Iowa House lawmakers approved a bill that would expand the length of time mothers and infants can receive Medicaid coverage after birth, but also lower the income threshold to qualify for benefits. 

The bill, Senate File 2251, will now head to the governor’s desk after passing the Iowa House, 70-25, with all Republicans and some Democrats supporting the bill. The bill passed the Iowa Senate on Feb. 20. 

According to an analysis by the nonpartisan Legislative Services Agency, 1,300 mothers and 400 infants would be kicked off Medicaid coverage because of the change in the income threshold, under the bill. 

Reynolds proposed the expansion in her Condition of State Address in January as one of her top priorities for the session. During a Senate subcommittee on the bill, Molly Severn, the governor’s legislative liaison, said to keep the bill cost-neutral, legislators are lowering the qualifying income threshold. The bill amends the threshold from 375 percent of the federal poverty level to 215 percent of the federal poverty level. 

Democrats argued the state should maintain the current income threshold to prevent the 1,700 moms and babies that would be eligible for services under current law from losing services under the proposed bill. 

“I’m not asking anyone in this chamber to increase the number of Iowans who are eligible for postpartum care,” Rep. Heather Matson, D-Ankeny, said during a floor debate on the bill Wednesday. “I’m asking you to ensure all the moms who are currently eligible for prenatal care and two months of postpartum will receive a full 12 months of postpartum care.” 

Matson said lawmakers should do more to ensure there is increased access to care while the state faces maternity care deserts. 

“At a time when maternal and infant mortality is on the rise, we should do our best to expand coverage for more women, not less,” Matson said 

Republicans said the bill keeps Iowa in line with other states in the Midwest in terms of coverage for mothers and infants after birth. They also argued that the bill would still expand access for 2,300 mothers still eligible under the bill. 

“This bill is imperative for those moms that need it most,” said Rep. Devon Wood, R-New Market. 

The bill takes advantage of a federal program, authorized by the American Rescue Plan Act of 2021, that allows states to expand the length of coverage. Iowa is one of three states that has yet to take advantage of the program.