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Iowa Medicaid Faces $257M Deficit Amid Budget Critique

10/4/2025

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Story summary
  • State Auditor Rob Sand projects Medicaid deficits of $76 million in 2026 and $181 million in 2027.
  • Sand criticizes Republican budgeting as irresponsible.
  • Medicaid covers about 700,000 Iowans; a $307 million 2024 surplus came from temporary pandemic aid, with reserves expected to deplete by 2027.
  • Legislative Republicans say they are committed to responsible budgeting amid rising Medicaid costs.