Iowa Senate Republicans approved a bill on Tuesday that would require Medicaid recipients to work at least 20 hours a week to maintain eligibility. The Senate voted along party lines, 33-15, to pass the bill Tuesday.
The bill, Senate File 615, would make exceptions for children, adults 65 or older, disabled adults, and others who are reasonably not able to work.
The bill differs from earlier versions that required just five hours per week and differs from the House version that House lawmakers could consider Wednesday.
With the Senate’s bill heading to the House for consideration, lawmakers will have to decide which version to pursue before it is sent to the governor’s desk.
The bill would also direct the Iowa Department of Health and Human Services to work with the U.S. Department of Agriculture and the U.S. Department of Health and Human Services to establish work requirements for other public assistance programs similar to the ones under the Supplemental Nutrition Assistance Program.
Iowa Sen. Mike Klimesh, R-Spillville, said the bill would make sure Iowans are working and gives Iowans the opportunity to “experience this dignity by requiring work.”
“Work is more than just a paycheck,” Klimesh said. “It provides individuals with a sense of pride, accomplishment, and a deeper connection to society. We are providing an important stepping stone to help Iowans develop life skills, build responsibility, and regain a sense of purpose.”
The bill would require Iowa HHS to discontinue its Medicaid expansion program if work requirements are prohibited as an eligibility requirement under federal law. The Iowa Medicaid expansion program is known as the Iowa Health and Wellness plan, which opened up Medicaid to recipients who make too much for Medicaid but not enough for private insurance.
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Iowa Sen. Janet Petersen, D-Des Moines, offered an amendment to the bill that would strike the provision that would end the Medicaid expansion program if work requirements were prohibited.
Approximately 181,000 Iowans receive health insurance from the program. Medicaid was part of a bipartisan effort in 2013 signed by former Republican Gov. Terry Brandstad.
The state only pays 10 percent of the costs of the program with the federal government picking up 90 percent.
“Make no mistake, this bill is about gutting Medicaid expansion,” Petersen said. “This amendment that I’m offering right now gets rid of the trigger language in the bill that would kick 181,000 Iowans off of their health care.”
The amendment failed on party lines with Democrats in support and Republicans against.
According to an analysis by the nonpartisan Legislative Services Agency, the bill would result in approximately 12.5 percent of Iowans on the program losing coverage, or approximately 32,000 Iowans might lose coverage due to work requirements.
The analysis also found the state would save $3.1 million in fiscal 2026 and $17.5 million in fiscal 2027 if the bill becomes law.
Iowa Gov. Kim Reynolds announced in her Condition of the State Address in January that Iowa HHS would submit a waiver to the federal government to require work requirements for Medicaid. According to The Des Moines Register, officials are preparing to submit the waiver, and the final language will match whatever lawmakers send to the governor’s desk.