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Senate Bill Requires Work For Some Iowans In Medicaid

Iowa Capitol
John Pemble
IPR file
With some exceptions, members of the Iowa Health and Wellness Plan, the state’s Medicaid expansion program, would have to show they are working or volunteering at least 20 hours per week.";

Republicans in the Iowa Senate have passed a bill that would require a portion of the state’s Medicaid recipients to work in order keep access to health coverage.

Members of the Iowa Health and Wellness Plan, the state’s Medicaid expansion program, would have to show they are working or volunteering at least 20 hours per week. They could also qualify by participating in a job training program. There are exceptions, including for people with disabilities, parents with children under 6-years-old and individuals going through treatment for substance abuse.

Sen. Jason Schultz, R-Schleswig, said the rules would push people to not rely on public assistance.

“These benefits were not meant to be lifelong and they weren’t supposed to be a permanent bed,” Schultz said. “They were supposed to be a bottom, a spring board back up into self-sufficiency.”

If the bill (SF 2366) were to become law, Iowa would become one of at least 20 states that has taken steps to connect work with Medicaid eligibility, although the bill that passed Tuesday has a narrower focus than the original proposal which would have impacted the state’s entire Medicaid population.

The plan is estimated to reduce state spending on Medicaid, but Senate Democrats said it would also create a burden for hospitals in rural areas that often have higher Medicaid participation rates by replacing paid medical care with costly, unpaid emergency room visits.

“I’m just shocked that we’re doing this bill and not offering up something else for those rural counties,” said Sen. Liz Mathis, D-Hiawatha. Mathis said the bill creates obstacles for struggling families by requiring them to report their work status. “It’s a bill that creates hurdles for families because it’s a bill of lists with no solutions to the real problems of poverty.”

In addition to adding work rules to Medicaid, the bill also reinforces existing work requirements for many adults enrolled in the federal SNAP food program by requiring the Iowa Department of Human Services to assign them to job training programs. Another measure prohibits the state from requesting a waiver suspending the SNAP work rules. The U.S. Department of Agriculture grants waivers during periods of high unemployment.

A final component of the bill allows families to gradually phase out of the state child care assistance program as their incomes increase.

Gov. Kim Reynolds would not stake a position on the work requirements bill. She said she is focused on expanding job training opportunities such as the Future Ready Iowa program.

“But the other side of that is we can’t pay people, able-bodied adults, we can’t continue to pay them to stay home,” Reynolds told reporters Tuesday.

The bill now goes to the Iowa House of Representatives.

Grant Gerlock is a reporter covering Des Moines and central Iowa