Gizmo Warehouseby Joe Eichenbaum | 17A

Medicaid work requirements · Indiana

Medicaid work requirements in Indiana: who is subject and who loses coverage (2027)

Data snapshot 2026-06-03 · part of These 5 Million People Are About to Lose Their Medicaid — But They Don't Have To

Indiana expanded Medicaid, so the federal work requirement that takes effect January 1, 2027 applies to its expansion adults. About 484,417 of them (12.1% of an expansion pool of 517,848) will have to prove 80 hours a month of work, school, or service, or an exemption, to keep coverage.

This model's bottom-up estimate is that 229,055 people in Indiana lose coverage by 2034: 214,522 of them still eligible but lost to paperwork and reporting failures, and 14,533 not meeting the requirement. Nationally the same model gives 5,461,400, against CBO's 5,200,000.

Whether those eligible people keep coverage depends on the state's ability to renew them automatically (ex parte) from data it already holds. Indiana scores 62 of 100 on this model's ex parte capability index, a mid band; its eligibility system is ICES (Cúram).

Key figures

Model v2-2026-06-03. "Strict" counts adults whose ACS record shows them subject with no observable exemption; "permissive" allows the broader exemption reading.
MeasureIndiana
Expansion stateYes
Subject to the requirement via waiverNo
Expansion pool (adults 19 to 64)517,848
Adults subject, strict definition484,417
Adults subject, permissive definition474,728
Share of expansion pool subject12.1%
Projected coverage loss by 2034229,055
Hardship exception statusNot adopting
Early implementerNo
Ex parte capability score (0 to 100)62 (mid)

Who is subject in Indiana

Of the 484,416 subject adults, 41% already work 80 or more hours a month and 52% are not working. 39% have a child under 14 at home. Among those not working, 53% report a disability and 17% are caregivers.

ACS PUMS 5-year 2020 to 2024, subject adults only.
CharacteristicShare of subject adults
Age 19-2414%
Age 25-3424%
Age 35-4422%
Age 45-5418%
Age 55-6423%
Not working52%
1 to 19 hours a month1%
20 to 79 hours a month6%
80 or more hours a month (meets the bar)41%
Not working: Disabled53%
Not working: Caregiver17%
Not working: Postpartum0%
Not working: Student2%
Not working: Other27%

Why eligible people lose coverage

Of the 229,055 projected to lose coverage in Indiana, 214,522 meet the requirement or qualify for an exemption but fail to document it. 87,289 of those are working people who cannot prove their hours through data the state can see, and 127,233 qualify for an exemption the state does not detect automatically.

Bottom-up model v8.0-2026-05-30; documentation-failure buckets compound over the 14 six-month renewal cycles through 2034.
GroupProjected to lose coverage
Variable shifts / on-call work22,822
Full-time students not auto-verified16,768
Self-employed (other)15,773
Multiple part-time jobs (aggregation failure)15,706
Volunteering / job training5,360
Cash-paid construction & trades4,408
Seasonal: agriculture, hospitality, food service4,181
Gig / courier (DoorDash, Uber, Lyft, Instacart)2,272
Medically frail without auto-match48,382
Parent caregivers of children ≤13 without auto-match26,974
Caregivers of a disabled adult20,796
Kinship caregivers (non-parent) of children ≤138,941
SUD treatment not flagged in claims data8,188
American Indian / Alaska Native (tribal exemption)6,214
Other categorical exemptions (foster, AYA cancer, SNAP/TANF)4,169
Recent incarceration (data-match gap)3,180
Pregnancy / postpartum data lag389

Can the state renew people automatically?

The ex parte capability index blends the state's observed automatic-renewal rate (74% in CMS eligibility-processing data), the wage, disability, and other data sources it can query, and its history of churn. Indiana's composite score is 62 (mid band). A low score means more eligible people will be dropped for paperwork unless the state changes its process before January 1, 2027.

ComponentScore
Composite62
Observed ex parte74
Core capability14
Data sources50
Historical churn50

How subjects overlap across exemption categories

Each subject adult sits in exactly one cell. Categories: Working ≥ qualifying hours / income; Parent caregiver of child ≤13; Medically frail; Full-time student.
CombinationAdultsShare
None of the four152,95231.6%
Working ≥ qualifying hours / income87,01518.0%
Working ≥ qualifying hours / income + Parent caregiver of child ≤1382,98217.1%
Medically frail74,59015.4%
Parent caregiver of child ≤1336,2747.5%
Full-time student11,6622.4%
Working ≥ qualifying hours / income + Full-time student11,5032.4%
Working ≥ qualifying hours / income + Medically frail8,0331.7%

Counties in Indiana

Subject adults concentrate: Marion County (61,598), Lake County (35,157), and Allen County (26,696) account for 25% of the state's subject population.

All 92 counties in Indiana with subject adults, sorted by count. County figures are model allocations of the state estimate by ACS tract characteristics.
CountyAdults subjectSubject rateProjected lossPoverty rateWorking-age population
Marion County61,59810.4%29,12615.0%591,167
Lake County35,15712.2%16,62415.0%289,139
Allen County26,69611.8%12,62312.0%226,678
Hamilton County24,00611.0%11,3514.0%217,576
St. Joseph County19,74112.4%9,33414.0%158,838
Tippecanoe County17,31114.4%8,18519.0%120,453
Elkhart County14,62612.6%6,91612.0%115,747
Monroe County12,71213.8%6,01121.0%91,959
Vanderburgh County12,70112.0%6,00614.0%105,648
Porter County12,59612.2%5,9569.0%103,442
Hendricks County12,30011.3%5,8165.0%108,696
Johnson County11,07511.3%5,2377.0%97,976
Madison County9,00611.7%4,25814.0%77,290
Delaware County8,98813.0%4,25021.0%68,934
Vigo County8,12412.8%3,84220.0%63,717
Clark County8,10110.8%3,83110.0%74,918
LaPorte County7,72511.8%3,65315.0%65,351
Kosciusko County6,02613.1%2,8499.0%45,854
Bartholomew County5,80211.9%2,74312.0%48,581
Howard County5,77912.3%2,73212.0%47,186
Hancock County5,72811.7%2,7095.0%49,126
Floyd County5,55211.7%2,6259.0%47,497
Morgan County5,26512.3%2,4909.0%42,661
Boone County5,06111.6%2,3936.0%43,680
Grant County4,95513.0%2,34319.0%38,138
Wayne County4,65912.4%2,20316.0%37,428
Warrick County4,64712.5%2,1976.0%37,280
Dearborn County3,74512.7%1,7718.0%29,502
Marshall County3,46613.6%1,63911.0%25,548
Noble County3,41012.5%1,6127.0%27,312
Henry County3,31511.4%1,56814.0%29,002
Jackson County3,25912.2%1,54112.0%26,617
Lawrence County3,20112.4%1,51311.0%25,833
Dubois County3,15512.9%1,49210.0%24,427
Shelby County3,13611.9%1,48313.0%26,230
DeKalb County3,10612.3%1,46810.0%25,149
LaGrange County3,10314.5%1,4676.0%21,357
Steuben County3,02415.4%1,4309.0%19,644
Montgomery County2,90813.3%1,37513.0%21,812
Harrison County2,88012.5%1,3628.0%22,968
Putnam County2,86412.5%1,3549.0%22,915
Huntington County2,73312.8%1,29211.0%21,444
Cass County2,66912.4%1,26214.0%21,484
Knox County2,66612.9%1,26113.0%20,712
Miami County2,63312.3%1,24516.0%21,382
Adams County2,61814.1%1,23811.0%18,570
Whitley County2,54212.9%1,2029.0%19,720
Jasper County2,39112.6%1,1307.0%18,982
Jefferson County2,37412.1%1,12313.0%19,638
Greene County2,36713.3%1,11914.0%17,773
Daviess County2,35813.2%1,11510.0%17,852
Gibson County2,34212.4%1,10710.0%18,822
Clinton County2,33912.8%1,1069.0%18,332
Wabash County2,25913.1%1,06811.0%17,190
Ripley County2,14913.1%1,01610.0%16,454
Wells County2,10713.3%9966.0%15,788
Washington County2,06912.7%97813.0%16,266
Jennings County2,04012.7%96414.0%16,097
Posey County1,88313.2%89010.0%14,214
White County1,86313.8%8819.0%13,496
Decatur County1,83912.1%87010.0%15,158
Clay County1,81812.0%86011.0%15,103
Starke County1,75013.4%82714.0%13,055
Randolph County1,71312.6%81013.0%13,560
Franklin County1,70013.0%8047.0%13,090
Fayette County1,68012.8%79416.0%13,122
Scott County1,66911.6%78916.0%14,380
Owen County1,62213.1%76712.0%12,392
Carroll County1,58113.6%7477.0%11,618
Fulton County1,54713.8%73115.0%11,194
Jay County1,49913.5%70914.0%11,105
Spencer County1,49713.2%7087.0%11,332
Orange County1,41212.9%66815.0%10,948
Perry County1,41112.4%66712.0%11,349
Sullivan County1,39410.9%65912.0%12,757
Brown County1,26514.5%5988.0%8,749
Rush County1,20912.7%57112.0%9,544
Parke County1,20213.0%56816.0%9,221
Tipton County1,16013.4%54912.0%8,649
Fountain County1,15312.1%54512.0%9,491
Vermillion County1,13912.9%53915.0%8,838
Newton County1,02212.7%48313.0%8,080
Pulaski County91913.4%43413.0%6,872
Pike County89013.2%42111.0%6,722
Blackford County88613.7%41917.0%6,476
Crawford County78613.0%37222.0%6,052
Switzerland County75213.5%35617.0%5,580
Martin County74313.5%35114.0%5,516
Warren County63413.4%30013.0%4,742
Benton County62912.6%29714.0%4,996
Union County53013.4%2516.0%3,954
Ohio County45913.8%21710.0%3,332

State brief and methodology

Estimates, not counts. The model rakes to CBO's national subject total and allocates by ACS microdata; state agencies hold the administrative data that would replace these figures.

Sources

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