IndianaSB 1Second Regular Session 124th General Assembly (2026)SenateWALLET

Human services matters.

Sponsored By: Chris Garten (Republican)

Signed by Governor

Summary

Establishes the Indiana rural health transformation fund and makes allotments and expenditures from the fund subject to budget committee review before the allotment and expenditure may occur. Requires the office of the secretary of family and social services to report biannually to the budget committee concerning the use of the money in the fund. Prohibits recipients of Supplemental Nutrition Assistance Program (SNAP) benefits from using SNAP benefits to purchase candy and soft drinks. Requires the office of the secretary of family and social services to apply for a waiver or authorization to implement the prohibition if a waiver or authorization from a federal agency is required. Terminates the state's participation in the use of expanded categorical eligibility within the federal SNAP. Specifies gross income standards and countable resources for SNAP eligibility. Establishes immigration eligibility requirements for SNAP and requires the division of family resources to verify compliance with the requirements and submit information to the federal government about individuals for whom the division could not verify the immigration status. Specifies the time frame for Medicaid eligibility redeterminations. Requires the office of the secretary of family and social services (office) to transmit certain information to the federal government to prevent multiple state Medicaid enrollment. Specifies the time frame concerning the initial date of Medicaid assistance based on the application date. Sets forth additional countable income requirements for Medicaid. Modifies immigration status requirements for Medicaid, including presumptive eligibility and the healthy Indiana plan (HIP), and requires the office to verify compliance of the requirements and report information to the federal government. Modifies work and exemption requirements for HIP and requires the conditions to be met in the three preceding months before an individual applies to HIP. Requires the office to verify compliance with the work requirements on an ongoing basis and at least quarterly. Prohibits the office from expanding the medically frail exemption beyond the federal definition of the term. Removes the 12 month eligibility period for HIP and requires semiannual renewal. Sets forth additional copayments for the use of an emergency room setting for nonemergency services and other services under HIP.

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Bill Overview

Analyzed Economic Effects

8 provisions identified: 0 benefits, 4 costs, 4 mixed.

New Medicaid rules for immigrant households

Beginning October 1, 2026, lawful permanent residents, Cuban or Haitian entrants, and lawful Compact of Free Association residents receive citizen-like eligibility treatment. Federal funding and immigration eligibility limits still apply, and people outside the stated federal requirements are not entitled to assistance. Indiana counts income from household members barred from Medicaid because of immigration status, unless federal law says otherwise. Applications for temporary Medicaid coverage, called presumptive eligibility, must include immigration status. Approved organizations must collect and send that information, and cannot approve coverage until the status meets Indiana's requirements.

Revised eligibility routes for Indiana adults

Beginning July 1, 2026, Healthy Indiana Plan eligibility includes 80 monthly hours of work, work programs, volunteering, community service, or combined activities. Another route is monthly earnings of at least the minimum wage times 80 hours, with separate seasonal-work tests. Other routes include meeting SNAP or TANF work rules, substance-use treatment or recovery, medical frailty, pregnancy, postpartum assistance, or caregiving. The dependent-child age limit expands to under 14, and students must attend at least half time. Specified American Indian or Alaska Native status, total disability-rated veteran status, and another listed federal eligibility group also qualify. Adults must still meet the plan's other eligibility and Medicaid residency requirements.

More frequent Medicaid checks for recipients

Indiana must verify eligibility facts before Medicaid enrollment, rather than accept self-reported information, unless federal law requires otherwise. Recurring data checks trigger prompt eligibility reviews when relevant circumstances change. Unless federal law prohibits, reviews occur at least every six months for nonelderly adults qualifying through income-based rules, and yearly for others. Monthly lottery and gambling checks flag winnings of $3,000 or more; coverage ends when verified winnings make someone ineligible. Beginning July 1, 2026, Indiana also sends enrollment information to federal health officials monthly to prevent enrollment in multiple states.

Shorter Medicaid coverage for earlier bills

Beginning January 1, 2027, Medicaid's payment window for earlier care is shorter. Healthy Indiana Plan applicants can receive payment for eligible care no earlier than one month before their application month. For other applicants, the limit is two months before their application month. Applicants can remain responsible for bills from earlier care outside those windows.

Stricter medical frailty proof for participants

Beginning January 1, 2027, the Secretary can recognize medical frailty only with certification meeting the federal definition. Certification must come from a listed physician, physician assistant, advanced practice nurse, nurse, psychologist, or social worker. A qualifying physician's office representative can certify on a listed professional's behalf. The Secretary cannot broaden the federal definition or seek plan exemptions beyond those listed in the law.

Higher plan charges with quarterly limits

Beginning July 1, 2026, Healthy Indiana Plan participants pay minimum copays for nonemergency emergency-room care. Copays are at least $8 at or below the federal poverty level, and at least $35 above it. Health account money cannot pay for that care unless the condition meets the law's reasonable-person emergency standard. Participants above the poverty level must also pay additional cost sharing of $1 to $35. Total quarterly cost-sharing charges cannot exceed 5% of family income unless federal law allows otherwise.

More plan reviews, fewer reenrollment barriers

Healthy Indiana Plan participants remain eligible while meeting plan requirements, without the prior 12-month plan-period limit. Renewals change from yearly to every six months, and Indiana must review each participant's eligibility at least every six months. The law removes the six-month wait to rejoin after failing to complete renewal. The law also requires implementation of section 3(c) before January 1, 2027, with ongoing compliance checks at least quarterly beginning that day. Participant statements or a managed care organization's decision alone cannot satisfy those compliance checks.

Medicaid immigration checks trigger federal referrals

Beginning October 1, 2026, Indiana checks citizenship or satisfactory immigration status for Medicaid applicants, recipients, and identified household members. People whose status cannot be verified get a reasonable opportunity to provide proof before referral to federal authorities. Indiana must also promptly refer people confirmed to lack satisfactory status who entered without inspection or admission, or overstayed.

Sponsors & Cosponsors

Sponsor

  • Chris Garten

    Republican • Senate

Cosponsors

  • Aaron Freeman

    Republican • Senate

  • Blake Doriot

    Republican • Senate

  • Brad Barrett

    Republican • House

  • Brett Clark

    Republican • Senate

  • Brian Buchanan

    Republican • Senate

  • Craig Snow

    Republican • House

  • Cyndi Carrasco

    Republican • Senate

  • Daryl Schmitt

    Republican • Senate

  • Ed Charbonneau

    Republican • Senate

  • Eric Koch

    Republican • Senate

  • Gary Byrne

    Republican • Senate

  • Greg Goode

    Republican • Senate

  • James Tomes

    Republican • Senate

  • Jeff Raatz

    Republican • Senate

  • Jeffrey Thompson

    Republican • House

  • Joanna King

    Republican • House

  • Justin Busch

    Republican • Senate

  • Linda Rogers

    Republican • Senate

  • Liz Brown

    Republican • Senate

  • Michael Crider

    Republican • Senate

  • Michael Young

    Republican • Senate

  • Mike Gaskill

    Republican • Senate

  • Randy Maxwell

    Republican • Senate

  • Rick Niemeyer

    Republican • Senate

  • Ryan Mishler

    Republican • Senate

  • Scott Alexander

    Republican • Senate

  • Scott Baldwin

    Republican • Senate

  • Stacey Donato

    Republican • Senate

  • Travis Holdman

    Republican • Senate

  • Tyler Johnson

    Republican • Senate

Roll Call Votes

All Roll Calls

Yes: 487 • No: 787

Senate vote • 2/25/2026

Senate concurred with House amendments

Yes: 39 • No: 9

House vote • 2/23/2026

Third reading: passed

Yes: 64 • No: 30

House vote • 2/19/2026

Amendment #3 (Shackleford) failed

Yes: 29 • No: 61

House vote • 2/19/2026

Amendment #11 (DeLaney) failed

Yes: 30 • No: 64

House vote • 2/19/2026

Amendment #12 (DeLaney) failed

Yes: 34 • No: 55

House vote • 2/19/2026

Amendment #6 (Porter) failed

Yes: 28 • No: 62

House vote • 2/19/2026

Amendment #5 (Porter) failed

Yes: 29 • No: 60

House vote • 2/19/2026

Amendment #4 (Porter) failed

Yes: 28 • No: 60

House vote • 2/19/2026

Amendment #2 (Pack) failed

Yes: 30 • No: 56

House vote • 2/19/2026

Amendment #17 (Shackleford) failed

Yes: 30 • No: 59

House vote • 2/19/2026

Amendment #15 (Clere) failed

Yes: 31 • No: 57

House vote • 2/19/2026

Amendment #7 (Porter) failed

Yes: 32 • No: 60

Senate vote • 1/22/2026

Third reading: passed

Yes: 38 • No: 8

Senate vote • 1/20/2026

Amendment #1 (Qaddoura) failed

Yes: 10 • No: 38

Senate vote • 1/20/2026

Amendment #2 (Qaddoura) failed

Yes: 12 • No: 35

Senate vote • 1/20/2026

Amendment #3 (Yoder) failed

Yes: 10 • No: 38

Senate vote • 1/20/2026

Amendment #6 (Yoder) failed

Yes: 13 • No: 35

Bill Text

  • Engrossed Senate Bill (S)

  • Enrolled Senate Bill (S)

  • Introduced Senate Bill (S)

  • Senate Bill (H)

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