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 provide these individuals with access to health care coverage while removing barriers related to income and resources that previously limited eligibility. Key definitions are introduced, including "countable income" and "disability," and the program will be administered by the Department of Health and Human Services (HHS). The bill outlines that individuals eligible for the program must be at least 18 years old, employed, and have a qualifying disability, while also ensuring that those receiving supplemental security income are automatically eligible without needing to apply.

Significantly, the bill eliminates previous resource limits and income restrictions that were part of the Medicaid for employed people with disabilities program. It prohibits HHS from implementing eligibility rules based on an individual's income or resources, and it allows individuals to maintain other health care coverage without incurring additional premiums under the program. The monthly premium 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 to implement the program, which takes effect immediately upon enactment.