Read the full stored bill text
Kim Reynolds
governor
Office of the Governor Chris Cournoyer
LT GOVERNOR
June 02, 2026
The Honorable Paul Pate
Secretary of State of Iowa
State Capitol
Des Moines, Iowa 50319
Dear Mr. Secretaiy,
I hereby transmit:
Senate File 2422, 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.
The above Senate File is hereby approved on this date.
Kim Reynolds!
Governor of Iowa
Sincerely.
cc: Secretaiy of the Senate
Clerk of the House
STATE CAPITOL DES MOINES, IOWA 50319 515.281.5211 WWW.GOVERNOR.IOWA.GOV
uHiiiiumnii lîTÎHÎÎÎÏÎÏÎÎÏllllllUllllinUIHHr»U»H»Hltl
jnnnnnnnni
5§s
IR RlQHTj
WILL MAINTA» Lmmi I »tu t h I un i itimiiiii ihiiihiuih Himmni [umniiiimE
Minium innnin^’:
/HiiiutmnitH nuiii?
. ;-..;;i:;i.,ii::;; : t . j..;;;:;i:;iiii:;i;:;.;.. ; • •.••kuhikü;
Senate File 2422
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.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
DIVISION I
PUBLIC ASSISTANCE PROGRAMS - VERIFICATION
Senate File 2422, p. 2
Section 1. Section 239.6, subsection 1, paragraph a,
subparagraph (4), Code 2026, is amended to read as follows:
(4) Information maintained by the United States citizenship
and immigration services of the United States department of
homeland securi ty , including but not limited to information
accessible through the systematic alien verification for
entitlements online service, or successor federal verification
system .
Sec. 2. Section 239.6, subsection 2, Code 2026, is amended
by adding the following new paragraph:
NEW PARAGRAPH , g. The systematic alien verification for
entitlements online service maintained by the United States
citizenship and immigration services of the United States
department of homeland security to verify immigration and
United States citizenship information, or successor federal
verification system.
DIVISION II
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM AND MEDICAID -
ELIGIBILITY AND ERROR RATE REPORTING
Sec. 3. Section 239.1, Code 2026, is amended by adding the
following new subsection:
NEW SUBSECTION . 01. "Alien" means any person not a citizen
or national of the United States.
Sec. 4. Section 239.2, Code 2026, is amended to read as
follows :
239.2 Supplemental nutrition assistance program — -incom e
eligibility.
1. a, The department shall establish the gross countable
monthly income threshold for the supplemental nutrition
assistance program at less than or equal to one hundred sixty
percent of the federal poverty level for the household size.
b. The department shall consider the income and
financial resources of all household members in determining
the eligibility and benefit allotment of the household,
including all household members determined to be ineligible
to participate in SNAP under this section or pursuant to 7
U.S.C. §2015(f). Notwithstanding 7 C.F.R. §273 . 11 (c) ( 3 ) , the
individual's income, deductible expenses, and resources shall
be counted, and none shall be prorated.
Senate File 2422, p. 3
c. Pursuant to 7 U.S.C. §2015(f), an individual shall be
ineligible to participate in SNAP unless the individual is a
resident of the United States and meets at least one of the
following criteria;
(1) The individual is a citizen or national of the United
States .
(2) The individual is an alien lawfully admitted for
permanent residence as an immigrant, as defined in 8 U.S.C.
§1101(a)(15) and 1101(a) (20), excluding alien visitors,
tourists, diplomats, students, or other individuals admitted
temporarily with no intention of abandoning their residence in
a foreign country«
(3) The individual is an alien who has been granted the
status of Cuban and Haitian entrant, as defined in section
501(e) of the federal Refugee Education Assistance Act of 1980,
Pub« L. No. 96-422«
(4) The individual lawfully resides in the United States in
accordance with a compact of free association referred to in 8
U.S.C. §1612(b) (2) (G) .
2. The department shall comply with federal reporting
requirements relating to a household member who is determined
to be ineligible to participate in SNAP pursuant to 7 C.F.R.
§273. 4(b) .
Sec. 5. NEW SECTION . 239.12 SNAP error rate — reporting.
Beginning with the fiscal quarter that starts on October
1, 2026, and every fiscal quarter thereafter, within thirty
calendar days of transmission of data to the food and nutrition
services of the United States department of agriculture, the
department shall submit a report to the general assembly
detailing payment error rates associated with SNAP for the
immediately preceding fiscal quarter.
DIVISION III
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM - WAIVERS
Sec. 6. FEDERAL SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM
— WAIVER OF EXPUNGEMENT RULES.
1. The department of health and human services shall
request a waiver from the food and nutrition services of the
United States department of agriculture to provide that, for
purposes of state administration of the supplemental nutrition
Senate File 2422, p. 4
assistance program, expungement of benefits on a household's
electronic benefit account under 7 C.F.R. §274. 2(i) be
permitted after three months or ninety-one days of inactivity,
or of benefits remaining, on the electronic benefit account.
2. The department of health and human services shall
implement the waiver upon receipt of approval of the waiver
from the United States department of agriculture.
Sec. 7. FEDERAL SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM
— WAIVER OF ELIGIBILITY VERIFICATION RULES.
1. No later than January 1, 2027, the department of
health and human services shall request a waiver from the
food and nutrition services of the United States department
of agriculture to provide that, for purposes of state
administration of the supplemental nutrition assistance
program, information from the sources under section 239.6, and
the following automated sources, shall be considered verified
for purposes of 7 C.F.R. §272. 12(c):
a. The third-party automated asset verification services
contracted by the department or an equivalent third-party asset
verification platform.
b. The automated employment verification service known
as the work number or an equivalent third-party income
verification platform.
2. The department of health and human services shall
implement the waiver upon receipt of approval of the waiver
from the United States department of agriculture.
DIVISION IV
MEDICAID AND IOWA HEALTH AND WELLNESS PLAN - RETROACTIVE
ELIGIBILITY
Sec. 8. NEW SECTION . 249A.3B Medicaid — retroactive
eligibility.
1. Notwithstanding any provision of state law to the
contrary, effective January 1, 2027, in compliance with section
71112 of Pub. L. No. 119-21, commonly referred to as the One
Big Beautiful Bill Act, the department shall adopt rules to
provide that the eligibility of an individual who is a pregnant
woman, a child, or a resident of a nursing facility licensed
under chapter 135C shall be applied retroactively for no more
than two months prior to the month in which the individual
Senate File 2422, p. 5
submits a completed medical assistance program application.
2. The department shall not adopt rules, or submit a
request for a waiver or state plan amendment to the centers for
Medicare and Medicaid services of the United States department
of health and human services, to permit the department to
provide medical assistance program eligibility retroactively to
any other adult individual except as provided in subsection 1.
Sec. 9. Section 249N.4, subsection 5, Code 2026, is amended
to read as follows:
5. A member is eligible for coverage effective the first day
of the month following- the month of application for enrollment.
The department shall not adopt rules or submit a request for
a waiver or state plan amendment to the centers for Medicare
and Medicaid services of the United States department of health
and human services to permit the department to provide program
eligibility prior to the month in which the individual submits
a completed application for enrollment.
Sec. 10. 2017 Iowa Acts, chapter 174, section 12, subsection
15, paragraph a, subparagraph (7), as amended by 2018 Iowa
Acts, chapter 1165, section 107, is amended by striking the
subparagraph.
Sec. 11. MEDICAID RETROACTIVE ELIGIBILITY - WAIVER. The
department of health and human services shall submit a
request for a section 1115 demonstration waiver to the centers
for Medicare and Medicaid services of the United States
department of health and human services for approval to
allow, for purposes of state administration of Medicaid, for
implementation by the department of no retroactive eligibility
for any adult individual who is not a pregnant woman, a child,
or a resident of a nursing facility licensed under chapter
135C, upon the submission of a completed Medicaid application,
instead of three months as required under 42 C.F.R. §435.915.
The department shall implement the waiver upon receipt of
approval of the waiver by the centers for Medicare and Medicaid
services of the United States department of health and human
services .
DIVISION V
MEDICAID - MEDICAID MANAGED CARE ORGANIZATION HEALTH CARE TAX
FUND; EXPENDITURE NEUTRALITY; AND EXCEPTIONS TO POLICY
Senate File 2422, p. 6
Sec. 12. Section 249A.13, subsection 2, Code 2026, is
amended to read as follows:
2. Moneys in the fund are appropriated to the department
of health and human services for the purposes of the medical
assistance program. Unless expressly approved by the general
assembly through legislation, or as required by federal law
or regulations, the department shall not take any action that
reduces moneys deposited in the fund from a health maintenance
organization contracting with the department to administer the
medical assistance program under this chapter. Such moneys
shall not be diverted, reduced, or used by the department for
any other purposes than those permitted by this subsection.
Sec. 13. NEW SECTION . 249A.59 Medicaid waivers and state
plan amendments — expenditure neutrality.
1. For purposes of this section, unless the context
otherwise requires, "expenditure neutral" means that the cost of
a federally approved change to an existing, or new request for
a, Medicaid waiver or state plan amendment will not result in a
net increase in expenditures from the appropriation enacted for
the fiscal year the change or new request is made, as certified
by an actuary retained by the department.
2. a. The department shall not implement a change to a
Medicaid waiver or a state plan amendment approved by the
centers for Medicare and Medicaid services of the United
States department of health and human services, or submit a
new request, if the change or new request is not expenditure
neutral, unless expressly approved by the general assembly
through legislation prior to implementation of the change or
submission of the new request.
b. The department shall not implement a change to a Medicaid
waiver or a state plan amendment approved by the centers for
Medicare and Medicaid services of the United States department
of health and human services, or submit a new request, if the
change or new request expands coverage under the Medicaid
program to individuals or classes of individuals, unless
expressly approved by the general assembly through legislation
prior to implementation of the change or submission of the new
request .
3. This section shall not apply when the department
Senate File 2422, p. 7
implements a federally approved change to, or submits a new
request to the federal government for, a Medicaid waiver
or state plan amendment that meets any of the following
requirements:
a. The change or new request was submitted for federal
approval prior to January 1, 2026, regardless of whether
federal approval has been received by the department by January
1, 2026.
b. The change or new request is required by federal law
or regulation, or is necessary to comply with federal law or
regulations .
c. The change or new request is necessary to comply with a
settlement agreement, consent decree, or other resolution of a
state violation of the federal Medicaid program. A change or
new request initiated under this paragraph shall be reported
to the general assembly, with an estimate of the fiscal impact
of the change or new request to the extent it is known, within
thirty days of the date of the settlement agreement, consent
decree, or other resolution of a state violation of the federal
Medicaid program.
d. The change or new request involves the development or
implementation of actuarially sound capitation rates consistent
with 42 C.F.R. §438.4.
4. The department may adopt rules pursuant to chapter 17A to
administer this section.
Sec. 14. NEW SECTION . 249A.60 Medicaid — exceptions to
policy.
The department shall make publicly available, pursuant to
section 217.22, information on petitions for a waiver, also
referred to by the department as exceptions to policy, of the
rules governing the rules of department, including but not
limited to the following:
1. The total number of exceptions to policy granted.
2. The cumulative cost of the exceptions to policy that were
granted.
3. The types of exceptions to policy that were granted.
4. Identifiable trends noted by the department including
any of the following:
a. The number of exceptions to policy granted in a
Senate File 2422, p. 8
particular geographic location.
b. The types of Medicaid services that were the basis for
exceptions to policy.
c. The Medicaid program classification of individuals
granted exceptions to policy.
Sec. 15. EFFECTIVE DATE. The following takes effect on
January 1, 2027:
The section of this division of this Act amending section
249A.13, subsection 2.
DIVISION VI
MEDICAID - HOSPITAL DIRECTED PAYMENT PROGRAM
Sec. 16. Section 2490.2, Code 2026, is amended by adding the
following new subsection:
NEW SUBSECTION . 01. Unless otherwise authorized by the
general assembly through legislation, the department shall
continue to implement a hospital directed payment program
under this chapter utilizing rates up to the maximum amount as
permitted under 42 C.F.R. §438.6.
DIVISION VII
PROGRAM ADMINISTRATION - ELECTRONIC BENEFITS FUNDS PAYMENT
Sec. 17. Section 217.24, Code 2026, is amended to read as
follows :
217.24 Payment by electronic funds transfer.
1 . The department shall continue expanding the practice of
making payments to program participants and vendors by means
of electronic funds transfer. The department shall seek the
capacity for making payment by such means for all programs
administered by the department.
2, The department, in coordination with the department of
management's division of information technology, shall seek
the capacity to allow premium payments by program participants
to be made by electronic benefits transfer for all programs
administered by the department that require premium payments.
By January 1, 2028, the department shall allow premium payments
made by participants pursuant to section 249A.3, subsection
2, paragraph ^a", subparagraph (1), to be made by electronic
benefits transfer.
DIVISION VIII
EFFECTIVE DATE
Senate File 2422, p. 9
Sec. 18. EFFECTIVE DATE. This
immediate importance, takes effect
Act, being deemed of
upon enactment.
AMY SINCLAIR PAT GRASSLEY.
President of the Senate Speaker of the House
I hereby certify that this bill originated in the Senate and
is known as Senate File 2422, Ninety-first General Assembly.
W. CHARLES SMITHSON
Secretly o ,e Senate
Approve 2026
KIM 'REYNOLDS
Governor