A bill for an act relating to the establishment of the work without worry program under the medical assistance program for employed individuals with disabilities, and including effective date provisions.

HF 424 establishes Iowa's "Work Without Worry" program, providing health coverage through the state's medical assistance program for employed individuals with disabilities aged 18-64 who meet income requirements. It removes typical Medicaid barriers by allowing participants to keep coverage while working, with premiums calculated as 6% of "countable income" (income used for basic needs), and automatically enrolling Supplemental Security Income (SSI) recipients. The program includes a 6-month grace period for temporary job loss or health issues without requiring premium payments during that time, and participants retain access to all standard Medicaid services plus additional community-based support. This directly affects Iowans with disabilities who work but would otherwise lose health coverage due to income limits under current Medicaid rules.