Notice is hereby given, in accordance with 42 CFR Β§457.65 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) 24-0005 to address Mandatory Continuous Eligibility for Children.


SPA 24-0005 requires Iowa to demonstrate compliance with mandatory continuous eligibility to children in CHIP and Medicaid under the Consolidated Appropriations Act (CAA) of 2023, Section 5112 of the CAA, 2023 amended section 1902(e)(12) and paragraph (K) to section 2107(e)(1) of the Act to require one year of continuous eligibility under the state plan or a waiver of the state plan for children under age 19 enrolled in Medicaid and CHIP, effective April 1, 2024. 

There are three statutory exclusions that states are allowed to disenroll children from CHIP during a 12-month continuous eligibility coverage period:

  • The child reaches age 19
  • The child is no longer a resident in the state of Iowa
  • The child becomes eligible for Medicaid

States are prohibited from disenrolling children from CHIP during a 12-month continuous eligibility coverage period due to non-payment of premiums for the Hawki program. 

Effective date for this SPA is April 1, 2024. 

Fiscal Impact

SFY25 Continuous Eligibility for Children Estimated Impact


Public Review and Comments

A copy of SPA 24-0005 and this public notice are posted on the HHS website at Public Notices | Health & Human Services ( 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 β€œSPA 24-0005 Mandatory Continuous Eligibility for Children” in the subject line of the email.

All comments must be received by Monday, July 29, 2024, at 4:30 p.m. 


Submitted by: 

Elizabeth Matney, Medicaid Director 

Iowa Department of Health and Human Services