Lee Grossman comes home, bringing Wyoming experience to transform Iowa Medicaid for recipients.
Significant changes are coming if you're one of the 700,000+ Iowans who depend on Medicaid for your healthcare coverage.
The Iowa Department of Health and Human Services recently appointed fellow Iowan Lee Grossman as the new Medicaid Director, as sweeping Medicaid policy shifts are arriving, including new federal work requirements that could affect 146,000 recipients.
The leadership transition matters because it determines how Iowa Medicaid provides health coverage moving forward.
IowaMedicaidHelp is here to help you understand the major Medicaid program changes and how they might affect your benefits.
Meet Lee Grossman: New Medicaid Director With Wyoming Experience
Lee Grossman, an Iowa native, has returned home after spending more than 14 years at the Wyoming Department of Health.
In February 2023, Grossman served as Wyoming's Medicaid Director, managing Home and Community-Based Services (HCBS) programs with budgets exceeding $160 million.
His track record shows strengths in three key areas that Iowa HHS Director Kelly Garcia specifically highlighted:
- Rural healthcare access expertise - Iowa faces rural challenges similar to those in Wyoming, where Grossman successfully expanded provider networks in underserved areas.
- Budget management capabilities - He maintained program stability while implementing cost-effective solutions.
- Program transformation leadership - Led major system overhauls while protecting recipient benefits.
Matney departed in November 2024, leaving the position vacant until Grossman begins his new role in early September.
"I'm thrilled to welcome Lee back home to Iowa," Director Kelly Garcia said when announcing the appointment. She emphasized that his knowledge of building rural healthcare access makes him perfectly fit to guide our Medicaid team at this moment.
Rural Healthcare Focus for Iowa
Grossman's past rural healthcare achievements offer hope for Iowa's underserved communities.
According to Governor Reynolds, during his tenure as Wyoming's Medicaid Director, he implemented innovative solutions that Iowa HHS plans to adapt for local needs.
Rural strategies coming to Iowa include:- Provider recruitment initiatives - Financial incentives for healthcare professionals serving rural areas, including loan forgiveness programs and signing bonuses.
- Telehealth expansion plans - Virtual visit options for specialty care, mental health services, and routine check-ups.
- Transportation solutions - Coordinated ride services and mobile clinic programs reaching isolated communities.
Director Kelly Garcia says these rural program enhancements should begin in early 2026, with pilot programs launching in select counties.
Full statewide implementation will follow successful pilot results, typically within 12-18 months.
New Work Requirements and What You Must Do to Stay Eligible
The most immediate change facing Iowa Medicaid recipients involves new federal work requirements that impact able-bodied adults aged 19-64 enrolled in the Iowa Health and Wellness Plan.
Understanding these requirements helps you protect your medicaid eligibility.
How to maintain coverage- Complete 80 hours of qualifying activities each month.
- Acceptable activities include employment, job training, education programs, or community service.
- Document all activities thoroughly - poor record-keeping leads to coverage loss.
- Submit monthly compliance reports by specified deadlines.
- Individuals with documented disabilities.
- Pregnant women throughout pregnancy and 60 days postpartum.
- Primary caregivers for dependent children under age 6.
- Full-time students enrolled in approved educational programs.
- Recipients participating in substance abuse treatment.
- Those experiencing temporary medical incapacity.
Implementation of the new policy begins immediately, potentially affecting 146,000 Iowans, according to Governor Kim Reynolds, who signed the legislation in June 2025.
State and federal lawmakers designed these medicaid work requirements to encourage employment while maintaining protections for vulnerable populations.
However, compliance remains your responsibility.
Key Dates You Can't Miss
Staying informed about implementation dates protects your coverage during this transition period.
Critical dates
Medicaid recipients should mark these dates on their calendar:
- September 2025 - Lee Grossman begins his role as the new Medicaid Director.
- October 2025 - First monthly work requirement reports due for non-exempt recipients.
- November 2025 - Eligibility review cycles begin for existing recipients.
- January 2026 - Full enforcement of work requirements with termination proceedings for non-compliant recipients
The medicaid program operates on strict deadlines.
Recipients should consider contacting the legal experts at IowaMedicaidHelp to ensure they never miss a single reporting date that can trigger coverage reassessment or termination, which may take months to reverse.
Policy implementation
According to Iowa Health, and Human Services, execution of the new rules will follow a phased approach:
- Phase 1: Educational outreach and voluntary compliance (September-October 2025).
- Phase 2: Mandatory reporting with warnings for non-compliance (November-December 2025).
- Phase 3: Full enforcement with coverage terminations (January 2026 onward).
Grace periods exist for first-time violations, but repeat non-compliance results in immediate termination.
More on CCBHCs and Redesigned Waivers
Grossman has also promised to add two major program innovations that will transform how Iowa Medicaid provides health coverage: Certified Community Behavioral Health Clinics (CCBHCs) and redesigned HCBS waiver structures.
CCBHC program
- Offers comprehensive mental health and substance abuse services
- Same-day access for crisis intervention
- Integrated primary and behavioral healthcare
- 24/7 mobile crisis response teams
- Peer support and family education programs
- No waitlists for services
Eligibility will extend to all Medicaid recipients, with services available regardless of ability to pay additional costs.
Initial CCBHC locations will target areas with the highest overdose rates and suicide risks.
Improved HCBS waiver
- Expanded service options, including respite care, home modifications, and assistive technology
- Simplified application process, reducing approval time from months to weeks
- Enhanced funding mechanisms allowing more recipients to access services
- Greater flexibility in choosing service providers
Implementation will begin with a soft launch in January 2026, allowing early enrollment for recipients on waiting lists.
Iowa HHS projects these changes will serve an additional 15,000 Iowans within the first year.
Contact an IowaMedicaidHelp pro today to access these new programs or get more information on enrollment.
Action Steps for Protecting Your Coverage
Taking proactive steps now prevents coverage loss during this transition period.
With new requirements and eligibility reviews approaching, Medicaid planning becomes more necessary than ever.
Immediate actions to secure your benefits:
- Verify your eligibility category
- Update contact information
- Document exemption status
- Understand asset protection limits
Common mistakes include ignoring renewal notices, assuming automatic exemptions, and failing to report changes promptly.
For nursing home planning or complex asset protection needs, IowaMedicaidHelp attorneys preserve your eligibility while protecting family resources. Legal guidance becomes particularly valuable when facing long-term care decisions.
Additional Considerations for Special Populations
Certain groups face unique challenges under the new medicaid policy changes.
Parents and caregivers should document childcare responsibilities carefully. The exemption for caring for children under age 6 requires specific forms and periodic verification. Single parents juggling work requirements with childcare face particular challenges that advocacy groups actively address.
Individuals with disabilities must ensure their exemption documentation remains current. Annual reviews may require updated medical assessments. The state and federal work requirements include protections, but you must actively claim them.
Students enrolled in qualified educational programs meet work requirements through their studies. However, part-time enrollment may not qualify, and summer breaks could create coverage gaps without careful planning.
Resources and Next Steps for Getting Help
Your journey through upcoming Medicaid changes doesn't have to happen alone. IowaMedicaidHelp assists Iowans in maintaining benefits during policy transitions.
Stay informed about ongoing changes by visiting our website for updates, policy explanations, and practical guidance.
Our expert Medicaid attorneys provide tools to help you calculate work requirements, find local resources, and understand your rights as a recipient.
By actively participating and meeting new requirements, you can maintain your healthcare coverage and tackle any challenges that may arise.