All Roll Calls
Yes: 182 • No: 85
IowaSF 242291st General Assembly (2025–2026)SenateWALLET
A bill for an act relating to public assistance programs under the purview of the department of health and human services, including the supplemental nutrition assistance program, Medicaid, and the Iowa health and wellness plan, and including effective date provisions. (Formerly SSB 3140.) Contingent effective date, effective 01/01/2027.
Sponsored By: COMMITTEE ON HEALTH AND HUMAN SERVICES
Signed by Governor
health and human services
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 0 benefits, 3 costs, 2 mixed.
Shorter Medicaid retro coverage, later starts
Beginning January 1, 2027, pregnant women, children, and licensed nursing facility residents can get at most two months of retroactive Medicaid coverage before the month of a completed application. Other adults cannot get retroactive coverage. The state must ask the federal government to end retroactive coverage for those adults and will implement that change if approved. For the Iowa Health and Wellness Plan, coverage starts the first day of the month after you apply.
Tighter guardrails on Medicaid waivers
Beginning January 1, 2027, before Iowa seeks to expand Medicaid by waiver or a state plan amendment, the department must show the change is cost neutral. If not cost neutral, the change cannot be submitted without majority approval of both houses of the Legislature. Each year by October 1, the department reports on cost neutrality for all demonstration waivers and compliance with federal rules. A specific 2017 subparagraph is repealed as a technical change.
Medicaid moves to managed care
Beginning January 1, 2027, Iowa delivers Medicaid through managed care plans. Benefits that are already fee‑for‑service or excluded by a state plan or waiver in effect on or before July 1, 2026, stay outside managed care. This can change which doctors or hospitals you can use and how your care is coordinated.
New SNAP income and citizenship rules
Beginning January 1, 2027, Iowa sets SNAP gross monthly income at or below 160% of the federal poverty level. The state counts income, expenses, and resources of all household members, even those who are not eligible for SNAP. SNAP eligibility is limited to U.S. citizens or nationals, lawful permanent residents, Cuban or Haitian entrants, and certain Compact of Free Association residents. These rules can lower benefits or end eligibility for some households while letting others qualify under the 160% limit.
Immigration checks for public benefits
Beginning January 1, 2027, the state uses U.S. Citizenship and Immigration Services records, including SAVE, to verify immigration and citizenship for public assistance, including SNAP. Noncitizen applicants face added verification steps. Mismatches can delay or deny benefits until resolved.
Sponsors & Cosponsors
Sponsor
COMMITTEE ON HEALTH AND HUMAN SERVICES
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
Senate vote • 4/30/2026
Passed Senate
Yes: 27 • No: 16
House vote • 4/30/2026
Passed House
Yes: 60 • No: 24
House vote • 4/21/2026
Passed House
Yes: 65 • No: 28
Senate vote • 2/25/2026
Passed Senate
Yes: 30 • No: 17
Actions Timeline
Signed by Governor.
6/2/2026GovernorFiscal note.
5/28/2026legislatureReported correctly enrolled, signed by President and Speaker, and sent to Governor.
5/11/2026SenateExplanation of vote.
5/1/2026legislatureExplanation of vote.
5/1/2026legislatureMessage from House.
4/30/2026HouseImmediate message.
4/30/2026legislaturePassed House, yeas 60, nays 24.
4/30/2026HouseHouse concurred in Senate amendment H-8448.
4/30/2026SenateSenate amendment H-8448 filed.
4/30/2026SenateMessage from Senate.
4/30/2026SenateImmediate message.
4/30/2026legislaturePassed Senate, yeas 27, nays 16.
4/30/2026SenateSenate concurred with S-5206, as amended.
4/30/2026SenateAmendment S-5236 to S-5206 filed, adopted.
4/30/2026legislatureFiscal note.
4/23/2026legislatureMessage from House, with amendment S-5206.
4/22/2026HouseImmediate message.
4/21/2026legislaturePassed House, yeas 65, nays 28.
4/21/2026HouseAmendment H-8384 adopted, as amended.
4/21/2026legislatureAmendment H-8391 to amendment H-8384 filed, adopted.
4/21/2026legislatureAmendment H-8247 withdrawn.
4/21/2026legislatureAmendment H-8384 filed.
4/20/2026legislaturePlaced on calendar under unfinished business.
3/26/2026legislaturePlaced on calendar.
3/19/2026legislature
Bill Text
As Introduced
Enrolled
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