A bill for an act providing an appropriation to eliminate the current waiting lists for the Medicaid home and community-based services waivers.
Summary
HF 408 would appropriate state general fund dollars to the Iowa Department of Health and Human Services for fiscal year 2025-2026 in an amount sufficient to eliminate the existing waiting lists for Medicaid home and community-based services waivers as of June 30, 2025. The amount would be determined by the Medicaid forecasting group, which includes staff from HHS, the Department of Management, and the Legislative Services Agency fiscal division.
The bill also requires the forecasting group to report both the appropriation amount and the number of individuals removed from the waiting lists in the first forecasting report published during the 2025-2026 fiscal year. In practical terms, the measure is aimed at expanding access to waiver-based long-term services and supports for people who need care in home and community settings rather than institutional care.
Impact
If enacted, the bill would direct state general fund resources to Medicaid waiver services and could increase access to home and community-based supports for eligible Iowans currently waiting for services. It would affect administration of Medicaid waivers by HHS and require updated fiscal reporting through the Medicaid forecasting process, but it does not itself amend eligibility rules or create a new waiver program.
Sentiment
Based on the bill text and its introduction-only status, the measure appears to reflect a supportive policy goal of reducing or eliminating waiting lists for disability and long-term care services. No committee debate or recorded votes are available, so there is no documented opposition or bipartisan support in the provided materials. The bill’s framing suggests a focus on access to care and service capacity.
Contention
The main likely point of contention is fiscal: the bill requires an appropriation in an amount sufficient to clear the waiting lists, but it does not specify a dollar figure, leaving the cost to be calculated by the Medicaid forecasting group. That could raise concerns about budget impact, competing state priorities, and whether the state can sustain the ongoing cost of serving additional waiver recipients. Another possible issue is implementation capacity, since eliminating waiting lists depends not only on funding but also on provider availability and program administration.
A bill for an act relating to the Medicaid home and community-based services elderly waiver program, including transition planning and assisted living services.(Formerly HSB 739.)
A bill for an act relating to the Medicaid home and community-based services elderly waiver program, including transition planning and assisted living services.(See HF 2641.)