Iowa halts premium assistance for Medicaid expansion

Iowa's Medicaid expansion model, which pays beneficiaries' premiums so they can obtain private coverage plans, is coming to an end. In response, the state is seeking a waiver to move beneficiaries to its traditional Medicaid program.

There are now two coverage options for Iowans with incomes below 138% of the federal poverty level. One is called the Iowa Wellness Plan, which is for adults at or below 100% of the federal poverty level. The other is the Iowa Marketplace Choice Plan, offered to adults with income from 101% to 133% of the federal poverty level. Under this option, beneficiaries get healthcare coverage through insurers with plans on the Health Insurance Marketplace and the state pays the premiums.

Iowa now seeks to make enrollees in the Marketplace Choice Plan option eligible for the Health Insurance Marketplace through a waiver. The language in the new waiver allows Iowa to retain its authority to provide premium cost coverage to individuals with incomes between 100% and 138% of the federal poverty level, should it decide to do so at a later date.

Historically, members could elect to receive coverage through one of two qualified health plans—CoOportunity Health and Coventry Health Care of Iowa. CoOportunity withdrew from the program in November 2014, and Coventry told the state it will not be accepting any new members in 2015, and intends to discontinue coverage for Medicaid expansion individuals by the end of the year.

Go to top