State documents show that fewer than 30 percent of those enrolled in the Healthy Indiana Plan would be required to comply with Gov. Eric Holcomb's proposed work mandate.
Holcomb has proposed making able-bodied, low-income residents work at least 20 hours a week for eight months of the year in order to receive state-supported health care coverage through the plan, The Times of Northwest Indiana reported. Holcomb submitted a finalized proposal to the federal government in July, seeking changes to the plan.
A third of the program's participants already meet that work requirement, and most members qualify for at least one of 14 exemptions and wouldn't have to work. Exemptions apply to people who are medically frail, older than 60, full- or part-time students, or primary caretakers for young or disabled children, among other qualifications.
Residents qualify for the Healthy Indiana Plan by having an income below the $16,400 maximum to qualify for expanded Medicaid coverage, under the provisions of the Affordable Care Act.
If the federal government approves Holcomb's plan, an estimated 130,000 people would need to enroll in the state's Gateway to Work program or risk losing their health care coverage.
The state has offered job-search and employment training programs to Healthy Indiana Plan members since 2015. However, state records show that fewer than 600 individuals attended the work program during its first 15 months of operation.
State officials contend that the employment requirement would reduce Medicaid spending as individuals begin earning more money than the health plan eligibility limit or start receiving health insurance from their employer.
State records show that about 40 percent of program participants haven't received a high school diploma, so it's unlikely they would be hired for jobs that pay much more than minimum wage.
Officials with the American Diabetes Association have argued that most Medicaid recipients who can work already have jobs.
"Work requirements are contrary to the goal of the Medicaid program: offering health coverage to those without access to care," said Dr. LaShawn McIver, the association's senior vice president for advocacy.
Kentucky, Ohio, Arizona, Arkansas, Wisconsin, Florida and Maine have also applied for federal approval to have employment requirements in place for those hoping to receive state-supported health care coverage.
The federal government may have a decision on Indiana's mandate as soon as mid-September. If approved, the mandate likely wouldn't be in full effect until 2019 or 2020.