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Iowa Senate Passes Medicaid Work Requirements

jason schultz
John Pemble
Sen. Jason Schultz, R-Schleswig, speaks in the Iowa Senate as the floor manager for the Medicaid work requirements bill Tuesday, March 19, 2019.

Republicans in the Iowa Senate passed a bill Tuesday that would require some Medicaid recipients to report they are working or volunteering at least 20 hours a week in order to receive the government-funded health benefits.

Sen. Jason Schultz, R-Schleswig, said it will give people a “better chance at life.”

“If there’s nothing holding you back except your own decision not to move forward, we’re going to bump you forward,” Schultz said.

The bill exempts people who are pregnant, disabled, or have medical problems that keep them from working. It does not apply to Iowans who are caring for small children or senior citizens, those who are enrolled in a full-time educational program, or people who fit several other categories.

Schultz said statistics from the Iowa Department of Human Services indicate the work requirements could apply to about 60,000 Iowans between the ages of 19 and 64 who are not already reporting work and who do not qualify for exemptions.

Sen. Pam Jochum, D-Dubuque said Iowans in the Medicaid expansion population are already working, so the bill is not about new work requirements.

“It’s about new reporting requirements. Reporting requirements are going to add another $5 million in taxpayer money that’ll need to go to the Department of Human Services in order to track all of this down,” Jochum said.

The $5 million cost estimate is for the first year of implementation. It’s expected to cost Iowa $12 million in the second year. It is unclear how much money, if any, the state would save if a significant number of people are dropped from Medicaid.

Jochum said investing that money in workforce training, affordable child care, and reliable transportation would do a lot more to get people working and out of public assistance programs.

Sen. Jeff Edler, R-State Center, said enforcing Medicaid work requirements is an investment in getting people to be successful citizens of Iowa.

The bill passed the Senate on a party-line vote of 32 to 17.

If the House of Representatives and Gov. Kim Reynolds agree to this, it would still need federal approval.

Arkansas was the first state to implement Medicaid work requirements after the Trump administration opened the door to this policy. More than 18,000 people were removed from the Medicaid program for failure to meet the new requirements, according to the Kaiser Family Foundation.

Democrats in the Iowa Senate pointed out that at least some of those people were working, but they did not understand the monthly requirement to report their work hours to the state.

Katarina Sostaric is IPR's State Government Reporter