compliance for new applicants and how Hoosiers enrolled in HIP can fulfill their monthly 80-hour work requirements.
Anyone who plans to apply in January will need to meet work requirements starting in October.
HIP is Indiana’s version of Medicaid expansion, which extended eligibility for Medicaid under the Affordable Care Act to adults ages 19-64 who earn up to 138% of federal poverty guidelines.
Lawmakers OK’d the work requirements last year in part to rein in the state’s share of Medicaid costs, which had outpaced revenue growth despite the federal government covering two-thirds of the expense.
The law complies with President Donald Trump’s 2025 tax bill requiring all states to implement work requirements for Medicaid expansion.
“Hoosiers deserve a system that offers support in challenging times but also requires individuals who are able to contribute to take meaningful responsibility for their own progress,” Gov. Mike Braun said in a statement Monday. “These work requirements uphold that standard by ensuring members actively engage in education, training, and employment opportunities that build long-term independence. This approach strengthens families, fortifies communities, and moves our state forward.”
Participation in HIP reached 815,000 in April 2023, but has steadily declined since the state resumed Medicaid eligibility redeterminations at the end of the pandemic emergency.
Enrollment fell from around 671,000 Hoosiers when Braun signed work requirements into law last April to around 487,000 in June — a full six months before work requirements take effect.
FSSA Secretary Mitch Roob told reporters Tuesday he could not project how many people won’t meet the 80-hour monthly work requirement or an exemption, saying he hopes the number will be zero.
Estimates from the Urban Institute and Robert Wood Johnson Foundation suggest anywhere from 102,000 to 116,000 Hoosiers could lose eligibility due to the 80-hour work requirement.
Roob said HIP work requirements are not expected to result in cost savings for the state’s general fund — the expansion population is primarily funded by the federal government, with the remaining 10% paid through hospital assessment fees.
Who will work requirements apply to?
Only able-bodied adults ages 19-64 who participate in HIP must prove they are working, in school or volunteering 80 hours a month to remain eligible come Jan. 1.
That averages out to 20 hours a week.
Participants may combine hours from multiple activities to meet their hours each month, but must earn at least $580 a month to remain eligible.
Internships, apprenticeships and regular employment will count toward work hours, as will time spent in school so long as participants are enrolled in school at least half-time.
Volunteer work will also apply.
FSSA will conduct quarterly compliance checks using a three-month lookback period.
Compliance will be required for new applicants starting Jan. 1, at which time HIP applicants must prove they met the requirements for three consecutive months prior to their application to qualify.
Work requirements will not apply to children, disabled adults, the blind, seniors aged 65 and older or anyone enrolled in traditional Medicaid.
“Indiana has long maintained that healthcare assistance for able-bodied adults is not an automatic entitlement, but a benefit that must be earned through personal responsibility,” Roob said in a statement.
“HIP reflects that standard,” he said. “Eligibility rests with each member, and meeting program requirements is a fundamental obligation—not an optional step. We provide the tools, guidance, and opportunities needed to succeed, but it is the responsibility of members to fulfill their commitments. When individuals meet these expectations, they demonstrate accountability and take meaningful steps toward better health, greater stability, and long-term independence.”
Other exemptions include pregnancy, caregiving responsibilities, medical frailty, substance-use disorder treatment or recent release from incarceration, though documentation will be needed to qualify.
FSSA is awaiting guidance from the federal Centers for Medicare and Medicaid to determine how the medically frail exemption will be defined, Roob said.
The agency will host a series of town halls, video explainers and virtual webinars this summer to answer questions.
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