Iowa Lawmakers Approve Medicaid Work Requirements, Bill Sent to Governor

Iowa lawmakers have passed a bill requiring able-bodied adults aged 19 to 65 enrolled in the state's Medicaid expansion program to work at least 80 hours per month or participate in educational or job skills programs to maintain their health coverage. This legislation, supported by Governor Kim Reynolds, codifies work requirements into state law to prevent future repeal and aligns with Reynolds' federal waiver request for a 100-hour monthly work requirement. The bill exempts individuals who are pregnant, disabled, medically frail, or receiving unemployment benefits. Democrats expressed strong opposition, arguing that the measure risks the health of over 180,000 Iowans who may lose coverage and criticized the removal of a study on work programs for disabled workers. Republicans contend the policy encourages self-sufficiency and economic mobility, with projections indicating it could save the state $50 million over five years. The bill now awaits Governor Reynolds’ signature, who has committed to implementing the work requirements if federally approved.