1. 1. The department shall request any federal approval necessary to include work requirements as a condition of a member maintaining eligibility for the Iowa health and wellness plan.
2. 2. The goal of including work requirements is to reduce the dependence of low-income Iowans on public assistance programs through efforts that advance economic stability and mobility.
3. 3. The department shall require as a condition of maintaining eligibility for the Iowa health and wellness plan that a member work at least eighty hours each month, as determined by the department.

4. 4. The department shall exempt an individual from the work requirements for the Iowa health and wellness plan if the individual meets any of the following criteria:

   1. a. The individual is under nineteen years of age.
   2. b. The individual is sixty-five years of age or older.
   3. c. The individual is determined to be disabled by the United States social security administration.
   4. d. The individual is identified as medically frail or medically exempt under the Medicaid program.
   5. e. The individual is a caretaker of a dependent child under six years of age.
   6. f. The individual is pregnant and the pregnancy is high risk.
   7. g. The individual is receiving unemployment compensation as determined by the department of workforce development.
   8. h. The individual is participating in substance use disorder treatment, not to exceed a consecutive six-month period.
   9. i. The individual is otherwise exempt for good cause as determined by the director.
5. 5. To maximize fiscal stability and administrative efficiency, any exemption applied under the Iowa health and wellness plan shall be substantially similar to the exemptions applied under other public assistance programs.
6. 6. Upon the department’s receipt of federal approval, and the department’s operationalizing of a real-time system to facilitate recipient reporting and department evaluation efforts, the department shall implement work requirements as a condition of maintaining eligibility for the Iowa health and wellness plan. The department shall adopt rules pursuant to chapter 17A as necessary to administer the work requirements for the Iowa health and wellness plan.
7. 7. The department may resubmit a request for federal approval submitted under subsection 1 if the initial request is denied or withdrawn for any reason.
8. 8. If the department receives federal approval to include work requirements as a condition of a member maintaining eligibility for the Iowa health and wellness plan, and if federal law or regulations affecting work requirements for the Iowa health and wellness plan are modified to exclude work requirements as a condition of a member maintaining eligibility as provided in this section, the department shall discontinue the Iowa health and wellness plan, subject to federal approval. If, under federal law, the department is not allowed to discontinue the Iowa health and wellness plan, the department may implement an alternative plan as specified in the medical assistance state plan or waiver for coverage of the affected population, subject to prior statutory approval of implementation of the alternative plan.

NEW section

2025 Acts, ch 133, §1, 2