Medicaid, SCHIP, and Federal Authority²

Section 1115 Waiver - Approved in July of 2005, the new IowaCare program expands a limited set of Medicaid benefits to all adults (age 19 - 64), including parents of Medicaid or SCHIP eligible children, using a limited provider network. The program is a capped, non-entitlement program and converts uncompensated care funds into insurance coverage for adults.

High-Risk Pool  

The Health Insurance Plan of Iowa (HIPIOWA) is the high-risk pool that serves residents that cannot purchase coverage in the private market for reasons including: pre-existing medical condition or disease diagnosis that results in a premium higher than HIPIOWA rates, reduced benefits or benefit limitation, or an outright denial. Residents of Iowa are also eligible if they qualify under federal HIPAA or COBRA protections. At the end of 2005, just over 1,300 persons were enrolled.

The Iowa Individual Health Benefit Reinsurance Association (IHBRA), a previously existing pool of reinsured individuals, was merged into HIPIOWA effective January, 2005.

	Notes and Sources

Information presented in the profile was summarized in December 2006 from a review of state Web sites and reports, and through contacts with state officials. In most cases the profiles were reviewed by state officials; however, it is possible that states have implemented strategies that are not reflected in this profile.

² The profile only includes Medicaid and SCHIP waivers intended to make comprehensive expansions to the uninsured. At this time, the profiles do not include Family Planning, Pharmacy Plus waivers, or long-term care waivers.

³ Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2005 and 2006 Current Population Survey.