Iowa’s experience with Obamacare’s Medicaid expansion has been turbulent. In 2014, state officials agreed to expand Medicaid, despite the fact that the Obama administration denied virtually all of their requests for flexibility.
Iowa’s expansion was loosely modeled after Arkansas’ Obamacare expansion. Under Iowa’s “Marketplace Choice” waiver, able-bodied adults above the poverty line would receive Medicaid benefits through Obamacare exchange plans.
The program has seen double-digit premium hikes, one carrier becoming insolvent, both carriers eventually leaving the program, skyrocketing enrollment, cost overruns, and changes that make Medicaid enrollees less accountable. With that unfolding, it’s no wonder state officials announced in July 2015 that they were closing the Medicaid expansion waiver.