Reynolds signs law expanding postpartum Medicaid coverage, restricting eligibility

Gov. Kim Reynolds has signed several bills from the 2024 legislative session into law, including measures to extend postpartum Medicaid coverage and set new early literacy standards.

The governor signed Senate File 2251 into law Wednesday. The new law will extend Medicaid coverage for new and expecting mothers from its previous 60-day limit to one year, a provision allowed for under the 2021 federal COVID-19 pandemic emergency plan, beginning in 2025.

The law extends the duration of available postpartum Medicaid coverage for Iowa mothers and infants, but limits eligibility for the benefits. The new law lowers the income limit for families to 215% or below the federal poverty line — meaning a family of four making roughly $64,5000 annually or less, and a single mother and infant making $43,900 or less, would qualify. This restriction represents a drop from the 375% FPL income limit for coverage.

While Democrats have long called for Republicans to adopt the postpartum Medicaid expansion, members of the minority party criticized Reynolds and Republicans for the income restriction in floor debate on the 2024 measure.

According to analysis by the Legislative Services Agency, the income restriction will mean that each month, roughly 1,300 mothers and 400 infants who were eligible under the previous limit will not have Medicaid coverage.

But Republicans argued in floor debate that keeping the previous income limit at 375% of the poverty line would cost the state $6.2 million per year. Sen. Mark Costello, R-Imogene, said in a subcommittee meeting that the 215% FPL limit is still above the average 210% income cutoff among the 47 states that are participating in the Medicaid expansion.

Mazie Stilwell with Planned Parenthood Advocates of Iowa said in a statement on the law signing that while she was happy to see coverage extended, the income limitation will hurt Iowans. She also criticized Reynolds for supporting state Attorney General Brenna Bird joining a lawsuit against President Joe Biden’s finalized Title IX rules creating anti-discrimination protections for LGBTQ+ students in K-12 schools.

“If Gov. Reynolds and legislative Republicans actually cared about the health of Iowa moms and babies, they would have used our enormous budget surplus to continue coverage without changing income requirements,” Stilwell said in a statement. “Rather than fixating on culture wars like opposing Title IX rules, they should be focusing on cleaning up the devastating maternal care crisis created through reckless policy choices in this state.”

Not all infants would lose all government coverage through the new law — the LSA found approximately 1,100 babies would be moved from Medicaid coverage to the Hawki children’s health insurance program for families with an income level at 302% FPL or less.

Reynolds said in a news release that the new law – one of her priorities for 2024 – will help support Iowa families.

“Being pro-life means supporting mothers and strong families. By extending post-partum Medicaid coverage for thousands of new moms, we will set new families on a path to prosperity and opportunity,” Reynolds said in the news release. “Thank you to the legislature for passing this pro-family bill with bipartisan support.”

On Tuesday, Reynolds signed into law a measure on student literacy that she highlighted as goal for the legislative session.

House File 2618 sets up early literacy requirements for teachers, as well as adding new requirements for how schools and families must proceed if a child is not hitting reading proficiency benchmarks.

The law requires schools notify parents and guardians of students in kindergarten through sixth grade who are not reading at grade-level proficiency, having a personalized plan to assist the child until they are able to meet grade-level reading proficiency. Families of students who are not meeting benchmarks would also be informed of their ability to request that their child repeats a grade.

Reynolds said the law is part of an ongoing effort “to make literacy a priority in every Iowa classroom and for every Iowa student.”

“Iowa’s reading scores have held steady over the last several years, in part because we kept our kids in school during the pandemic and didn’t experience the level of learning loss other states did,” Reynolds said in a statement Tuesday. “But holding steady isn’t nearly good enough. We know that a lifetime of learning begins in the earliest years of school with the foundational skill of literacy.”

As the governor noted, Iowa has not seen the drop in reading scores that other states encountered due to the COVID-19 pandemic. But these measures are aimed at students such as the 34% of Iowa third-graders identified as not yet proficient in English Language Art skills in the 2022-2023 Iowa Statewide Assessment of Student Progress.

Other bills signed by the governor Wednesday include Senate File 2405, a measure changing the state’s fixed funding distribution formula for community colleges, and House File 2667, a measure increasing the maximum contribution to Iowa 529 college savings and ABLE savings accounts that can be deducted from income tax each year.