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 specifies that individuals receiving supplemental security income will be automatically eligible without needing to apply. It also establishes a monthly premium based on 6% of an individual's verified countable income and includes provisions for a six-month grace period for those who temporarily lose employment or face health crises. HHS is tasked with adopting rules for program administration and must submit necessary requests to federal authorities to implement the program, which takes effect immediately upon enactment.