The bill amends various public assistance programs overseen by the Iowa Department of Health and Human Services, with a particular focus on the Supplemental Nutrition Assistance Program (SNAP) and Medicaid. It introduces a requirement for the department to submit quarterly reports to the General Assembly on SNAP payment error rates starting October 1, 2026. Additionally, the bill seeks to obtain waivers from the U.S. Department of Agriculture to exclude certain earned income from household income for eligible youth, streamline eligibility verification processes, and modify expungement rules for benefits. It also mandates cost neutrality analyses before waiver requests related to the medical assistance program and includes provisions to increase reimbursement rates for rural service providers under home and community-based services waivers.

Moreover, the bill restricts participation in the Special Supplemental Nutrition Program for Women, Infants, and Children to citizens and qualified aliens, implements new residency requirements for public assistance applicants, and modifies Medicaid rules regarding premium payments while introducing penalties for missed appointments. It establishes a copay structure for dental procedures and prescription drugs, changing the full implementation timeline for the Department of Health and Human Services to January 1, 2027. The bill also allows certain members of the Iowa Health and Wellness Plan to reenroll without paying outstanding contributions if they have not been previously terminated for nonpayment. Additionally, it mandates annual reports on fraud in public assistance programs starting in 2026, establishes a work group for high-acuity pediatric recipients, and sets reimbursement rates for special population nursing facilities based on their average allowable per diem costs.

Statutes affected:
Introduced: 249A.3, 249A.4, 239.6, 249N.6, 249N.7
Reprinted: 249A.3, 249A.4, 239.6, 249N.6, 249N.7, 249A.2