Medicaid Unwinding in Iowa: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid renewals in Iowa are changing because of the end of the COVID-19 public health emergency (PHE) on May 11, 2023. This will lead to a loss of coverage through a process called unwinding.
During the PHE, Medicaid renewals were automatic and enrollees had continuous coverage. As part of the unwinding process, automatic renewals for Medicaid and the Children’s Health Insurance Program (CHIP) coverage stopped nationwide on March 31, 2023.
The Iowa Department of Health and Human Services (HHS) will determine who is eligible for Medicaid. So make sure the agency has your current contact information if you’re enrolled in the state’s program. If you no longer qualify for Medicaid, your coverage could end as early as May 1, 2023.
In January of 2020, the U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19. The PHE was renewed a dozen times through February 2023.
During the COVID PHE, Medicaid enrollees were able to keep their health insurance coverage without eligibility reviews. That’s because states and territories were required to provide continuous coverage during this period.
But automatic Medicaid renewals ended nationwide on March 31, 2023, ahead of the PHE expiring on May 11. And state Medicaid offices around the country are resuming case evaluations through a process known as redetermination.
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Why is Medicaid changing nationwide?
When the PHE ends on May 11, 2023, COVID will remain a public health priority, but will no longer be considered an emergency. As a result, Medicaid renewals will no longer be automatic. This process of reinstating pre-COVID coverage rules is being referred to as the unwinding of Medicaid.
The unwinding is going to affect Medicaid beneficiaries in all 50 states, the District of Columbia, and five U.S. territories. Millions of people nationwide are at risk of losing their Medicaid or Children’s Health Insurance Program (CHIP) benefits as eligibility reviews resume.
According to state projections, about 136,000 people in Iowa may lose Medicaid or Healthy and Well Kids in Iowa coverage. (Healthy and Well Kids in Iowa, also known as Hawki, is the state’s name for CHIP.) These changes will affect approximately 17% of people who are currently enrolled in Medicaid in the state.
If you or your family members no longer qualify for Medicaid in Iowa, your coverage could end as early as May 1, 2023. Here’s how to prepare for the upcoming Medicaid changes in the state and what to do if you lose coverage.
What’s happening with Medicaid renewal in Iowa?
The Iowa Department of Health and Human Services (HHS) is the office responsible for overseeing Iowa Medicaid. The agency has published a redetermination plan that explains how it will review more than 520,000 cases during the unwinding process — which it has already begun.
The agency will continue case eligibility reviews for a year, through March 2024, and advises Medicaid enrollees to take three actions:
Ensure the HHS has current contact information for your household.
Watch for mail from Iowa Medicaid.
Respond to requests for information.
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You can visit the HHS services portal any time to update your contact information.
When it’s time for your renewal evaluation, the HHS will attempt to verify your income automatically through organizations like the Internal Revenue Service. If the state can’t confirm your income automatically, you will be contacted by mail about completing a renewal packet. You should receive a request for information about 45 days before your renewal date, which is the anniversary of when you started receiving Medicaid benefits. But the state will exercise some leniency for people who miss their due date for submitting renewal information.
Some people who are losing Medicaid or Hawki may receive notices as early as April 2023, regarding the termination of their coverage in May.
As part of its communications plan, Iowa has launched a real-time Medicaid unwinding dashboard that is tracking the state’s progress. And it has created a guide for people who are refugees and covered by Medicaid, as well as an unwinding resource library that offers one-stop access to many pertinent documents.
If you need to reach the Iowa Medicaid office by phone, call member services at 515-256-4606 in the Des Moines area or toll-free at 1-800-338-8366.
What should I do if I lose my Medicaid coverage in Iowa?
If you no longer meet the eligibility requirements for Medicaid in Iowa, you will lose your benefits. And this could cause you to be temporarily uninsured.
In order to receive Medicaid or Hawki coverage in Iowa, you must meet the following criteria:
You are a resident of Iowa.
You are a U.S. citizen, permanent resident, or legal resident.
You need assistance accessing low-cost healthcare or insurance coverage.
Your annual household income before taxes are withheld meets the limit for your household size.
And you must be one of the following:
Pregnant
Someone who is 18 years old or younger
Responsible for the care of a child who is 18 years old or younger
Blind
65 years old or older (and meet certain criteria)
Person with a disability or a household member of someone who has a qualifying disability
In need of nursing-home care
If you no longer meet the eligibility guidelines for Medicaid in Iowa, your information will automatically be submitted to an alternate state or federal government healthcare insurance program for consideration.
If your coverage is terminated but you think you still qualify, you can reapply for Medicaid in Iowa. But it takes some time to be reapproved, and you may be uninsured while you wait. So you may want to look into free and low-cost healthcare options in the meantime. You can also save by using free GoodRx coupons to reduce the cost of your prescription medications.
If you lost your benefits and you do not plan to reapply for Medicaid, you might be able to take advantage of one of these other insurance options:
Affordable Care Act ACA) marketplace: Through the ACA exchange, you may be able to find coverage for $10 or less per month if you qualify for a premium subsidy. There is an unwinding special enrollment period from March 31, 2023 to July 31, 2024 for those who lose Medicaid benefits, and you may be able to purchase a plan on the ACA marketplace during this time.
Employer plan: If you are currently working, it’s possible your job offers employer-sponsored health insurance.
Medicare: You can enroll in Medicare at any age if you have a qualifying disability, such as end-stage renal disease or ALS (amyotrophic lateral sclerosis), commonly referred to as Lou Gehrig’s disease.
Partner’s plan: If you have a spouse or domestic partner who has insurance, you may be able to join their plan during an open enrollment or special enrollment period.
Special plans: There are a variety of short-term insurance plans that can be a great choice if you anticipate an option like job-based health insurance to be available soon. You could also consider alternative and limited-benefit plans, such as indemnity, accident, cost-sharing, and catastrophic insurance plans.
Student health plan: If you’re enrolled in a college or university, you likely have access to a campus health plan.
U.S. Department of Veterans Affairs (VA): Veterans and active-duty service members may qualify for TRICARE or VA benefits.
Iowa Medicaid resources
Here are some sites that have more information about Medicaid in Iowa and changes related to the end of the PHE:
Iowa Medicaid office: The Iowa HHS oversees Medicaid in the state.
Iowa Medicaid self-service portal: You can log in to your Medicaid account 24/7 through the HHS services portal to confirm or update your mailing address, email, and other contact information.
Iowa Medicaid redetermination: This site provides information about the Iowa Medicaid redetermination plan, including a timeline of changes.
Iowa Medicaid unwinding dashboard: Iowa has a real-time Medicaid unwinding dashboard that is tracking the state’s progress with Medicaid renewals and other data.
Iowa Medicaid unwinding resource library: Documents about and related to the unwinding of Medicaid in Iowa can be accessed from this site.
The bottom line
Automatic Medicaid renewals stopped nationwide on March 31, 2023 in advance of the COVID-19 public health emergency (PHE) ending on May 11. This change is part of a process that’s being called the unwinding of Medicaid.
The Iowa Department of Health and Human Services (HHS) will spend the next year reviewing Medicaid cases in the state and disenrolling people who no longer qualify. So it’s important for the agency to have your updated contact information if you’re enrolled in Iowa Medicaid.
When it’s time for your review, your renewal packet will arrive by mail if your income cannot be automatically verified.
If you no longer qualify for Medicaid benefits in Iowa, you still have other insurance options. You may be able to qualify for an insurance plan through the Affordable Care Act (ACA) marketplace, an employer-sponsored program, or Medicare.
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References
Administration for Strategic Preparedness and Response. (2020). Determination that a public health emergency exists.
Administration for Strategic Preparedness and Response. (2023). Renewal of determination that a public health emergency exists.
Centers for Medicare and Medicaid Services. (2023). Temporary special enrollment period (SEP) for consumers losing Medicaid or the Children’s Health Insurance Program (CHIP) coverage due to unwinding of the Medicaid continuous enrollment condition – Frequently asked questions (FAQ).
Iowa Department of Health and Human Services. (n.d.). State report on plans for prioritizing and distributing renewals following the end of the Medicaid continuous enrollment program.
Iowa Department of Health and Human Services. (n.d.). About Iowa Medicaid.
Iowa Department of Health and Human Services. (n.d.). Continuous coverage requirement unwind.
Iowa Department of Health and Human Services. (n.d.). Healthy and Well Kids in Iowa (Hawki).
Iowa Department of Health and Human Services. (n.d.). How to apply.
Iowa Department of Health and Human Services. (n.d.). Medicaid & COVID unwind.
Iowa Department of Health and Human Services. (n.d.). Unwind resource library.
Iowa Department of Health and Human Services. (n.d.). Who receives Medicaid?
Iowa Department of Health and Human Services. (2021). COVID-19 information for members.
Iowa Department of Health and Human Services. (2023). The continuous coverage unwind plan.
Iowa Department of Public Health. (2019). Health insurance & refugees in Iowa.
Medicaid.gov. (n.d.). Unwinding and returning to regular operations after COVID-19.
Ramm, M. (2023). More than 100k Iowans will lose expanded Medicaid soon. What you need to know:. Des Moines Register.
Tolbert, J., et al. (2023). 10 things to know about the unwinding of the Medicaid continuous enrollment provision. Kaiser Family Foundation.
U.S. Department of Veteran Affairs. (2022). VA and TRICARE information.
