Indiana — Medicaid Coverage Retention
Applies Last updated 2026-06-03 · confidence: high
Indiana is subject to federal Medicaid community-engagement/work-requirement implementation beginning January 1, 2027, unless modified by future federal or state guidance.
None identified
No public RFP for work-requirement communications/outreach identified as of 2026-06-03.
Procurement portal: Indiana Dept. of Administration (IDOA) Procurement "Current Business Opportunities" (in.gov/idoa/procurement/current-business-opportunities) and the state's supplier/eProcurement portal (supplier.in.gov); FSSA/OMPP posts notices through IDOA. Aggregated on indianabids.com. Federal items via SAM.gov. · Implementation funding: No state General Fund impact per FSSA Secretary Mitch Roob: HIP expansion population costs are split 90% federal / 10% state, with Indiana's 10% covered by Hospital Assessment Fee revenue, not GF. Roob explicitly said the state "will not save any money." Implementation spend so far is staffing-driven (400 new state eligibility employees), not a procured outreach budget; no dedicated communications/outreach contract value identified. (No public figure for the ~$2M federal implementation split was found specific to Indiana.)
Latest detail
Indiana is implementing H.R.1/OBBBA Medicaid community-engagement (work) requirements for the Healthy Indiana Plan population (~560,000 enrollees) effective Jan 1, 2027, under recently enacted Senate Enrolled Act 1, which mandates a stricter design than federal minimums: quarterly compliance checks plus a three-month lookback, and Indiana is one of only two states (with Iowa) declining optional hardship exceptions. Rather than procuring a new member-communications/outreach vendor or eligibility-system contractor via RFP, FSSA is hiring 400 state eligibility employees (50 onboarded since March 2026) and relies on existing vendors/MCEs (Anthem, CareSource, MHS, UnitedHealthcare; Maximus as enrollment broker). The only active FSSA/OMPP procurement activity is a managed-care re-procurement (HCC/PathWays/Hoosier Healthwise/HIP combined solicitation expected August 2026) and a Hoosier Care Connect MCE contract-extension notice—neither is a dedicated work-requirement outreach/communications solicitation. The mandatory federal member-outreach window runs June 30–Aug 31, 2026.
Key exemption categories to monitor
- 80 hours/month of work, job training, education, or community service — or qualifying monthly income.
- Targets many ACA Medicaid expansion adults (19–64); non-expansion states largely have no such group.
- Federal enforcement: January 1, 2027 (states implement; some earlier).
- New: expansion adults redetermine every 6 months (not annually).
- Commonly-defined exemptions: pregnancy/postpartum; medically frail; primary caregiver; disability; SUD treatment; certain students; tribe (AIAN); short-term hardship. Exact definitions set by CMS rule and each state.
Short-term hardship exemptions to track
Short-term hardship exemptions — adoption pending state guidance.
Member communication risk
Risk detail pending.
What MCOs & state partners should do now
- Segment affected members
- Identify likely exemptions
- Send plain-language multilingual notices
- Deploy SMS/email/IVR reminders
- Track retention outcomes
Operating in Indiana?
The member-notice window is open now and closes August 31, 2026. Complete a Coverage Retention Readiness Audit while there is still time to act — we build CMS-compliant, plain-language, multilingual outreach to keep eligible Indiana members enrolled.
Request a Coverage Retention AuditFrequently asked
Who is subject to Medicaid work requirements in Indiana?
Many ACA Medicaid expansion adults ages 19–64 who do not qualify for an exemption. Final scope is set by CMS rule and state implementation.
When do Indiana Medicaid work requirements start?
Federal enforcement begins January 1, 2027 (some states may implement earlier). Member notices are expected in the federally-required window of June 30–August 31, 2026.
What exemptions are available?
Federal baseline categories include parent/caretaker of a child under 14, pregnant/postpartum, disabled/medically frail, American Indian/Alaska Native, and those already meeting SNAP/TANF work rules. Short-term hardship exemptions and exact definitions are set by CMS rule and state implementation.
Sources
- https://www.kff.org/medicaid/medicaid-work-requirements-tracker-overview/
- https://indianacapitalchronicle.com/2025/09/18/medicaid-work-requirements-delayed-until-2027-following-federal-action/
- https://www.wfyi.org/news/articles/house-passes-hip-work-requirements-medicaid-fiscal-reforms-despite-concerns-about-loss-of-coverage
- https://www.in.gov/medicaid/members/member-resources/managed-care-health-plans/
- https://www.kff.org/medicaid/an-early-look-at-policy-decisions-as-states-get-ready-to-implement-work-requirements/
- https://indianacapitalchronicle.com/2026/04/29/fssa-hiring-400-medicaid-eligibility-checkers-ahead-of-work-requirements/
- https://www.in.gov/idoa/procurement/current-business-opportunities/
- https://mirrorindy.org/indiana-medicaid-snap-senate-bill-1-immigration/
This page tracks publicly available implementation information and is updated as Indiana publishes guidance. State-specific rules are evolving. Not legal or eligibility advice.