A bill making its way through the Iowa Legislature could have a large impact on Marshall County Medicaid recipients.

Senate File 615 (SF615) requires able-bodied Medicaid recipients, who have low income and are between the ages of 19 to 64, to work at least 80 hours per month in order to continue receiving coverage. Medicaid is a government program providing low-income and disabled citizens who are younger than 65 years of age with the means to pay for medical expenses.

Sen. Kara Warme (R-Ames) and representatives David Blom (R-Marshalltown) and Brett Barker (R-Nevada) voted in favor of SF615. Warme explained her vote.

“I want to encourage able-bodied adults to experience the intrinsic value of work and gain self-sufficiency, while also boosting our economy via more candidates for the open jobs so many employers in Iowa have,” she said.

Barker

According to Barker, numbers provided by the Iowa Department of Health and Human Services (DHHS) show more than 100,000 Medicaid recipients in Iowa are able to work but are not. He said it is an important program created to provide health insurance for the most vulnerable populations.

“As a very large portion of our state budget, in order for this program to remain available for the Iowans who really need it, there must be some reasonable guardrails in place,” Barker said.

Warme added there is a lot of misinformation swirling around about SF615 and offered some clarification. First, she said there will be no impact to participants on traditional Medicaid in Iowa, which includes children and those with disabilities. The bill deals specifically with participants on the Iowa Health & Wellness Plan, also known as expanded Medicaid. Participants are able-bodied adults whose household income is less than 250 percent of the federal poverty level. Expanded Medicaid was designed to help people temporarily receive public assistance, while they improve their financial standings.

“It should not be looked at as a long-term benefit like traditional Medicaid, which aims to assist those with disabilities and children facing poverty,” Warme said.

She said the monthly 80-hour work requirements have common sense exceptions that exempt some people from fulfilling the requirement — for example, if a person does not fall in the age range or is determined to be disabled by the United States Social Security Administration. More examples Warme provided include people who receive unemployment from Iowa Workforce Development, are medically frail, are caretakers of dependent children younger than 6 or have high-risk pregnancies.

Barker said the bill also gives DHHS the flexibility to determine what qualifies as work to include education, skills training or caregiving.

“Requiring work or job training is also a way for Iowans to take control of their future and move up the economic ladder,” he said.

Marshall County

According to 2023 data gathered by Mid-Iowa Community Action (MICA), 22 percent, or 8,823, of Marshall County citizens are on Medicaid.

MICA Resource Development and Communications Coordinator Abra Dougherty said while the organization does not oversee Medicaid services, they support families receiving the coverage.

“We are concerned the legislation will make it even harder for families to access medical and dental care,” she said. “There are currently significant barriers for families on Medicaid to find providers who accept Medicaid. Not all providers accept Medicaid, which results in fewer options for care and result in more travel costs to routine visits for families.”

Those barriers may lead to missed work and school time, and families could choose to skip routine preventative medical and dental visits. Dougherty said they anticipate emergency room visits will also increase, creating higher costs for families and providers, and a burden on the healthcare system.

“An emergency room for a dental issue costs three times as much as a visit to the dentist,” she said. “Changes to Medicaid eligibility may also have a trickle down effect to other services and programs for families, which can lead to even more barriers. Overall, we anticipate this could lead to poorer health outcomes.”

If someone loses their Medicaid coverage, Dougherty said there are not a lot of self pay options. The options that are available are more expensive than what families can afford.

As SF615 continues to move forward, MICA will continuously be aware of legislation which might impact Marshall County families, and will make lawmakers aware of those impacts.

“We have met with many decision makers and continue to build relationships with them, so we can share the stories of our communities,” Dougherty said.

She suggested that Marshall County residents can help those affected by SF615 by making their voices heard.

“By sharing their stories and how this will affect them and their neighbors to decision-makers, you can influence how they vote,” Dougherty said.

Contact information on legislators can be found on the website, legis.iowa.gov. Dougherty said MICA can support families through changes to services and programs. They have a Hawk-I coordinator on staff to help families apply for Medicaid, and answer questions. MICA can also be contacted at 641-752-7162 or via email info@micaonline.org.

“We will stay as informed as possible as changes happen,” she said.

Contact Lana Bradstream at 641-753-6611 ext. 210 or lbradstream@timesrepublican.com.