Iowa lawmakers approve Medicaid extension for new mothers, ending coverage for hundreds

Legislation granting low-income Iowa mothers a full year of Medicaid coverage after giving birth — and ending coverage for others — is heading to Gov. Kim Reynolds' desk for her signature.

The bill, which lowers the income threshold to qualify for coverage and will cut off coverage to an estimated 1,700 women and babies each month, received final approval from the House on Wednesday. Senate File 2251 was passed on a 70-25 vote, with some Democrats in opposition.

Reynolds proposed the measure during her annual address in January.

Current Iowa law provides new mothers with Medicaid coverage during pregnancy and for 60 days after giving birth — the minimum length of time under federal law.

If signed by Reynolds, Iowa will join almost every U.S. state in implementing a 12-month extension on that coverage.

"This bill is imperative for those moms that need it most," said Rep. Devon Wood, R-New Market.

Income threshold to be eligible for Medicaid is lowered

Under the bill, the maximum family income to be eligible for postpartum Medicaid coverage in Iowa is reduced.

Currently, new mothers with a maximum family income of 375% of the federal poverty level — about $117,000 for a family of four — are eligible for coverage in Iowa.

Reynolds' plan lowers that income ceiling for postpartum coverage to 215% of the federal poverty level, about $64,5000 annually for a family of four.

An analysis of the bill by the nonpartisan Legislative Services Agency determined that the eligibility restrictions would lead to about 1,300 women and 400 babies losing coverage each month.

The eligibility changes have been criticized by Democrats, who have supported extending coverage but oppose removing Iowans from Medicaid rolls.

"215 (percent) feels arbitrary to me, and it feels unnecessarily low," said Rep. Heather Matson, D-Ankeny, of the new income threshold.

Opponents have cited Iowa's rising maternal mortality rate as evidence that coverage is still necessary for those with higher income.

"It's not an expensive endeavor, and the cost is so high for not doing it," House Minority Leader Jennifer Konfrst, D-Windsor Heights, said.

An attempt by Democrats to amend the bill to retain the current 375% income threshold was defeated on party lines.

Wood, the bill's sponsor, defended it as addressing the most vulnerable mothers in Iowa, and said their coverage remained more generous than in several neighboring states.

"This is a step that is an essential puzzle piece to the programs we've done in the last couple of years," Wood said.

More: Iowa Senate votes to extend Medicaid for low-income mothers; others would lose coverage

Lawmakers OK governance changes for Reynolds' anti-abortion MOMS program

Also heading to Reynolds' desk is a series of tweaks to her More Options for Maternal Support (MOMS) program.

The program sends state dollars to pregnancy resource centers that counsel women against abortion, offer donated items for new mothers and conduct family planning classes and other programs.

Under the changes approved by lawmakers in Senate File 2252, the state would no longer be required to hire a third-party administrator to oversee the program, instead allowing the Department of Health and Human Services to take on that role.

The department has overseen the program on an interim basis as the state failed twice last year to identify a qualified entity to serve as administrator. Any administrator hired would no longer need three years of experience in Iowa to be hired, a previous requirement repealed under the changes.

Rep. Michael Bergan, R-Dorchester, said he had "full confidence" in the department to oversee the program, and praised the pregnancy resource centers.

"These entities provide necessary safety nets to women in need who want to bring their child into the world," Bergan said.

More: Iowa fails — again — to find administrator for network of contentious anti-abortion centers

Democrats opposed the bill, questioning the MOMS program's efficacy after the state's failure to find an outside administrator and questioning the veracity of clinics involved with the program.

"I see the failure to find a suitable administrator as a time when we should reflect on the viability of the program that will send taxpayer dollars to pregnancy resource centers," Matson said.

Matson said she had seen one such clinic promoting "abortion pill reversal" services, arguing that the state shouldn't send money to "an organization that promotes medically dangerous information as part of their pregnancy support services."

Bergan said the department would take efforts to establish standards of care across clinics that receive state support. And Rep. Brad Sherman, R-Williamsburg, defended the qualifications of those employed by one such clinic, of which he was previously a co-founder.

"I'm proud of the work we did at Informed Choice (of Iowa), and it continues today, and I just feel like that needed to be correct," Sherman said.

The legislation passed the House 61-34.

Stephen Gruber-Miller contributed reporting.

Galen Bacharier covers politics for the Register. Reach him at [email protected]m or (573) 219-7440, and follow him on Twitter @galenbacharier.

This article originally appeared on Des Moines Register: Iowa Legislature: Medicaid extension for new mothers goes to governor