Medicaid Work Requirements in Iowa

Check your situation in Iowa

When it starts in Iowa

• December 1, 2026: the rule starts for new applicants, and the Community Engagement Portal opens.
• February 2027: renewals for current IHAWP members begin to include the requirement.

Who has to meet it

The rule applies to people ages 19 to 64 in Iowa Health and Wellness Plan (the adult expansion group), unless they are pregnant, have Medicare, or are exempt. You meet it in a month with 80 hours of work, community service, a work program, or school (in any mix), by going to school at least half-time, or with at least $580 in monthly income.

You are exempt if, for example, you care for a child 13 or younger or a person with a disability, are pregnant or postpartum, are American Indian or Alaska Native, are medically frail, are a veteran with a 100% disability rating, were in foster care at 18 and are under 26, are in drug or alcohol treatment, meet SNAP or TANF work rules, or left jail or prison in the last 3 months. See the full exemption list.

How Iowa checks and how to report

Months checked: Applicants: the month before the month you apply. Current members: at least two months since your last Medicaid review.

Iowa HHS will check its records first and contact you if it needs proof. Then you can upload information in the Community Engagement Portal, which is open only while you must submit hours. You can also report by phone, by fax (number on your request letter), or at a local HHS office.

Other things to know in Iowa

• Ways to meet the rule: 80 hours a month of work, job training, community service, or a mix; earnings of at least $580 a month; or school at least half-time.
• "Ellie," the virtual assistant in the Iowa HHS Self-Service Portal, can tell you whether the requirements apply to you.

Official tools and contacts

• Check if it applies: Self-Service Portal virtual assistant "Ellie"
• Report and upload: Community Engagement Portal
• Income Maintenance Customer Service Center (requirement questions and reporting): 1-877-347-5678
• Iowa Medicaid Member Services: 1-800-338-8366
• Iowa HHS: IHAWP community engagement requirements
• Iowa HHS: requirements FAQ (PDF)
• Agency: Iowa Department of Health and Human Services (Iowa HHS)

Federal protections that apply in Iowa

• The state must check its own records before asking you for proof.
• If it can't confirm you meet the rule, you get a notice and at least 30 days to respond, and your coverage continues meanwhile.
• You get written notice and the right to a fair hearing before coverage ends, and you can reapply at any time.
• If you lose Medicaid for not meeting the rule, you cannot get marketplace premium tax credits for those months. Learn more.