Iowa would fund health coverage, family care, and veterans services

Iowa would set aside money for health coverage, family care, and veterans services from its general fund and several separate funds. The budgets cover Iowa programs serving veterans, older adults, people with disabilities, children, and other residents. The listed budgets allow spending up to the stated amounts, using only as much as needed for their designated purposes. The general fund health coverage budget would include $1,930,142,662 for Medicaid, $61,266,871 for Hawki children's health insurance, and $4,479,762 for state supplementary assistance. Abortion payments from this budget would be barred unless authorized under section 9. Each Medicaid abortion reimbursement would require approval from the governor's office. These rules would also cover the Iowa Health and Wellness Plan. Veterans budgets would include $1,369,205 for administration, $8,145,736 for the Iowa Veterans Home, and $2.2 million for home ownership assistance for eligible service members. The home would submit monthly spending reports and bills involving the health agency at least monthly, and the agency would transfer home ownership money to the Iowa Finance Authority to continue that program. The cited eligibility law is not reproduced here. These are program budgets, not guaranteed individual payments. The main budgets cover July 1, 2026, through June 30, 2027.

The Iowa Department of Health and Human Services would follow payment rules, review provider rates, and seek federal permission concerning Medicaid coverage in mental health institutions. The payment rules cover health and social service providers paid through the department, including Medicaid providers. Provider payments would generally follow June 30, 2026, rates or calculation methods, except for negotiated contracts, updated fee schedules, or other exceptions in section 15. Money for rate increases, as far as funding allows, would include $5 million for Medicaid services helping older adults live at home or in the community, $2.8 million for rehabilitation and speech therapy, and $1,167,867 for outpatient surgery centers. Other rate-increase amounts would be $300,000 for adult day services, $250,000 for prosthetics, and $333,000 for nursing facilities serving special populations. Another $250,000 would cover air medical services from the largest community-based provider with over 40 years of experience. Medicaid managed care plans would follow agency rate notices for specified nursing, home care, and community services. Adjustments would apply back to each notice's effective date. Nursing facility rates would use the June 30, 2026, calculation method, with resident care needs measured over the stated six-month periods for rates effective July 1, 2026, and January 1, 2027. The rate-increase budgets cover the fiscal year beginning July 1, 2026. The federal application would be due no later than July 1, 2027.

The Department of Health and Human Services would run a funded family support program for disability needs that other programs do not meet. Eligible Iowa households could apply to the department or a family support center. Centers would help families identify unmet needs and find services. Families must live in Iowa, intend to keep the person with a disability in their home, and have taxable income below $60,000 for the most recently completed tax year. The person must be under 22 and meet the federal definition of a developmental disability. Covered households include relatives or a legal custodian living with the person. Short-term foster caregivers qualify when the care plan calls for reunion with a parent. Paid workers providing care outside the home do not count as family. Support would meet needs that other programs do not meet, rather than replace available services. It could cover equipment, caregiver breaks, and other disability-related costs. Families would receive payments through vouchers or another suitable method. The program provisions would take effect upon enactment and apply retroactively to July 1, 2025.

Iowa would direct leftover local child welfare and juvenile justice money to state agencies and require counties to pay sheriffs for specified transport. The funding rules cover local projects pooling child welfare and juvenile justice money. The transport rules apply to counties and sheriffs. Money committed to multiyear local projects for the fiscal year beginning July 1, 2025, would remain available until June 30, 2029, or the end of the fiscal year when the work finishes, whichever comes first. Uncommitted leftover money would go to the Department of Health and Human Services and juvenile court services in proportion to their legislative funding shares. The county where the sheriff takes a person into immediate custody under a court order would pay for transport to a detention location. The county board would determine compensation under the cited county payment law. The transport provisions cover court-ordered custody before substance use commitment or mental health hospitalization hearings. They do not cover every trip involving someone with these conditions. The leftover-money rules would take effect upon enactment and apply retroactively to July 1, 2025. They concern balances at the close of the fiscal year beginning that day.

The Department of Health and Human Services would publish staffing information and report spending to lawmakers. The staffing and spending duties apply to the department. Grant reporting applies to community mental health centers receiving the designated money. A public staffing dashboard would show approved positions, vacancies, and worker categories. It would also show staffing money and how positions are funded. The yearly behavioral health report would cover spending for adults and children in the previous fiscal year and identify the funding sources. Quarterly reports would cover spending of money allowed to remain available after the 2026–2027 budget year. Community mental health centers receiving designated federal grant money would receive quarterly payments and submit quarterly performance reports. Behavioral health spending reports would be due each December 15. Quarterly reports on carried-forward spending would begin October 1, 2027.