Mothers and infants in the U.S. without legal status and some lawfully present immigrants would be barred from food assistance under a bill that passed the Iowa House Tuesday.
The bill (HF 2716) would limit WIC — food assistance for pregnant and postpartum women, infants and young children — to citizens and qualified immigrants as defined by federal law. Children who are citizens and qualified immigrants would be allowed to join the program regardless of their parents’ status.
Rep. Austin Harris, R-Moulton, said these restrictions already apply to other public assistance programs.
“It comes down to this: Are we a nation of laws or not? Do we play by the rules or not?” he said. “Do we put Iowans first, or do we allow people who broke into this country to take advantage of these public assistance programs?”
WIC provides food, infant formula, breastfeeding support and other family services.
Rep. Angel Ramirez, D-Cedar Rapids, said the program is not a luxury, and it can be the difference between a healthy birth and a preventable tragedy.
“Iowa has always stood for the dignity of every child,” Ramirez said. “This bill asks us to abandon that value, to look at a hungry infant and say, ‘Your paperwork matters more than your health.’”
Bill would expand Medicaid eligibility for employed people with disabilities
The bill also expands Medicaid eligibility for people with disabilities who work.
It would raise the income limit from 250% of the federal poverty level to 300% and would exempt the income of a disabled individual’s spouse and one vehicle from the asset limit.
People with disabilities have been pushing for the removal of income and asset limits, saying the restrictions have prevented them from advancing their careers and getting married because they risk losing necessary health services when they make more money.
Rep. J.D. Scholten, D-Sioux City, proposed an amendment to fully remove income and asset limits, but it was voted down.
“Don’t we want to enable Iowans with disabilities to enter the workforce and advance their career without the fear of losing their essential health care?” he asked.
Rep. Megan Jones, R-Sioux Rapids, said she appreciates that the bill exempts spousal income because Iowans deserve the opportunity to get married.
“I understand that we’d maybe all like to go a little further with this, but I also understand that we have to be realistic in the ask and where we can get with the ‘Work without Worry’ bill right now,” she said. “So today, this is where we’re going to get.”
Harris said he has met with several people who would be impacted by this part of the bill.
“It almost breaks my heart, listening to their stories,” he said. “These are folks that have to be on this program to no fault of their own. We have people who are on welfare who are begging us to let them work more. I think that’s a pretty conservative principle.”
The bill would also require Iowans who apply for some public assistance programs to prove they have lived in the state for at least a year. It would add new fees and cost-sharing for Iowans in the Medicaid expansion population.
The Iowa Department of Health and Human Services (HHS) would be required to use the federal SAVE system to verify the immigration status of public assistance applicants. State law already mandates HHS to check federal information for applicants’ immigration status.
The bill directs the state to seek federal waivers related to the Supplemental Nutrition Assistance Program (SNAP) and to provide quarterly reports on public assistance error rates and fraud in Iowa.
The House passed the bill with a vote of 62-30, sending it to the Senate for consideration.
Parents of Iowans with disabilities urge House to reject managed care requirement
Several parents of Iowans with disabilities called on lawmakers Tuesday to reject a proposal that would require the state to continue using private companies to manage most of Iowa’s Medicaid system.
The provision is part of a Senate bill (SF 2422) that would make some changes to public assistance programs, including preventing future governors from ending or reducing the use of Medicaid managed care organizations (MCO).
Stacy Ring of Council Bluffs said her son Alex relies on intellectual disability services through Medicaid, and an MCO tried to cut his services in half when his needs had not changed. She said the system seems to be getting worse, and she opposes any action that would make it harder change it.
“We need an exit strategy for what is rapidly becoming a failed experiment,” Ring said. “My son’s life and the lives of thousands of other Iowa constituents are in your hands. Please do not betray their trust in you.”
Wendy Andersen of Treynor said her son receives Medicaid services because he has tumors, epilepsy, intellectual and developmental disabilities and autism. She said during Christmas week in 2023, she spent 49 hours on the phone because an MCO suddenly denied coverage for a drug her son had been taking for six years to prevent brain tumors.
“Families raising children with disabilities already live with enormous amounts of stress,” Andersen said. “When systems designed to help us create barriers, delays and denials, it becomes almost unbearable. I strongly encourage you to not lock Iowa further into Medicaid managed care systems that is already failing so many of our families that rely on it every day.”
Former Republican Gov. Terry Branstad took executive action to switch Medicaid to a managed care system, which was implemented in 2016. Medicaid recipients and health care providers have since complained about increased denials and delays of health services.
Opponents of Medicaid privatization have also questioned claims that managed care companies would help save the state money. State health officials are planning to remove pharmacy services from the MCOs to save more than $27 million next fiscal year.
Under the Senate bill, similar actions would be prevented after Jan. 1, 2027, about two weeks before the next governor takes office.
Republicans on a House subcommittee said the bill needs a lot of work, but they advanced it to continue the conversation.
