Indiana says 58,000 Medicaid members don't yet meet coming work rules
Indiana says about 58,000 people on Medicaid do not yet meet work rules that start Jan. 1, WFYI reported Tuesday. Adults who are not exempt must log 80 hours a month of work, school or volunteering. Missouri, meanwhile, will skip optional federal exemptions for people who are in the hospital or live in disaster areas.
Indiana officials say about 58,000 people on the state's Medicaid plan are not yet meeting work rules that start in January. The estimate comes from income checks and other eligibility data, WFYI reported Tuesday. "It's really sort of a guesstimate at this point," said Sunshine Beam of the state's Family and Social Services Administration.
Starting Jan. 1, adults who are not exempt must work, go to school or volunteer 80 hours a month to keep coverage. People who plan to apply for the first time in January had to start meeting the rules this month. Indiana still has not defined "medical frailty," a key exemption. "We are sharing this information to strongly encourage HIP members to take personal responsibility for their coverage," agency Secretary Mitch Roob said. HIP is the Healthy Indiana Plan.
Advocates are worried. "We know that a lot can go wrong, and the state sometimes has inaccurate data," said Tracey Hutchings-Goetz of Hoosier Action. She urged every member, even those who should be exempt, to stay on top of their paperwork.
In Missouri, the state will not use optional federal exemptions for people who are in the hospital, travel for medical care, or live in disaster areas, the Missouri Independent reported. A state spokesperson said those cases will be handled through the required exemptions for caregivers and people who are "medically frail." The state also plans to check work hours using one month in each six-month period. Joel Ferber of Legal Services of Eastern Missouri said it is "speculative" that the frailty rule will cover short hospital stays, because the state has not published its definition.
The backstory: The rules come from the One Big Beautiful Bill Act. Starting Jan. 1, 2027, states must check that adults ages 19 to 64 covered through Medicaid expansion meet the 80-hour test. A federal rule issued in June requires states to verify both a qualifying condition and that it keeps a person from meeting the work rules. That rule faces several lawsuits, the Missouri Independent reported.
Paperwork is a real risk. In Missouri, only 52.3% of Medicaid renewals in early 2026 were done using data the state already had, below the national middle mark of 54.8%, according to Georgetown University's Center for Children and Families. Renewals that miss that step can require enrollees to send in documents themselves.
What we know: Indiana counts 58,000 enrollees not yet in compliance, and the rules start Jan. 1.
What we don't: How states will define medical frailty, and how many people will lose coverage.
Where outlets agree WFYI and the Missouri Independent both report the work rules start in January and require 80 hours a month of work, school or volunteering.
Where they differ Missouri says its caregiver and medically frail exemptions will cover short-term hardships, but advocates there call that unproven because the state has not published its frailty definition.