Iowa cancer patients shouldn't be at risk of losing Medicaid

March 27, 2023

Iowa is losing its battle with cancer. According to the Cancer in Iowa report, Iowa is the only state with a significant increase in cancer incidence from 2015 to 2019, and has the second-highest overall cancer incidence of all U.S. states. What is our state government doing about it?  

Instead of adopting the policies we know will reduce cancer rates, the Iowa Legislature is trying to separate people from their health insurance. A short-sighted bill, House File 613,  would add work requirements to Medicaid coverage and add layers of administrative red tape between Iowans and their doctors. That’s not acceptable for the 20,460 Iowans who will be diagnosed with cancer this year. Medicaid is the health insurance that tens of thousands of Iowans depend on to detect and treat major illnesses like cancer.

At the American Cancer Society Cancer Action Network, we know that cancer patients in active treatment are often unable to work or require modifications in their employment due to their treatment. Between 40% and 85% of them stop working, and their absences range from 45 days to six months.

Many cancer survivors also continue to deal with chronic issues, as a result of their treatments, that impact their ability to work. We have found that the complexity and frequency of administrative reporting requirements, like those in this bill, have led to thousands of people losing their Medicaid coverage. For a patient who is mid-treatment, a loss of health care coverage could seriously jeopardize their chance of survival.  

Medicaid work requirements could hinder access to lifesaving preventive services, as well. Individuals without health insurance are diagnosed with cancer at later stages when the disease is more expensive to treat, and survival is less likely. If the human costs don’t shock you, the financial ones should. A similar proposal from 2019 would have cost taxpayers millions of dollars every year.   

This bill simply won’t have the effect politicians think it will. We know because we’ve seen it tried in other states. Arkansas’ failed work requirement experiment — later struck down by the courts — clearly showed that work requirement reporting increased uninsured rates without increasing employment, studies by Harvard researchers found. People who lost Medicaid did not transition to other coverage, and there was no evidence that it increased employment. The vast majority of people with Medicaid are already working. 

Consistent access to health care coverage is a matter of life and death for thousands of low-income cancer patients and survivors. Please join me in asking to stop this bill.  Moving a Medicaid work requirement bill forward would be a major step backward for our state. 

This piece originally ran as an Iowa View opinion in the Des Moines Register on 03/23/2023.