Evaluation of the IowaCare Program: Information about the Medical Home Expansion

The IowaCare program is a limited-benefit, public health insurance program for Iowa adults with income that does not exceed 200% of the federal poverty level. It was authorized by Iowa House File 841 under a Medicaid expansion program and approved on July 1, 2005. This program covers some inpatient and outpatient services, physician, and advanced registered nurse practitioner services, limited dental services, routine yearly physicals, smoking cessation, and limited prescription drug benefits. The program was created, in part, to fill the gap in adult health care coverage that was expected to occur from the loss of the Iowa Indigent Care Program (a.k.a. the State Papers Program). The 2010 Iowa Legislature modified the program so that an IowaCare Medical Home pilot project was started on October 1, 2010, in part, to prepare for what was expected to be an influx of new Medicaid enrollees in 2014 resulting from the Medicaid expansion component of the Patient Protection and Affordable Care Act (ACA). The IowaCare 1115 waiver will expire on December 31, 2013. As of June 2013, the Iowa Legislature passed the Iowa Health and Wellness Plan that will provide coverage to existing IowaCare members through a combination of an expansion of Medicaid with a slightly different benefit package, based on that of Iowa State Employees, and the purchase of subsidized insurance on the forthcoming Health Insurance Exchanges. This report evaluates a variety of aspects of the IowaCare program from the perspective of the consumer. Enrollee perceptions of the IowaCare program were evaluated using mailed surveys with a sample of current IowaCare enrollees. A companion report evaluates outcomes of care for IowaCare enrollees using Medicaid claims and enrollment data.