"Indiana has become the second state to win permission from the Trump administration to require certain low-income residents on Medicaid to work, study or perform public service to qualify for the safety-net health insurance.
Federal officials’ approval Friday came almost exactly three years after the Obama administration allowed Indiana to test novel rules within its Medicaid program — among them, charging insurance premiums to even those in deep poverty — but rejected the state’s attempt to impose work requirements.
Blocked in 2015 from compelling people on Medicaid to hold or prepare for jobs, Indiana officials created a voluntary “Gateway to Work” as part of their expansion of Medicaid under the Affordable Care Act. The state has been referring people working fewer than 20 hours a week to programs that could help them train or search for jobs.
In the summer, with a conservative new administration in Washington, the state altered a federal application submitted to renew its experiment, known as the Healthy Indiana Plan 2.0. The amended version said the voluntary method “has not been successful in connecting individuals with sustained employment” and revived the request for a work requirement."