Thousands of Hoosiers on the Healthy Indiana Plan will soon have to prove they meet new work requirements to keep their health insurance. But for many, the countdown starts this fall.
Anyone applying for or renewing coverage in January 2027 will have to show they were working, attending school, or volunteering beginning in October because of the state’s three-month lookback period.
This is what you need to know about what’s changing, who it affects, and what Gary residents on the Healthy Indiana Plan should do now.
What’s new with HIP
- Most adults ages 19 to 64 enrolled in HIP must complete 80 hours a month of work, school or volunteer activities.
- Enforcement begins Jan. 1, 2027, but applicants and members must already meet the requirement three months before they apply or renew. So people who want coverage at the start of the year must be in compliance as of this October.
- Broad exemptions exist for caregivers, people with disabilities, pregnant residents, and others, but claiming an exemption requires documentation.
Why the update is happening
The requirement stems from the 2025 federal reconciliation law, which for the first time made Medicaid expansion eligibility contingent on work and reporting requirements nationwide. States had to comply or risk losing federal funding. Indiana lawmakers later passed Senate Enrolled Act 1, which adds state requirements, including quarterly compliance checks.
Mitch Roob, Indiana Family and Social Services Administration secretary, has said keeping Medicaid eligibility is the recipient’s responsibility.
“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. “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.”
Advocacy group Hoosier Action says the paperwork burden will knock eligible people off coverage through error and confusion rather than actual ineligibility, a dynamic Indiana has already seen play out. When the state resumed annual eligibility checks in 2023 after the pandemic pause, nearly 500,000 Hoosiers were disenrolled, and more than three-quarters of those were “procedural” disenrollments, meaning the state didn’t have enough information to confirm eligibility, not that the person no longer qualified.
Who has to comply
Adults enrolled in HIP must meet the work requirement if they:
- Are ages 19 to 64
- Are not pregnant
- Are not enrolled in or eligible for Medicare
How to meet the requirement
Members and applicants need at least 80 hours a month in some combination of:
- Employment
- School at least half-time
- An apprenticeship
- A work program
- Community volunteering
Activities may be combined to meet the 80-hour monthly requirement.
Who is exempt
HIP members don’t have to meet the requirement for a given month if, for at least one day that month, they:
- Are younger than 26 and formerly were in foster care.
- Are a member of a federally recognized tribe.
- Are a parent or caregiver of a child age 13 or younger.
- Are caring for a person with a disability.
- Are a veteran with a 100% disability rating.
- Are pregnant or within 12 months after the end of a pregnancy.
- Are incarcerated or were released from incarceration within the previous 90 days.
- Already follow Supplemental Nutrition Assistance Program (SNAP) or Temporary Assistance for Needy Families work requirements.
- Are receiving treatment for drug or alcohol use.
- Are considered medically frail, including people with blindness or disabilities, substance use disorder, serious mental illness, or serious physical, intellectual, or developmental disabilities.
FSSA says other exemptions may apply.
What’s already happening
The enrollment drop started before the rule takes effect. HIP membership fell from about 671,000 when Braun signed the work-requirements law in April 2025 to roughly 487,000 by June 2026 — a loss of more than 180,000 people, six months before work requirements are even enforced. But outside estimates from the Urban Institute and the Robert Wood Johnson Foundation project that 102,000 to 116,000 Hoosiers could lose eligibility specifically because of the 80-hour requirement once it’s enforced.
FSSA is hiring 400 new employees just to handle eligibility checks for the roughly 560,000 Hoosiers on HIP, since the state law requires quarterly compliance verification. That is twice as often as before.
What HIP members should do now
- Check your contact info at the FSSA Benefits Portal (fssabenefits.in.gov). Outdated addresses are a major cause of procedural disenrollment.
- Set up a Benefits Portal account if you don’t have one; it’s how members will report work hours starting in 2027.
- Figure out if you qualify for an exemption now, before the paperwork crunch hits.
- Watch your mail for renewal notices. The state sends a renewal form about 45 days before your renewal date if it can’t auto-renew your coverage.
- Respond to every notice. Missing deadlines, not actual ineligibility, is the most common reason Hoosiers lose coverage.
