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Work on Health Care Reform Begins

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As mentioned before, the Governor signed into law the Iowa Health and Wellness Program that was adopted by the Legislature in the final days of the legislative session.  This carefully crafted compromise gives low-income Iowans access to health insurance by:

  1. Expanding Medicaid for Iowans earning up to 100% of the federal poverty level. This new Medicaid plan (called the “Wellness Plan”) and its benefit package would be similar to the State Employees Plan.  It is expected to include parity in mental health coverage, but will probably not include transportation (although the Federal government could still require it).

  2. Giving Iowans earning between 101-138% of the federal poverty level private insurance plan coverage paid for by Medicaid.  People would be able to choose from the two insurers that have said they will offer plans on the Health Insurance Exchange (CoOpportunity and Coventry). Eligible Iowans would have to take part in certain preventive health activities, like getting an annual physical, in order for their coverage to remain free. This part of the Iowa Health and Wellness Program is called the “Marketplace Choice Plan.” 

Both parts of the Iowa Health and Wellness Plan will require federal approval.  To get federal approval, the state must file two state plan amendments for the Medicaid expansion portion of the program (to create the new eligibility group and to create a separate benefits package) and two demonstration waivers (one that allows waivers from certain Medicaid requirements, and another allowing federal dollars to be used to purchase private insurance plans).  

The Iowa Medicaid Enterprise is busily writing these plans and waivers, and will have them available for public comment later this month.  They plan to host public hearings around the state on July 21-23 (but details on these meetings are not yet available).  They will take public comment at the meetings, but comments can also be submitted by email or mail. Iowa Medicaid plans to submit the waivers and state plan amendments on August 19. As part of the application process, the Iowa Medicaid Enterprise must show how they addressed issues brought up by the public.  After the plans are submitted, the Federal government will also have a public comment period.

The state has to be ready to go when enrollment begins on October 1.  Iowans have only until March 2014 to sign up for this new coverage, so you can see that things will move very quickly.  While we can’t tell you much more now, we will continue to provide updates on our website ( and on Facebook, or watch for more details here.