Latest news with #SenateFile615
Yahoo
14-05-2025
- Health
- Yahoo
Work requirements for state Medicaid sent to Gov. Reynolds
DES MOINES, Iowa — While the Iowa House and Senate are working through the state budget for the next fiscal year; priorities from the majority party are getting passed in between. In a vote down party lines, the Iowa Senate approved Senate File 615, which requires 80 hours of work per month for those able to work on state Medicaid expansion. The Senate Republican caucus agreed with an amendment from the Iowa House that strikes a disabled worker program study out of the bill. House Republicans estimate that there are around 100,000 Iowans on state health care that can work but don't. Senate Democrats on Tuesday argued that this bill will end up costing the state millions. 'And in every state where this has been enacted, it has cost states tens of millions of dollars to implement for little to no savings. And the only benefit they get is more uninsured people who don't have a way to get their care covered,' said State Senator Sarah Trone Garriott (D), District 14 from Waukee. Pleasant Hill construction will cause detours for DART State Fair Shuttle at SEP Senate Republicans pointed at other states when the bill first came through the chamber earlier in session, and one senator argued the opposite of Trone Garriott's point. 'So, at the end of demonstration year five, we will see a savings in the state of Iowa as a result of this program of $50 million. $50 million in savings that we can really reallocate or reappropriate to other areas, perhaps work with our programs. We may be able to develop with further communication between ourselves in the House,' said State Senator Mike Klimesh (R), District 32 from Spillville. Senator Klimesh said that the five-year demonstration of the bill was made available by the Iowa Department of Health and Human Services. Just last month, Iowa Governor Kim Reynolds requested a federal waiver to add 100 hours of work per month. Those who would be deemed as able to work would need to reach that threshold to receive benefits from the Iowa Health and Wellness plan, or state Medicaid expansion. Reynolds told WHO 13 News two weeks ago that that number will be decided once the waiver is approved, whether it is 80 or 100 hours. The bill has been sent over to her desk and is eligible to be signed into law. There are exemptions for individuals in between the ages of 19 and 65 that will not have to work, that list can be found in the bill. Iowa News: Work requirements for state Medicaid sent to Gov. Reynolds Pleasant Hill construction will cause detours for DART State Fair Shuttle at SEP Forecast: Heat, then storms north Thursday Bill restricting DEI in government entities sent to Gov. Reynolds to be signed into law Caitlin Clark Foundation dishes another assist Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
14-05-2025
- Health
- Yahoo
Iowa Senate sends expanded Medicaid work requirements bill back to the House
Sen. Mike Klimesh, R-Spillville, spoke May 13, 2025 on the legislation to implement work requirements for Iowa's expanded Medicaid program. (Photo by Robin Opsahl/Iowa Capital Dispatch) The Iowa Senate on Tuesday sent back to the House a bill to implement work requirements for the Medicaid program, although the Iowa Department of Health and Human Services has already requested a waiver from the federal government to implement similar requirements. There are some differences between Senate File 615 and the waiver request announced by Gov. Kim Reynolds in April. The legislative proposal would require people who receive health coverage through Iowa Health and Wellness Plan (IHAWP), the Medicaid coverage available for low-income, able-bodied adults from ages 19 to 64, to work at least 80 hours each month to stay in the program. The HHS proposal sets a higher work requirement of 100 hours per month, and includes other means to retain IHAWP coverage, such as being enrolled in education or job skills programs, or earning the equivalent in wages to working 100 hours a month at $7.25 per hour. Both versions of the proposal contain exceptions for certain groups, including people with disabilities, individuals who are in a substance abuse treatment program for up to six months, and those with children under age 6. While the legislative proposal has a lower monthly work requirement, it also contains a provision that would end the IHAWP program entirely if work requirements are ever approved by the federal government and later revoked. Iowa HHS would be directed to discontinue the expanded Medicaid program if federal law or regulations are changed to exclude work requirements in the future — contingent on the federal government having previously approved Iowa's implementation of these restrictions. Ending IHAWP would be subject to federal approval. If ending the program is not allowed, the state department would be directed to implement an alternative plan. Both the Senate and House have approved this measure, but the House had sent the legislation back to the Senate with an amendment clarifying the language calling for the discontinuation of IHAWP if the federal government revokes work requirement approval, in addition to adding a requirement for HHS to conduct and submit a report to lawmakers on the Medicaid for Employed People with Disabilities (MEPD) program by Dec. 15, 2025 — before the 2026 legislative session. The Senate amended the House's change to remove the language calling for a MEPD report. Sen. Mike Klimesh, R-Spillville, said the report was unnecessary as conversations on this topic will occur 'on a voluntary basis' before the legislature reconvenes in 2026. Democrats criticized the measure, which they said will remove, due to reporting requirements, low-income people who are working and are in need of health coverage. Sen. Sarah Trone Garriott, D-West Des Moines, compared the feedback lawmakers received at the subcommittee meetings discussing IHAWP work requirements to the subcommittee held on the 'Work Without Worry' legislation that proposed removing Medicaid income and asset limits for Iowans with disabilities. While advocates and Iowans who attended at the 'Work Without Worry' bill subcommittee praised the measure for allowing them to return to the workforce without risking the loss of health coverage, people at the subcommittee meeting for the bill setting Medicaid work requirements overwhelmingly spoke against the proposal. 'Everyone who was a local Iowan showing up on behalf of folks with disabilities, children, pregnant mothers, just folks in the population who are low income and struggling — trying so hard to make ends meet — they said this bill will hurt Iowans,' Trone Garriott said. 'It will push people off of their health care. In other states where it's been implemented, legislation like this has just made it harder for people who do qualify to actually get the paperwork done and stay on.' While supporters have said work requirements will help reduce the costs of Medicaid, Trone Garriott said other states that have implemented similar work requirements have not seen significant savings, and that these requirements will raise overall health care costs in the state because it will cause more people to be uninsured. 'We have a growing number of people who are uninsured when measures like this are enacted, and those folks end up seeking charity care at emergency rooms and hospitals,' she said. 'Charity care is not free. A health care provider needs to spread out the cost, shift those costs on the other folks in order to keep paying the bills and keeping their doors open. It raises costs on everyone when folks are not insured.' Senate Minority Leader Janice Weiner also said the legislature is moving forward with this measure 'without having any firm idea what the fiscal impact will be.' The Legislative Services Agency fiscal notes on the bill stated the nonpartisan agency did not receive responses to multiple requests for information from HHS about the financial impact of implementing work requirements. Klimesh said HHS has included fiscal impact estimates in its waiver request over a demonstration period of five years that have found a cumulative savings of $50 million for the state, and held public hearings on the proposal, a part of the process of seeking approval from the federal Centers for Medicare and Medicaid Services. Klimesh also pointed to movement by the U.S. Congressional Committee on Energy and Commerce to make federal changes to Medicaid which includes requirements for able-bodied people between ages 19 to 65 to work, attend educational programs or participate in community service for at least 80 hours a month to stay eligible for coverage. 'Essentially, if you look at the blueprints the federal government is utilizing, it almost lines up specifically with what the state's requirements are,' Klimesh said. The bill was approved as amended in a 33-13 vote, and returns to the Iowa House.
Yahoo
27-03-2025
- Health
- Yahoo
House sends expanded Medicaid work requirements bill back to Senate
Rep. Carter Nordman, R-Adel, spoke in support of enacting work requirements for Iowa's expanded Medicaid program during floor debate March 26, 2025. (Photo by Robin Opsahl/Iowa Capital Dispatch) The Iowa House sent the bill imposing work requirements on recipients of Iowa's expanded Medicaid program back to the Senate Wednesday. Senate File 615 was approved by the House 61-35 with some changes. The bill, which passed in the Senate Tuesday, would require people receiving health insurance through Iowa's expanded Medicaid program known as IHAWP, or the Iowa Health and Wellness Plan, to work at least 80 hours each month to be eligible for coverage. IHAWP coverage is available to able-bodied Iowans from ages 19 to 64 who have household incomes at or below 133% of the federal poverty level — roughly $20,030 in annual income for a single individual and $27,186 for a household of two. Rep. Carter Nordman, R-Adel, the bill's floor manager, said Medicaid is intended to serve individuals with disabilities and with very low incomes. However, he said currently 'more able-bodied adults are accessing Medicaid benefits without the requirement of work' through the IHAWP program. 'While Medicaid expansion has been a vital safety net, it is not meant to be a permanent solution,' Nordman said. 'We want to help individuals transition off the reliance of government and into a position where they can thrive independently. Requiring work is a key part of that transition.' According to analysis by the Legislative Services Agency, roughly 142,000 of the 181,000 Iowans currently enrolled in IHAWP would be subject to work requirements under the bill when accounting for medical exemptions and other caveats provided in the legislation, like exemptions for people with children under age 6 and in substance abuse treatment programs for up to six months. Of the people who would be required to work 80 hours a month — and report this information to the state to continue receiving care — LSA estimated that 32,000 Iowans would lose IHAWP coverage if the bill is implemented. This figure was calculated using data from Arkansas, a state that previously implemented Medicaid work or community engagement requirements. Rep. Austin Baeth, D-Des Moines, said the bill will deprive low-income people of health care and coverage using a false argument that there are a large number of people receiving Medicaid coverage who are choosing not to work. He cited a study from the Kaiser Family Foundation that found 92% of adults under age 65 who did not receive benefits through other programs like Social Security or Medicare were working full or part time, or were not working because of caregiving responsibilities, school or due to an illness or disability. Baeth said the bill sends a 'cynical message that people in poverty are lazy' and will take away health care coverage from working Iowans who do not have the time or resources to meet the reporting requirements that would be implemented under the bill. 'Hardworking people are too busy working their jobs, trying to make rent, trying to put food on the table, not watching the news (to know) that they have to go to a particular website by a particular amount of time to press some particular button,' Baeth said. 'That's how people fall through the cracks. And when they fall through the cracks, in this particular case, it can be the matter of life or death.' A major point of contention for Democrats on the bill was language that directed the Iowa Department of Health and Human Services to discontinue IHAWP if the federal government does not approve work requirements for the program. The House amended the bill to clarify that this 'trigger' language to seek federal approval for ending IHAWP would only apply if the implementation of work requirements has been federally approved and later revoked. If the federal government does not allow the state to end the Medicaid expansion program, the bill would direct Iowa HHS to pursue implementation of an 'alternative plan' acceptable under federal Medicaid administration guidelines. Nordman said the language on discontinuing IHAWP without work requirements was to avoid making Medicaid policy changes in Iowa contingent on who is in the White House. 'The reason why this is in there is we are not going to play this back-and-forth game with the federal government that would disallow us to do it every four years, and then we do it another four years, and then four years later we're not allowed to do it,' Nordman said. '… Just to make it clear, if this is approved by the Trump administration, as I believe it will be, the only reason why Medicaid expansion in the state would go away is because of a Democrat president.' Rep. Timi Brown-Powers, D-Waterloo, questioned how these changes would be implemented by HHS, pointing to the fact that the department has a 'pause' on hiring for new positions. LSA, a nonpartisan agency, noted that the Iowa Department of Health and Human Services had not responded to multiple requests for information on the fiscal impact of implementing work requirements, but estimated that the bill would result in $3.1 million in decreased Medicaid expenditures for fiscal year 2026 and $17.5 million in FY 2027. Iowa HHS has not responded to requests for comment on why information was not shared with LSA or lawmakers who said they had made requests. Brown-Powers said the department has also not shared figures on Medicaid waste, fraud or abuse occurring through IHAWP that would be addressed through work requirements. She said unless HHS data shows there is a substantial number of people misusing the expanded Medicaid system, the costs of implementing the bill will outweigh money saved. 'And guess what? We don't have a lot of money,' Brown-Powers said. 'We're already dipping into the funds to pay the bills. So how are we going to pay for this? Where are the (full-time employees) going to come (from) to monitor this? How are we going to assure Iowans that they're not going to lose their insurance?' Nordman said that in Iowa 'it is estimated that more than 100,000 able-bodied people on Medicaid expansion are not working … to their capacity or what they should be.' The bill also directs Iowa HHS to seek federal approval to implement work requirements for public assistance programs like Supplemental Nutrition Assistance Program (SNAP). SNAP recipients who are able-bodied adults with no dependents already are required to work, volunteer or participate in work programs for at least 80 hours a month to receive benefits. The House passed another bill Wednesday related to SNAP benefits that proposes a new $1 million appropriation to the food stamps program to the Double Up Food Bucks program, allowing recipients to double SNAP dollars for fresh produce purchases. However, the bill makes the additional funding contingent on the federal government approving restrictions on what foods are available for purchase through SNAP to only include healthful foods 'based on necessary nutrition for good health.' The House sent the legislation back to the Senate with some changes, including the language clarifying IHAWP federal approval contingencies as well as a new section requiring Iowa HHS to conduct a review on the Medicaid for employed people with disabilities program. The department would be directed to look at issues like eligibility criteria, asset limits and cost-sharing requirements in other states' programs over the 2025 interim and deliver a report to lawmakers by December with recommendations on how to expand employment opportunities for people with disabilities on this Medicaid program. The bill also includes a provision to raise the amount of available resources that a married couple receiving coverage through the Medicaid for employed people with disabilities program can have from $13,000 to $21,000. Individuals with disabilities on this program would still have the $13,000 asset limit if they are single. The amended bill must be approved by the Senate before it would go to Gov. Kim Reynolds for final approval. A spokesperson for the governor said Tuesday that the governor has directed HHS to submit a federal waiver for Medicaid work requirements independent of the legislation 'which will be done soon.'
Yahoo
26-03-2025
- Politics
- Yahoo
Iowa bill adds work requirements for many on Medicaid
The Iowa Senate sent a bill to the Iowa House that would add work requirements for many people on Medicaid. The bill, Senate File 615, passed along party lines, with Republicans backing it. The bill would require 80 hours of work a month to stay eligible for the income-based medical assistance. Those given exceptions include those younger than 19, people over 65, those with dependents under the age of six and pregnant women. For more information, click here. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
