Nearly 1,000 Iowa refugees face Medicaid cutoff
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Nearly 1,000 Iowa refugees could lose Medicaid coverage Thursday under a federal law that Polk County health officials fear could drive more uninsured patients to emergency rooms.
The big picture: Losing routine care can allow chronic conditions to become life-threatening, push patients into emergency rooms and raise costs for hospitals, Polk County Health Department director Juliann Van Liew tells Axios.
Driving the news: Refugees, asylees and several other groups of immigrants legally living in the U.S. without green cards will generally lose federally funded Medicaid under last year's tax and budget law, Iowa HHS says.
By the numbers: The Refugee Alliance of Central Iowa estimates at least 973 Iowa refugees are unlikely to have green cards by the cutoff.
- Children legally residing in the U.S. will remain eligible because Iowa has chosen to continue a federal coverage option for them.
State of play: Polk County recently launched a resource page on Medicaid changes to help people find alternative care options, including free nonprofit clinics.
Zoom out: The Oct. 1 cutoff is one part of broader federal restrictions on health coverage for immigrants.
- Additional Marketplace and Medicare restrictions are expected to increase the number of uninsured immigrants affected by the law to about 1.4 million by 2034.
Context: Republicans say the changes protect Medicaid and taxpayer dollars by narrowing eligibility for immigrants.
- The law rolls back parts of a policy dating to 1996 that allowed refugees, people granted asylum and some other humanitarian immigrants to qualify.
Zoom in: The federal government is expected to save about $131 billion through 2034 from the immigrant health-coverage restrictions, including about $6.2 billion from the Oct. 1 Medicaid change alone, per Congressional Budget Office (CBO) estimates summarized by KFF.
Yes, but: CBO's estimate does not quantify potential downstream costs for states, counties, hospitals and patients.
What they're saying: A coalition led by the Iowa Catholic Conference is urging Gov. Kim Reynolds to use a federal option already adopted by 32 states to preserve coverage for certain pregnant immigrants.
The latest: As of Friday, the governor's office had only acknowledged receiving the letter, Tom Chapman of the Iowa Catholic Conference tells Axios.
What we're watching: Iowa begins new Medicaid work requirements Dec. 1, with existing members phased in at renewals starting in February 2027.
- An earlier state estimate suggested a similar requirement could reduce average monthly enrollment by about 47,000 people in 2027.