This bill proposes significant amendments to the supplemental nutrition assistance program (SNAP) and medical assistance programs managed by the Iowa Department of Health and Human Services (HHS). A notable addition is the requirement for HHS to submit quarterly reports on payment error rates for SNAP starting October 1, 2026. The bill also mandates HHS to request waivers from the U.S. Department of Agriculture to adjust rules concerning earned income exclusions, eligibility verification, and expungement of benefits. Furthermore, it aims to increase reimbursement rates for rural service providers while ensuring that any requested waivers remain cost-neutral.

In addition to these provisions, the bill modifies existing laws to change income thresholds for medical assistance eligibility, necessitate proof of residency for public assistance applicants, and limit participation in the special supplemental nutrition program for women, infants, and children to citizens and qualified aliens. It introduces new copayment structures for the Iowa health and wellness plan based on income and service types, and establishes a work group to address the needs of high-acuity pediatric recipients. The work group is tasked with identifying barriers to care and proposing a tiered reimbursement methodology for home health services, with findings due to the general assembly by December 1, 2026. Other changes include extending Medicaid eligibility for employed persons with disabilities and implementing a $5 nonattendance fee for members of the Iowa health and wellness plan.

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