Reynolds announces submission of federal waiver for Medicaid work requirements

Today, Governor Kim Reynolds directed Iowa Health and Human Services to submit a waiver to the Centers for Medicare & Medicaid Services to establish work requirements for able-bodied Medicaid recipients. "It has always been a priority of mine to make sure our government programs reflect a culture of work. It is common sense and good policy," Gov. Reynolds said. "If you are an able-bodied adult who can work, you should work. We need to return Medicaid back to its core purpose-to provide coverage to the people who truly need it."   The waiver reflects pending Iowa House and Senate legislation, which includes the following common-sense exemptions in addition to other individually approved exemptions:  

A person under 19 years old 
A person who is over 64 years old 
A person who is disabled 
A person who is medically frail or medically exempt under Medicaid 
A caretaker of a dependent child under six years old 
A woman with a high-risk pregnancy 
A person receiving unemployment benefits 
A person participating in substance use disorder treatment

Iowans who do not meet the new requirements will be given time to do so; those who choose not to will no longer be eligible for Medicaid coverage. This proposed change aims to help members take an active role in their health and well-being, while preserving Medicaid for those who need it most. Today approximately 171,000 able-bodied adults are enrolled in Iowa's Medicaid program through the Iowa Health and Wellness plan. Nearly 100,000 of those members report no income. Pursuant to CMS requirements, Iowa HHS will launch a 30-day public comment period and host two public hearings to gather input from Iowans.

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AM April 20, 2025, 1:53 am Those all sound like reasonable enough requirements, but I am curious how that would affect people with a criminal history or that do not have a driver's license, making it difficult to secure employment? I am a little embarrased I guess to share that I have accepted jobs far below my skillset and paygrade, and despite exceeding expectations from day 1, each time I have been let go a couple days later. It is very frustrating, but that is why I dedicate my time to writing and research and advocacy. I do not receive welfare assistance and I am blessed with good health, so no I do not have insurance either. So this does not affect me personally, but I do know quite a few people that could potentially lose their health care coverage because they are in a similar situation. So, while I understand the motivation behind this move, and I agree that there should be more incentives to encourage people to better themselves! But the real problems with welfare are 1. the poverty rate is nowhere near a livable wage.
2. the drastic cutoff cliff is an all or nothing system that traps people in poverty, rather than supporting them with a gradual reduction in benefits that would allow them a little freedom to take that better paying job or ask for more hours at work, without losing vital child care assistance they have to have in order to be able to afford to go to work! Or food assistance that they would not be able to make ends meet without. I ran into this exact problem when I was in nursing school, and ended up taking out extra loans every semester to play catch up on bills, because my boyfriend at the time worked full time as a fork lift operator, and if I worked just one day a month, that would put us over income and I would lose the child care assistance that allowed me to go to school! Also, with the automation of so many jobs that would typically be held by people in these kind of situations, what then?

When are we going to realize as a society that unless people are able to meet their basic human needs, they will struggle to find the motivation and drive to pursue a fulfilling role in life. It may require a large investment up front, but the long term return-on-investment would make up for it- financially and improved quality of life indicators in general.

I agree that there should be certain expectations that come along with the assistance. There are always strings attached, even with "free money." Like the Family Investment Program, the financial assistance is offered alongside training and other opportunities that empower the individual... Another all or nothing contingency, dictated by people in comfy offices and far removed from the real world... that is not the answer.

News : Reynolds announces submission of federal waiver for Medicaid work requirements

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