Notice is hereby given, in accordance with 1902(a)(10)(A)(ii)(XIII) of the Social Security Act, 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 IA-24-0009 to address updating the premium scale for the Medicaid for Employed People with Disabilities (MEPD) program.


This amendment proposes to adjust the federal poverty level increments used to assess premiums for applicants and recipients under the Medicaid for Employed People with Disabilities (MEPD) program with income over 150% of the federal poverty level (FPL).

The Department is requesting these changes as Iowa Code section 249A.3(2)(a)(1)(b) requires that “the maximum premium payable by an individual whose income exceeds one hundred fifty percent of the official poverty guidelines shall be commensurate with the cost of state employees’ group health insurance in this state.” The average cost to the state for state employees’ health insurance for a single person is $958.50 effective January 1, 2024. Therefore, the maximum premium must not be above that amount. 

HHS seeks an August 1, 2024, effective date for this SPA.

Fiscal Impact

The estimated fiscal impact for year 2024 is $495 for federal dollars. The estimated fiscal impact for year 2025 is $4,530 - $2,963 federal dollars and $1,567 state dollars.

The new premium scale reflects the increase in the maximum premium allowed to reflect the increase in the cost of state employees’ health insurance by updating the current top increment and corresponding premium amount (1480% FPL and above= $879 premium). There will be changes to the other increments or premium amounts.

MEPD eligibility is based upon countable household income of no more than 250% of the FPL for the household size. MEPD premiums are assessed based on gross individual income.  Currently, there are no MEPD members with gross individual income higher than 450% of the FPL.


Public Review and Comments

A copy of SPA IA-24-0009 and this public notice are posted below, under Related Files. To reach all stakeholders, non-electronic copies will be made available for review at each local HHS office.


Written comments may be sent to: Lara Brewer, Iowa Medicaid, 1305 E. Walnut Street, Des Moines, IA 50319-0114. Comments may also be sent via e-mail to Please indicate “SPA IA-24-0009” in the subject line of the email.

All comments must be received by Monday, July 22, 2024, at 4:30 p.m. 


Submitted by: 

Elizabeth Matney
Iowa Medicaid Director
Iowa Department of Health and Human Services