The bill establishes a new "work without worry" program under Iowa's medical assistance program specifically designed for employed individuals with disabilities. This program aims to eliminate barriers to employment by providing access to health care coverage without the restrictive income and resource limits that currently apply to the Medicaid for employed people with disabilities program. The bill defines key terms such as "countable income" and "disability," and outlines the program's intent to offer medical assistance in accordance with federal guidelines. It mandates that the Department of Health and Human Services (HHS) administer the program and coordinate benefits with employers' health care coverage.

Eligibility for the program is broadened, as it prohibits HHS from imposing rules based on an individual's income, resources, or federal disability benefits receipt. Individuals receiving supplemental security income will be automatically eligible without needing to apply. The bill stipulates that participants will pay a monthly premium of 6% of their verified income, with provisions for a six-month grace period for those who temporarily lose employment or face health crises. HHS is tasked with adopting necessary rules and submitting any required waivers to federal authorities to implement the program, which takes effect immediately upon enactment.