Healthy Behaviors Claims-Based Outcomes Report #3 and Healthy Behaviors Modeling Report #2

Wright, B.; Momany, E.T.; Askelson, N.M.; Bentler, S.E.; Ahrens, M.; Damiano, P.C.
06/2021

Abstract

On January 1, 2014 Iowa implemented the Iowa Health and Wellness Plan (IHAWP). IHAWP expands cover- age for low income Iowans through two new programs: the Marketplace Choice and the Wellness Plan.

The Wellness Plan provides coverage for adults aged 19-64 years with income up to and including 100 percent of the Federal Poverty Level (FPL). It is administered by the Iowa Medicaid Enterprise (IME). Members will have access to the Medicaid provider network established for this program.

The Marketplace Choice Plan provides coverage for adults aged 19-64 years with income from 101-133 percent of the Federal Poverty Level (FPL). The Marketplace Choice Plan allows members to choose cer- tain commercial health plans available on the health insurance marketplace, with Medicaid paying the member’s commercial health plan premiums.

IHAWP replaces the IowaCare program with plans that cover more services, offer a broader provider network, and expand coverage to other low income adults in Iowa who were not previously enrolled in IowaCare.

The Marketplace Choice Plan ended on January 1, 2016, and all of these members were transitioned to the Wellness Plan. Then, starting April 1, 2016, all Wellness Plan members were enrolled into Medicaid managed care.