Nearly 2,000 refugees in Iowa are affected by new federal Medicaid eligibility rules that took effect Oct. 1, local support groups estimate. County health departments in Des Moines, Cedar Rapids, and Sioux City are steering those families toward free and sliding-fee clinics, Iowa Public Radio reported on Oct. 15.
The change, part of the 2025 federal tax and budget law known as H.R. 1, generally bars refugees, asylees, and several other groups of lawfully present immigrants without green cards from federally funded Medicaid. Iowa families have been receiving letters about the change from the state's Department of Health and Human Services (HHS), which some say they do not understand.
