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An opioid epidemic. High smoking rates. Health care provider shortages. Indiana faces serious public health challenges. Side Effects Public Media provides in-depth coverage of these issues and more.

Indiana Medicaid Will Require People To Work To Maintain Health Coverage

Alex Azar, right, Secretary of the U.S. Department of Health and Human Services, announced federal approval for the Healthy Indiana Plan alongside Gov. Eric Holcomb.

Indiana is now the second state that will make people work in order to receive Medicaid benefits.

Indiana’s Medicaid program, known as the Healthy Indiana Plan, is approved by the federal government under a special waiver. That waiver allows the state to experiment with different ways to offer insurance coverage.

Before it received a temporary extension, the program was set to expire at the end of January. The newly-approved waiver, which includes changes to the program such as the work requirement, allows HIP to operate until December 2020.

Alex Azar, head of the U.S. Health and Human Services department, announced federal approval Friday in Indianapolis. He said getting people to work can help them escape poverty and improve their health.

“Healthy, fulfilling lives require not just health coverage and health care, but also a sense of purpose often obtained through work,” Azar said.

But critics point to data that shows that most people on Medicaid who are able to work already do. They worry the new rules will create administrative hurdles by making people prove they are working, or not required to, and these hurdles may cause people to lose coverage.

There are exceptions under the new rules. For instance, parents with young kids at home or people who have a disability won’t have to satisfy the work requirement. But many people on Indiana’s Medicaid will have to work, volunteer or train for 20 hours a week to keep their insurance.

The work requirement will take effect in 2019, said Jennifer Walthall, who heads Indiana’s Family and Social Services Administration. “We will build this program thoughtfully, and communicate it clearly,” she said.

Similar rules were approved in Kentucky last month. Advocates there say the new rules conflict with Medicaid law. Three organizations jointly filed a lawsuitwith the goal of preventing the policy from taking effect.

In addition to the work requirement, the federal waiver approval will also allow the state to move forward with several other proposed changes to HIP. It will cover additional addiction treatment services. The state has also increased the monthly charge for HIP members who use tobacco. And a new policy will allow pregnant mothers to have more consistent coverage on HIP.

This story was produced by Side Effects Public Media, a reporting collaborative focused on public health.

Jake Harper is an investigative reporter for Side Effects Public Media, and he is a co-host of the Sick podcast. He can be reached at