The Iowa House of Representatives passed a bill Tuesday that would increase income limits for Iowans with disabilities who rely on Medicaid for essential services and also put certain restrictions on nutrition assistance programs.

Several House Democrats said the bill would lead to starving infants and have a negative impact on Iowa’s economy.

While several lawmakers argued the bill could go further, the changes to benefits for Iowans with disabilities were supported across the House. The changes to nutrition programs, namely a provision that would restrict participation in the federally funded Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC, was opposed by Democrats in the House.

House File 2716 would require the Iowa Department of Health and Human Services to use the Systematic Alien Verification for Entitlements, or SAVE, program to verify immigration or citizenship status when determining eligibility for public assistance programs, including the Supplemental Nutrition Assistance Program, WIC, medical assistance programs, the state child care assistance programs and the family investment program.

Rep. Angel Ramirez, D-Cedar Rapids, said WIC, a program providing infant formula, breastfeeding support and nutrition to children and mothers, “isn’t a luxury.”

“It’s the difference between a healthy birth and a preventable tragedy,” Ramirez said. “And right now, WIC reaches families regardless of immigration status, because hunger does not know papers.”

Ramirez said the bill would deny food to children and infants who “had no say in how they came into this country.”

“Iowa has always stood for the dignity of every child – this bill asks us to abandon that value, to look at a hungry infant and say: your paperwork matters more than your health,” Ramirez said.

Rep. Austin Harris, R-Moulton, said restricting programs like WIC so that “only U.S. citizens and qualified aliens can partake” is “not a new concept.”

“It comes down to this: Are we a nation of laws or not? Do we play by the rules or not?” Harris said on the floor. “Do we put Iowans first, or do we allow people who broke into this country to take advantage of these public assistance programs?”

Reps. Ross Wilburn, D-Ames and Rob Johnson, D-Des Moines, said the provisions related to nutrition would also have a negative impact on the local economy as fewer participants in the food assistance programs would mean less money spent in the local food economy.

“We are here not only stripping people from their SNAP benefits, but we’re also costing the state millions of dollars in monthly income,” Johnson said.

A fiscal note on the bill shows it will cost the state $44 million in fiscal year 2027. A large share of that figure comes from the Legislative Services Agency’s calculation that compliance with the bill would require 86 new full-time employee positions with Child Support Services.

Rep. Timi Brown-Powers, D-Waterloo, referenced the bill’s fiscal note and said the estimated costs show the Legislature is “jumping the gun and throwing a lot of stuff in one bill.”

Harris, who managed and introduced the bill, said the fiscal note was “way off.” He noted the section calling for nearly 90 full-time employees drew on requirements from a bill that was enacted in 2023.

Work without worry

Harris said the “best part” of HF 2716 is the “work without worry” section that allows Iowans with disabilities to continue working and earning money without losing access to Medicaid services.

This section of the bill would increase the income limit from 250% of the federal poverty limit to 300% of the federal poverty limit for Iowans to qualify for the Medicaid for Employed People with Disabilities program.

“I know some would like to have seen us go further in that, but this is a start, and I think it is, without a doubt, a large step in the right direction,” Harris said.

He also said the fiscal note did not take into consideration that with the bill in place, Iowans with disabilities on Medicaid would be able to earn more, pay more in taxes and potentially “get off” other public assistance programs.

“We have people who are on welfare who are begging us to let them work more – I think that’s a pretty conservative principle,” Harris said. “I think that this bill will give them the opportunity, a further opportunity, to contribute to society in the ways that they want to.”

Rep. J.D. Scholten, D-Sioux City, introduced an amendment that would have further expanded the “work without worry” policy in the state and removed the income cap for eligibility. Scholten’s amendment also would have removed the other provisions of Harris’ bill, which Harris argued made the amendment not germane to the bill. The House, in a vote of 62-31, sided with Harris and the amendment was scrapped.

Harris introduced his own amendment to the bill which exempted spousal income and one vehicle from income considerations for the Medicaid for employed persons with disabilities program. Harris said the amendment, which was adopted, also specified that “legal children are allowed to receive WIC benefits, even if their parents are illegal.”

HF 2716 also requires HHS to submit various reports to the Legislature and waivers to the federal government, which Harris said would help the state align with changes to the programs made in the federal spending law known as the “one big beautiful bill.”

The federal law included certain provisions that would penalize states with error rates in assistance programs above a certain threshold. HF 2716 would require periodic reports to the Legislature on error rates so the body could “see the train coming down the tracks” and know if they would need to appropriate more money for the programs, Harris explained.

HHS could also require public assistance benefit program applicants to provide proof of 12 months of residency in the state, under the bill.

The bill passed with a vote of 62-30, primarily along party lines. It moves to the Senate for further consideration.