On April 15, 2025, Governor Kim Reynolds announced the state’s intentions to request approval for a waiver to establish work requirements for able-bodied Medicaid recipients. Read the full press release here.
Iowa HHS is seeking approval to amend the Iowa Health and Wellness Plan (IHAWP). The proposed amendment would add work requirements for IHAWP members as a condition for keeping their health coverage.
NOTE: These proposed work requirements would only apply to Iowa Medicaid members covered by the Iowa Health and Wellness Plan (IHAWP), which provides low to no-cost health coverage for Iowans ages 19-64.
People who are receiving care through IHAWP would be required to meet one of the following work requirements:
Working 100 hours per month (or earnings equal to the state minimum wage multiplied by 100. See table.)
Enrolled in an educational/job skills program.
Enrolled in and compliant with Iowa’s Temporary Aid to Needy Families (TANF) or Supplemental Nutrition Assistance Program (SNAP) work requirements.
Caregiving services for dependents with disabilities
Members will need to provide documentation to verify activities.
Iowa HHS will continue with the current IHAWP application process.​ Applicants do not need to meet work requirements to enroll.​ HHS will check that requirements have been met every six months.​
Current members: ​Will begin at the member’s next renewal period after work requirements are implemented.​
New members: ​Will begin six months after the member’s enrollment date.
HHS is amending the IHAWP 1115 Demonstration and requesting CMS approval, effective July 1, 2025.
Implementation is planned for 2025, with a target start date of January 1, 2026.
Individuals who meet one of the following will be exempt from work requirements:
Are under 19 years of age or are 65 years of age or older.​
Are pregnant and the pregnancy is high-risk.​
Caretakers of children under the age of 6.​
Have been determined disabled by the United States Social Security Administration (SSA).​
Have been identified as medically exempt under the Medicaid program.​
Receiving unemployment compensation as determined by Iowa Workforce Development.​
Participating in substance use disorder (SUD) treatment, not to exceed a consecutive six-month period.​
Provide proof of good cause as defined by HHS.
For questions about who qualifies for IHAWP, call Member Services toll free at 1-800-338-8366 or email IMEmember@hhs.iowa.gov.
Iowa HHS will continue with the current IHAWP application process. Applicants do not need to meet work requirements to enroll.​
Public Comment Hearings
Iowa HHS will be holding two (2) hearing for public comment this month for the proposed amendment. This is a time where people can comment on the proposed work requirements.
If you wish to submit a comment or question after this hearing, you can do so by emailing qimp_public_comment@hhs.iowa.gov.
All comments must be received before ​May 15, 2025, at 4:30 PM
Public Hearing Schedule
Public Hearing #1
Public Hearing #2
Date: April 23rd, 2025
Time: 10:30 A.M. - 11:30 A.M.
Location: Urbandale Public Library
(3520 86th St, Urbandale, IA 50322), Meeting Rooms A & B