The bill establishes a new "work without worry" program under the medical assistance program in Iowa, aimed at providing employed individuals with disabilities access to health care coverage. It defines key terms such as "countable income," "disability," and "long-term services and supports," and outlines the 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 previous resource limits and income tests that were part of the Medicaid for employed people with disabilities program. Individuals receiving supplemental security income will be automatically eligible without needing to apply. The bill stipulates that the monthly premium for the program will be 6% of the individual's verified countable income, with 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. The bill takes effect immediately upon enactment.