Iowa Medicaid Program Overview
Enrollment, funding, and managed care facts for Iowa Medicaid.
Get Iowa's Medicaid Fee Schedule →Enrollment
Iowa Medicaid covered approximately 0.65-0.67M people. Two independent sources give different-period figures for total Iowa Medicaid/CHIP enrollment: CMS's 2024 Medicaid Managed Care Enrollment and Program Characteristics report counted 649,899 total Medicaid enrollees as of July 1, 2024; KFF's Total Monthly Medicaid & CHIP Enrollment indicator shows 674,796 as of May 2026. Reported as a range rather than a false-precision single number; the increase across this window is plausible (Iowa is an expansion state) but not independently decomposed here.
Funding & federal match
Iowa has adopted ACA Medicaid expansion, effective 2014-01-01.
For FFY2026 (Oct 1, 2025 - Sep 30, 2026), Iowa's Federal Medical Assistance Percentage (FMAP) is 62.7%.
Delivery system & managed care
A large share of Iowa Medicaid is delivered through managed care organizations (MCOs) rather than fee-for-service — estimates range from 93-95% of Medicaid enrollees.
Waivers
Iowa operates Medicaid managed care under the Iowa Wellness Plan / Iowa Health and Wellness Plan (IHAWP), a Section 1115 demonstration waiver. Section 1115 demonstration authorizing Iowa's ACA Medicaid expansion population coverage with healthy-behavior incentives, a Dental Wellness Plan component, and (pending Dec 2026 sunset) non-emergency medical transportation provisions. Approved December 10, 2013, effective January 1, 2014. Current authority runs through December 31, 2026; a temporary extension/amendment was approved by CMS on November 28, 2025 while a formal renewal (including new work requirements effective December 1, 2026) is under review.
Has Iowa expanded Medicaid under the ACA?
Yes. Iowa has adopted ACA Medicaid expansion. Effective 2014-01-01.
How many people are enrolled in Iowa Medicaid?
Approximately 0.65-0.67M people.
What percentage of the federal Medicaid match does Iowa receive?
62.7% for FFY2026 (Oct 1, 2025 - Sep 30, 2026) — meaning the federal government pays roughly 63 cents of every Iowa Medicaid dollar, and the state pays the rest.
Is most of Iowa Medicaid delivered through managed care?
Estimates range from 93-95% of Medicaid enrollees in managed care.
What Medicaid waivers does Iowa operate under?
Iowa Wellness Plan / Iowa Health and Wellness Plan (IHAWP), a Section 1115 demonstration waiver. Section 1115 demonstration authorizing Iowa's ACA Medicaid expansion population coverage with healthy-behavior incentives, a Dental Wellness Plan component, and (pending Dec 2026 sunset) non-emergency medical transportation provisions. Approved December 10, 2013, effective January 1, 2014. Current authority runs through December 31, 2026; a temporary extension/amendment was approved by CMS on November 28, 2025 while a formal renewal (including new work requirements effective December 1, 2026) is under review.
Get Iowa's Free Medicaid Fee Schedule
Request actual Iowa Medicaid reimbursement rates by billing code — free, delivered as a CSV.
Sources
- CMS - Medicaid Managed Care Enrollment and Program Characteristics, 2024
- KFF State Health Facts - Total Monthly Medicaid & CHIP Enrollment
- KFF State Health Facts - Federal Matching Rate (FMAP) and Multiplier
- Congressional Research Service - Medicaid's Federal Medical Assistance Percentage (FMAP), R43847 (Table A-1)
- KFF State Health Facts - Status of State Action on the Medicaid Expansion Decision
- healthinsurance.org - Medicaid eligibility and enrollment in Iowa
- Iowa HHS - IA Health Link
- Iowa HHS - Managed Care 101 (October 2022)
- Iowa HHS - Iowa Wellness Plan
- Medicaid.gov - Section 1115 Demonstrations, Iowa Wellness Plan
Data last verified 2026-09-17. Also see our free Medicaid Fee Schedule tool.