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The Deyoe Dispatch: Iowa Health and Wellness Plan update

This past spring, the Iowa Legislature passed the Iowa Health and Wellness plan. In simple terms, the plan is a partial expansion of Medicaid, but it is not the full expansion that was part of the Affordable Care Act or “Obamacare.” Because the plan requires some reforms of Medicaid, Iowa needs a waiver from the federal government to proceed.

The Iowa Health and Wellness Plan Waivers were submitted to the federal government at the end of August. One waiver was submitted for the Iowa Wellness Plan and one was submitted for the Marketplace Choice Plan. The two plans together comprise the Iowa Health and Wellness Plan.

Iowa Wellness Plan – This plan is for people with income up to and including 100 percent Federal Poverty Level, or $11,490 for a family of one person and $15,510 for a family of 2. This plan will be administered by Iowa Medicaid. This is a very important aspect of the plan because people under the Marketplace Choice Plan will not be administered by Iowa Medicaid Enterprise.

Marketplace Choice Plan – This plan is for people with income 101 percent FPL up to and including 133 percent FPL. This translates to $11,491-$15,281 for a family of one and $15,511-$20,628 for a family of two. Members of this plan will select a commercial health plan available on the health insurance marketplace. Iowa Medicaid Enterprise will pay premiums on behalf of the member. This is called premium assistance. This plan is what sets the Iowa Health and Wellness Plan apart from traditional “Medicaid Expansion” or “Obamacare.” While Iowa’s plan does expand coverage of Medicaid to more recipients, standard Medicaid expansion did not include any premium assistance. Therefore, the people that will be in the Marketplace Choice Plan in Iowa would have been enrolled in the traditional Medicaid program if we had simply expanded Medicaid.

Throughout the public comment period, the DHS received 75 comments from advocates, stakeholders, and the general public. Comments have been incorporated into the waivers that were submitted to the federal government. After submission of the waivers to the federal government, there is an additional period of public comment. People wishing to make additional comments on the waivers may visit Medicaid.gov for instructions. Below is a timeline of events for implementation of the Iowa Health and Wellness Plan:

• Aug. 23: two waivers were submitted to CMS and the Iowa Administrative Code Rules were released

• August 2013 – March 2014: Public outreach and education about the plan

• September 2013: Public Comment Period Continues

• Oct. 1: Beginning of open enrollment period

• Dec. 31: IowaCare Program Ends

• Jan. 1: Iowa Health and Wellness Plan Coverage Begins

As of the time I am writing this, the federal government has not approved Iowa’s waiver request, even though the enrollment is supposed to begin on Oct. 1. This raises the possibility that Iowa may have to delay some aspects of the Iowa Health and Wellness Plan until we do receive a waiver.

For more information on the Iowa Health and Wellness Plan, visit: http://www.ime.state.ia.us/iowa-health-and-wellness-plan.html.

If you have any questions or concerns, please contact me.

Home phone: 515-382-2352

E-mail: Dave.Deyoe@legis.iowa.gov

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