Indiana's Medicaid agency now has a number for how many people could lose their health insurance to the new federal work rule: 58,000.
That's how many people on the Healthy Indiana Plan aren't meeting the rule today, according to internal estimates the Indiana Family and Social Services Administration shared on Monday, the Indiana Capital Chronicle reported. It's as many as 12% of everyone in the program — and the rule doesn't even start until January 1, 2027.
The rule comes from Trump's 2025 budget bill. Every Republican Indiana sends to the U.S. House voted for it: Jim Baird, Erin Houchin, Mark Messmer, Jefferson Shreve, Victoria Spartz, Marlin Stutzman and Rudy Yakym. The House roll call shows all seven voting "Aye" on July 3, 2025. Indiana's two Democrats voted no.
Who's on the Healthy Indiana Plan
The Healthy Indiana Plan, or HIP, covers adults ages 19 to 64 who earn a little too much for traditional Medicaid. As of August, 461,700 Hoosiers were enrolled — about 32% of everyone on Medicaid in the state.
HIP is the only one of Indiana's five Medicaid plans that falls under the new federal work rule.
What the rule demands
Starting January 1, new applicants and current members have to prove they are working, going to school, volunteering, or in an apprenticeship or work program — at least 80 hours a month, or earning at least $580 a month. If they can't show it, and don't qualify for an exemption, they lose their coverage.
The 2025 budget law requires states to start a Medicaid work requirement by January 1, 2027, as a Racine County Eye fact-check of a Wisconsin congressman laid out over the weekend. Indiana's legislature had already voted for a HIP work requirement of its own in 2025, a measure Gov. Mike Braun signed — but the one starting in January is required by Washington.
And the clock is already running. The state is using a three-month look-back, the Capital Chronicle reports, so anyone applying or renewing in January has to be in compliance starting this month — October — to keep their coverage without a gap.
State officials estimated in August that as many as 300,000 Hoosiers could be subject to the rule after exemptions.
Paperwork, not work
The people who lose coverage under rules like this mostly aren't people who refuse to work. They're people who get lost in the paperwork.
That same fact-check recounts what happened the last time a state tried this. When Arkansas started a Medicaid work requirement in 2018, more than 18,000 people lost coverage before a federal judge struck it down in March 2019. Harvard researchers later found, the paper notes, that more than 95% of the Arkansas members they surveyed already met the requirement or should have been exempt. The coverage losses came from people failing to get through the reporting process.
Across the country, the Congressional Budget Office projects, per the same report, the work requirement alone will leave 5.3 million more people uninsured in 2034.
Indiana has been here before
This isn't the first time we've written about what this law is doing to Indiana. In September, we reported that Indiana had dropped more of its children from Medicaid than any other state — and that all seven of these same Republicans voted for the law cutting about $900 billion more from the program.
Now the work rule is about to hit the adults. The state's own agency is touring Indiana holding town halls to explain it. The next one is Tuesday evening at Ivy Tech's Valparaiso campus.
Adding it up
Indiana's Medicaid agency estimates 58,000 people on the Healthy Indiana Plan — up to 12% of its members — don't meet the federal work rule that starts January 1, 2027, and up to 300,000 Hoosiers could be subject to it. The rule comes from Trump's 2025 budget bill. Jim Baird, Erin Houchin, Mark Messmer, Jefferson Shreve, Victoria Spartz, Marlin Stutzman and Rudy Yakym — every Indiana Republican in the House — voted for that bill.
Source
- 58,000 Hoosiers not in compliance with new HIP work rules — Indiana Capital Chronicle
