DES MOINES, IOWA (April 15, 2025) — Governor Kim Reynolds is directing Iowa Health and Human Services to submit a waiver to the Centers for Medicare and 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 nineteen 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 thirty-day public comment period and host two public hearings to gather input from Iowans.
