Can I Get Medicaid Under Obamacare (Obama Care or Affordable Care Act) in Iowa?

Iowa has expanded Medicaid coverage. That may make it easier for you to get health coverage under the Affordable Care Act (Obamacare).


Iowa Medicaid Expansion: Can I Use Medicaid to Satisfy the Health Insurance Requirement?


One way to satisfy Obamacare’s health insurance requirement is to obtain coverage under Medicaid. If you qualify for Medicaid and enroll in Iowa's Medicaid program, you do not have to sign up for another insurance plan.

It’s Now Easier to Qualify for Medicaid in Iowa

The Affordable Care Act expanded Medicaid eligibility to cover more people who can’t afford health insurance. The U.S. Supreme Court later decided that it was up to individual states to decide whether or not to expand Medicaid.

Iowa did decide to expand its Medicaid program, but it has done so in a way that differs from most states. Iowa residents who need health coverage and are newly eligible for Medicaid -- those who earn less than 138% of the federal poverty level -- may go to the health insurance marketplace at (For 2018, 138% of poverty level is about $16,753 for an individual or $34,638 for a family of four.) There, they can apply for a private health insurance plan. Those who earn at least 100% of the federal poverty level will be expected to pay premiums of up to 2% of their annual household income.

People who qualify for Medicaid under the old Iowa rules will continue to be enrolled in the traditional Medicaid program rather than a state subsidized private insurance plan. To find out whether you're eligible, contact the Iowa Medicaid office or fill out an application at

Note: In November 2017, Iowa changed a longstanding Medicaid requirement that allowed people to get coverage retroactively for the three months before they applied. Retroactive coverage will no longer be available, except for pregnant women and infants under the age of one.

The Medicaid Expansion Threshold: 133% or 138%?

If you have been reading about Medicaid eligibility, you may have noticed that some sources say the threshold has been raised to 133% of the federal poverty level, while others say 138%. It seems confusing, but both are true. The text of the Obamacare law says 133%, but a new way of calculating income means that the practical outcome is you will qualify if you fall below a threshold of 138%. For a full explanation, see the Affordable Care Act FAQs from the American Public Health Association.

If You Don’t Qualify for Medicaid

If you make more than 133% of the federal poverty level but your income is still low, you can investigate the health insurance plans available to you at You will probably be eligible for cost-saving subsidies based on your income and family size.

For more information, see Ways to Save Money on Obamacare in Iowa.

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