Notice is hereby given, in accordance with 42 CFR §447.57, that the Iowa Department of Health and Human Services (HHS) will be submitting to the Centers for Medicare and Medicaid Services (CMS) State Plan Amendment (SPA) IA 23-0026 to address Medicaid premiums and cost-sharing.


This SPA provides technical information regarding how Iowa Medicaid ensures compliance with the federal requirement that Medicaid premiums and cost sharing incurred by all individuals in the Medicaid household do not exceed an aggregate limit of five percent of the family’s monthly income. As described in the June 12, 2023 public notice regarding SPA IA-23-0016, HHS will continue to suspend all premiums for Hawki and Medicaid for Employed People with Disabilities (MEPD) until January 1, 2024 and copayments for all enrollees until June 1, 2024.

Fiscal Impact

There is no fiscal impact.

Public Review and Comments

A copy of SPA 23-0026 and this public notice are posted on the HHS website at To reach all stakeholders, non-electronic copies will be made available for review at each local HHS office.

Written comments may be sent to: Jeanette Brandner, Iowa Medicaid, 1305 E. Walnut Street, Des Moines, IA 50319-0114. Comments may also be sent via e-mail to Please indicate “Premium and Cost Sharing SPA 23-0026” in the subject line of the email.

All comments must be received by September 28, 2023, at 4:30 p.m.


Submitted by: 

Elizabeth Matney, Medicaid Director

Iowa Department of Health and Human Services