On October 26, 2017, the Centers for Medicare and Medicaid Services (CMS) approved an amendment to Iowa's Section 1115 demonstration waiver eliminating 3-month retroactive coverage for nearly all new Medicaid applicants as of November 1, 2017. Populations affected by Iowa's waiver include low-income parents, children over age 1, Affordable Care Act (ACA) expansion adults, seniors, and people with disabilities. Retroactive coverage waivers have been approved in a limited number of other states with certain conditions. This issue brief answers key questions about Medicaid retroactive coverage, describes Iowa's recent waiver amendment, considers the policy implications of retroactive coverage waivers, and identifies issues to watch.
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