Iowa: Medicaid expansion enrollment up 28% since COVID hit; total Medicaid up 17%


I've once again relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.

For the various enrollment data, I'm using data from's Medicaid Enrollment Data Collected Through MBES reports. Unfortunately, they've only published enrollment data through December 2020. In some states I've been able to get more recent enrollment data from state websites and other sources.

Today I'm presenting Iowa. For enrollment data from January 2021 on, I'm relying on adjusted estimates based on raw data from the Iowa Dept. of Human Services.

After ACA expansion ramped up starting in early 2014, Iowa's overall enrollment in both traditional and ACA-expansion Medicaid has been remarkably steady, hovering around the 600,000 mark for more than 4 years straight...until COVID hit last spring. Since then, traditional Medicaid enrollment has increased by 12.6% and ACA expansion has gone up by 28.2%, for an overall climb of 17.2% as of May 2021.

Iowa has 3,190,369 residents according to the 2020 U.S. Census. As of May 2021:

  • around 703,000 are enrolled in Medicaid overall, or 26.9% of the population
  • around 477,000 are enrolled in non-ACA Medicaid
  • around 226,000 are enrolled in ACA Medicaid expansion.
  • Add in the ~55,000 subsidized ACA exchange enrollees and that's around 281,000 Iowans who would lose healthcare coverage if the Supreme Court strikes down the Affordable Care Act, or 9% of the state population.