States must determine whether people are eligible for Medicaid.
Iowa needs to ensure tax dollars are funding those who are truly in need in order to take some burden off hardworking taxpayers and encourage those wrongfully receiving benefits to return to the workforce.
Iowa has an ever-growing Medicaid problem. Under the current, federally-declared COVID-19 health emergency, individuals enrolled in Medicaid at any point during the pandemic cannot be removed from the Medicaid rolls, even if they become otherwise ineligible. This has resulted in a significant increase in Medicaid enrollees.
When the public health emergency comes to an end, all individuals enrolled in Medicaid who would otherwise not be eligible will need to be removed from the program. Now is the time to pass legislation requiring automated eligibility checks to help better screen recipient eligibility in real time. Presently, all verification checks at the Iowa Department of Health and Human Services (HHS) are performed manually. This means that workers at HHS are required to contact 10-12 individuals daily to check all recipients annually, not taking into account the current backlog due to the health emergency rules. If HHS were to use the National Accuracy Clearinghouse software, workers would only need to contact individuals flagged by the system. If trends in other states are used as a guide, roughly 15 percent of public assistance recipients would be flagged for a verification check during standard times of public benefit administration. Further, individuals utilizing public assistance would be required to submit documentation much less frequently, easing the burden on those following the law. To clarify, if an individual is flagged, benefits are NOT automatically terminated; it is simply a prompt to HHS to follow up with the individual because there is a discrepancy in their file.
Per the 2018 Farm Bill, all states were to be using the National Accuracy Clearinghouse software to verify SNAP eligibility by 2021. Rules for this provision went into effect in December 2022, and all states will need to be utilizing the National Accuracy Clearinghouse software by October 2027 per this rule.
Unfortunately, Iowa has a history of inaccuracy when it comes to eligibility verification. On July 30, 2019, the U.S. Department of Agriculture (USDA) fined the State of Iowa $1.79 million due to a high error rate in the disbursement of SNAP benefits. In Fiscal Year 2018, Iowa’s SNAP error rate was over 10 percent. This put Iowa’s SNAP overpayment rate at fifth highest in country, fourth if Washington, D.C., is excluded, and Iowa’s overall error rate was sixth highest in the country.
With a backlog of eligibility checks on the horizon, it is time to give workers at the Iowa HHS the necessary tools to more efficiently perform eligibility checks. People wrongfully receiving benefits may be choosing not to work or working less because the taxpayer is picking up the tab. To be clear, the intent of this eligibility verification tool is not to remove benefits from anyone who legitimately qualifies for public assistance; rather, the intent is to make sure that tax dollars are funding those who are truly in need in order to take some burden off hardworking taxpayers and encourage those wrongfully receiving benefits to return to the workforce.