House File 948 H-1195 Amend House File 948 as follows: 1 1. By striking everything after the enacting clause and 2 inserting: 3 < DIVISION I 4 IOWA HEALTH AND WELLNESS PLAN —— WORK REQUIREMENTS 5 Section 1. NEW SECTION . 249N.4A Work requirements. 6 1. The department shall request any federal approval 7 necessary to include work requirements as a condition of a 8 member maintaining eligibility for the Iowa health and wellness 9 plan. 10 2. The goal of including work requirements is to reduce the 11 dependence of low-income Iowans on public assistance programs 12 through efforts that advance economic stability and mobility. 13 3. The department shall require as a condition of 14 maintaining eligibility for the Iowa health and wellness 15 plan that a member work at least eighty hours each month, as 16 determined by the department. 17 4. The department shall exempt an individual from the work 18 requirements for the Iowa health and wellness plan if the 19 individual meets any of the following criteria: 20 a. The individual is under nineteen years of age. 21 b. The individual is sixty-five years of age or older. 22 c. The individual is determined to be disabled by the United 23 States social security administration. 24 d. The individual is identified as medically frail or 25 medically exempt under the Medicaid program. 26 e. The individual is a caretaker of a dependent child under 27 six years of age. 28 f. The individual is pregnant and the pregnancy is high 29 risk. 30 g. The individual is receiving unemployment compensation as 31 determined by the department of workforce development. 32 h. The individual is participating in substance use disorder 33 treatment, not to exceed a consecutive six-month period. 34 i. The individual is otherwise exempt for good cause as 35 -1- HF 948.1267 (1) 91 (amending this HF 948 to CONFORM to SF 615) lh/ko 1/ 4 #1.

determined by the director. 1 5. To maximize fiscal stability and administrative 2 efficiency, any exemption applied under the Iowa health and 3 wellness plan shall be substantially similar to the exemptions 4 applied under other public assistance programs. 5 6. Upon the department’s receipt of federal approval, 6 and the department’s operationalizing of a real-time system 7 to facilitate recipient reporting and department evaluation 8 efforts, the department shall implement work requirements as a 9 condition of maintaining eligibility for the Iowa health and 10 wellness plan. The department shall adopt rules pursuant to 11 chapter 17A as necessary to administer the work requirements 12 for the Iowa health and wellness plan. 13 7. The department may resubmit a request for federal 14 approval submitted under subsection 1 if the initial request is 15 denied or withdrawn for any reason. 16 8. If federal law or regulations affecting work 17 requirements for the Iowa health and wellness plan are modified 18 to exclude work requirements as a basis for maintaining 19 eligibility as provided in this section, the department shall 20 discontinue the Iowa health and wellness plan, subject to 21 federal approval. If, under federal law, the department is not 22 allowed to discontinue the Iowa health and wellness plan, the 23 department may implement an alternative plan as specified in 24 the medical assistance state plan or waiver for coverage of the 25 affected population, subject to prior statutory approval of 26 implementation of the alternative plan. 27 Sec. 2. EFFECTIVE DATE. This division of this Act, being 28 deemed of immediate importance, takes effect upon enactment. 29 DIVISION II 30 WORK RULES AND REQUIREMENTS FOR PUBLIC ASSISTANCE PROGRAMS 31 Sec. 3. PUBLIC ASSISTANCE PROGRAMS —— WORK RULES AND 32 REQUIREMENTS ALIGNMENT. The department of health and human 33 services shall work with the United State department of 34 health and human services and the United States department 35 -2- HF 948.1267 (1) 91 (amending this HF 948 to CONFORM to SF 615) lh/ko 2/ 4

of agriculture to align the requirements and rules for 1 participants of public assistance programs related to working, 2 including but not limited to rules and requirements related 3 to employment and training for the supplemental nutrition 4 assistance program. 5 DIVISION III 6 INFORMATION TECHNOLOGY 7 Sec. 4. NEW SECTION . 217.25 Information technology fund. 8 1. An information technology fund is created in the state 9 treasury under the control of the department of health and 10 human services. The fund shall consist of moneys appropriated 11 or transferred to, or deposited in, the fund as provided 12 by law. All moneys deposited or paid into the fund are 13 appropriated to the department of health and human services 14 to be used for information technology systems and related 15 modernization initiatives. 16 2. Notwithstanding section 8.33, moneys appropriated in 17 this section that remain unencumbered or unobligated at the 18 close of the fiscal year shall not revert but shall remain 19 available for expenditure for the purposes designated until the 20 close of the succeeding fiscal year. Notwithstanding section 21 12C.7, subsection 2, interest or earnings on moneys in the fund 22 shall be credited to the fund. 23 Sec. 5. TRANSFER OF MONEYS. Any unobligated or unencumbered 24 moneys remaining in the public assistance modernization 25 fund created in section 239.11, on June 30, 2025, shall be 26 transferred to the information technology fund created in 27 section 217.25, as enacted in this division of this Act. 28 Sec. 6. REPEAL. Section 239.11, Code 2025, is repealed. 29 DIVISION IV 30 MEDICAID FOR EMPLOYED PEOPLE WITH DISABILITIES PROGRAM 31 Sec. 7. Section 249A.3, subsection 2, paragraph a, 32 subparagraph (1), subparagraph division (a), Code 2025, is 33 amended to read as follows: 34 (a) As allowed under 42 U.S.C. §1396a(a)(10)(A)(ii)(XIII), 35 -3- HF 948.1267 (1) 91 (amending this HF 948 to CONFORM to SF 615) lh/ko 3/ 4

individuals with disabilities, who are less than sixty-five 1 years of age, who are members of families whose income is 2 less than two hundred fifty percent of the most recently 3 revised official poverty guidelines published by the United 4 States department of health and human services for the family, 5 who have earned income and who are eligible for mandatory 6 medical assistance or optional medical assistance under this 7 section if earnings are disregarded. As allowed by 42 U.S.C. 8 §1396a(r)(2), unearned income shall also be disregarded in 9 determining whether an individual is eligible for assistance 10 under this subparagraph. For the purposes of determining the 11 amount of an individual’s resources under this subparagraph and 12 as allowed by 42 U.S.C. §1396a(r)(2), a maximum of ten thousand 13 dollars of available resources for an individual and twenty-one 14 thousand dollars of available resources for a couple shall be 15 disregarded, and any additional resources held in a retirement 16 account, in a medical savings account, or in any other account 17 approved under rules adopted by the department shall also be 18 disregarded. > 19 2. Title page, by striking lines 1 through 5 and inserting 20 < An Act relating to work requirements for the Iowa health and 21 wellness plan, public assistance programs, an information 22 technology fund, the public assistance modernization fund, and 23 the Medicaid for employed people with disabilities program, and 24 including effective date provisions. > 25 ______________________________ NORDMAN of Dallas -4- HF 948.1267 (1) 91 (amending this HF 948 to CONFORM to SF 615) lh/ko 4/ 4 #2.