The bill establishes a new "work without worry" program under Iowa's medical assistance program, aimed at providing health care coverage to employed individuals with disabilities. It defines key terms such as "countable income," "disability," and "long-term services and supports," and outlines the program's intent to remove barriers to employment for individuals who meet the definition of disability but face challenges due to income and resources. The program will be administered by the Department of Health and Human Services (HHS) and will offer access to traditional Medicaid services, long-term services, and community-based services, while also coordinating benefits with employers' health care coverage.

Eligibility for the program is broadened, as it eliminates the previous resource limits and income restrictions that were part of the Medicaid for employed people with disabilities program. The bill prohibits HHS from implementing eligibility rules based on income, resources, or federal disability benefits receipt. Individuals receiving supplemental security income will be automatically eligible without needing to apply. The monthly premium for the program is set at 6% of the individual's verified countable income, and a six-month grace period is established for those who temporarily lose employment or face health crises. The bill mandates HHS to adopt necessary rules for administration and to submit any required waivers or amendments to federal authorities. It takes effect immediately upon enactment.