Review cadence
- Source date
- 2026-07-15
- Claim review
- 2026-07-19 · 22/22
- Proven sweep
- 2026-07-15
- Target
- T2 · biweekly
Loading...
Iowa has 14 community health centers across 140 sites serving 253,976 patients — the #33 FQHC state by patients in the national-breadth layer. As an expansion state, Medicaid anchors the safety net, and H.R. 1 work requirements plus the December 2026 funding cliff are the key risks.
Save Iowa to Your Pulse for policy, funding, and workforce updates in this browser.
Share with your team
We keep source date, claim review, and a completed source sweep separate. None of these clocks substitutes for another.
48,477 reported patients
Actual values: 11/12 · source-backed: 9/12
Visible gaps: reported financials, NPPES operator identity, history.
Hash-pinned review: 2026-07-19 · next 2026-10-17
This public log starts July 14, 2026. Zero logged changes does not mean a page or claim never changed before that date.
2026-07-19 · addition
New tracked IA development added to the state intelligence feed.
2026-07-19 · addition
New tracked IA development added to the state intelligence feed.
2026-07-19 · addition
New tracked IA development added to the state intelligence feed.
2026-07-16 · addition
New tracked IA development added to the state intelligence feed.
2026-07-16 · addition
New tracked IA development added to the state intelligence feed.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-15 · material correction
Corrected this IA record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
Send a correction or new source to improve this state page.
Iowa's current implementation focus is the federal Medicaid work requirement. Iowa HHS says certain Iowa Health and Wellness Plan members must meet monthly requirements by December 1, 2026; the member guidance sets an 80-hour monthly threshold, or at least $580 in monthly earnings, and lists mandatory exclusions. KFF's April 2026 state survey reports that Iowa plans to implement one month before the federal January 1, 2027 start date and, with Indiana, does not plan to adopt any of the four optional hardship exceptions. A March 2025 fiscal note for the earlier SF 615 design estimated that approximately 32,000 people might lose IHAWP coverage, but that estimate assumed federal approval and applied Arkansas loss rates; it is a model, not an observed result or a current state count. At the same time, the Iowa Primary Care Association reports that its first year as the statewide Behavioral Health Administrative Organization included 49 navigators, 34 in-person locations, and 52,916 calls, while Iowa HHS's current Healthy Hometowns page identifies a $209 million first-year Rural Health Transformation award and says future funding could total $1 billion only if fully awarded.
Patient-weighted across the 14 centers with UDS 2024 data.
Iowa's licensing agency says advanced registered nurse practitioners may practice independently within their education, role, population focus, certification, and applicable standard of care. A physician collaboration agreement may be used when warranted, but the Iowa Board of Nursing does not require one. Licensed ARNPs may prescribe, administer, or dispense prescription drugs and devices, including controlled substances, within their role and population focus and subject to state and federal requirements.
Medicaid community-engagement (work) requirements under CMS-2454-IFC (80 hrs/month, full implementation Jan 1, 2027) plus expiry of the enhanced ACA premium tax credits (end of 2025) threaten Iowa's expansion population and FQHC Medicaid revenue.
Role implications
Pick the right lens and open a personalized daily brief. Links carry only state, role, and audience in the URL.
Iowa ranks #33 by FQHC patients, with 14 organizations and 140 sites tied to Medicaid work-requirement exposure.
Use this as the board agenda frame: exposure, owner, decision date, and the first source to recheck.
49% Medicaid/CHIP, 20.5% uninsured, and 3.8 points above the expansion peer average.
Turn the payer mix into scenarios for PPS, 340B, grants, and patient-volume stress.
30 public ATS snapshot rows across 4 sources; largest systems and directory links show where hiring capacity may need verification.
Use the state read to pick roles to watch, openings to save, and retention risks to discuss with managers.
Iowa combines 253,976 FQHC patients with full practice NP practice context and access pressure from payer mix.
Map the signal to panel access, team-based care, top-of-license planning, and patient-impact follow-up.
IPCA, state policy context, and the December 31, 2026 CHC Fund cliff define the sources to keep current.
Assign one source owner for state policy, one for federal deadlines, and one for billing/audit implications.
Iowa has 14 FQHC employers in the directory and 30 public ATS snapshot rows across 4 sources to compare before applying.
Use the state context to choose target employers, tailor proof, and save the next job or resource in My Progress.
30 live FQHC job postings in Iowa on the national board right now.11 include employer-posted pay.4 verified employer sources; newest review 2026-07-20.
The official Iowa Workforce Development, Workforce Services Division source was checked 2026-07-15, and the artifact contained 592 official rows. We publish only human-confirmed FQHC directory matches: 0 confirmed and 0 pending.
The row count describes the official artifact, not a count of FQHC layoffs. · Official source
Iowa raised its HMO premium tax from 0.925% to 3.5% and transferred $89M from the General Fund against a projected $167.6M FY2027 Medicaid deficit.
Because Iowa Medicaid is fully managed care, health centers should monitor whether the tax restructuring changes MCO rate negotiations or payment operations.
Primary source · as of 2026-07-14
22 primary-sourced findings on Iowa FQHC policy and financing.Newest item: 2026-07-15
The current Community Health Center Chronicles profile lists the Iowa Primary Care Association as representing 14 community health centers and 99 sites, with the quick facts attributed to Iowa PCA, 2023. The narrative describes the association as comprising 14 community health centers and one migrant health program and says those organizations collectively serve more than 588,000 Iowans through almost 780,000 visits each year.
The profile does not mention the Community Health Center Fund, its amount, or a December 2026 funding deadline; the prior funding-cliff claim was unsupported by this source.
Iowa HHS describes Healthy Hometowns as its Rural Health Transformation Program plan and says Iowa received $209 million in the first year. The page says Iowa could receive $200 million per project year, or $1 billion over five years, only if fully awarded.
Its five initiatives are Hometown Connections, Combat Cancer, Communities of Care, Health Information Exchange, and EMS Community Care Mobile. The page links current funding opportunities, dated updates, award documents, and a public dashboard.
It does not guarantee future-year funding, identify a total FQHC allocation, or support the earlier claim's $66 million/36-facility and $12.6 million/107-organization figures in the page body.
Iowa HHS says certain Iowa Health and Wellness Plan members must meet monthly community-engagement requirements by December 1, 2026 to enroll and maintain coverage. Qualifying activity is at least 80 hours per month of work, volunteer or community service, job training, or education, or earnings of at least $580 per month; activities may be combined.
The page lists exclusions for pregnancy or the 12-month postpartum period, specified caregiving, recent incarceration, treatment, disability or medical frailty, SNAP or FIP work compliance, totally disabled veterans, and American Indian or Alaska Native members. It warns that failure may lead to coverage ending or an application being denied.
The current page does not describe the earlier SF 615 waiver history or quantify affected members.
The Iowa Primary Care Association says it assumed the statewide Behavioral Health Administrative Organization role on July 1, 2025. Its first-year report lists 52,916 calls received, 34 locations with in-person system navigation, and 49 system navigators.
It also reports locally based staff and district advisory councils in all seven behavioral health districts, continued legacy services, and expanded system-navigation, jail-based, and school-based services. The post says year two will emphasize data collection, reporting, priorities, and network adequacy; it does not quantify health-center reimbursement or patient outcomes.
Little Village reports that Planned Parenthood's Iowa City Health Center will close July 31, 2026, leaving the Susan Knapp Health Center in Des Moines as the organization's only Iowa facility offering in-person medical services. Planned Parenthood of the North Central States said uncompensated and undercompensated care was expected to reach $7 million in fiscal 2026 and cited federal and state funding and policy pressures.
The Iowa City site provides pregnancy, prenatal and postpartum, contraceptive, STI, HIV, mental-health, gender-affirming, wellness, preventive, and abortion services. The article does not estimate how many patients will be displaced or establish that Iowa FQHCs or Title X providers will absorb a particular share of demand.
River Hills Community Health Center's June 23 staff update says it opened a Pennsylvania Avenue clinic to care for patients who lost their medical home after two local clinics closed. It says the new location is staffed by two nurse practitioners; the linked location page identifies 921 Pennsylvania Avenue in Ottumwa and names Allison Crall, ARNP, and Megan Griffin, GPCNP-BC, both listed as joining River Hills in 2026.
The update separately says the Centerville Clinic and Richland Dental Clinic are scheduled to close effective July 31, 2026, and that leadership is posting available positions internally first while trying to place as many affected employees as possible. At the July 19 review checkpoint, those two closures are scheduled, not completed.
The sources do not identify the two predecessor clinics, give the Penn clinic's opening date, report affected headcount or completed placements, establish net site or staffing change, or quantify capacity, visits, wait times or outcomes.
Iowa HHS's June 18 release names five Combat Cancer Health Hub awardees: Ottumwa Regional Health Center, Wayne County Hospital, Shenandoah Medical Center, Greater Regional Medical Center, and Mary Greeley Medical Center. It also reports 58 Best and Brightest workforce-recruitment awardees and 42 medical-equipment awardees, with details in separate award documents.
CMS approved Iowa's Graduate Medical Education expansion on June 5, securing about $49.5 million in additional annual federal funding and, once fully implemented, supporting more than 128 additional physicians in training across all 13 teaching hospitals. The release does not state a combined dollar value for the newly announced awards or say that the complete workforce and equipment lists exclude every community health center.
The enrolled SF 2422 adds the federal Systematic Alien Verification for Entitlements service to Iowa's public-assistance verification sources and directs the state to count the income and resources of all household members for SNAP, including members who are ineligible to participate. Effective January 1, 2027, Medicaid eligibility for pregnant women, children, and nursing-facility residents may apply retroactively for no more than two months; the law bars retroactive eligibility for other adults and directs HHS to seek a Section 1115 waiver for no retroactive eligibility for those adults, to be implemented only after federal approval.
The law text does not quantify resulting health-center uncompensated care or coverage churn.
Governor Reynolds's May 3 statement marks the conclusion of the 2026 legislative session and describes SF 2422 as directing Iowa HHS to seek waivers to strengthen SNAP program integrity, comply with the federal reconciliation law, and accept online premium payments from Medicaid members. The statement also summarizes other legislative priorities.
It does not provide the HHS appropriation amount, characterize the Medicaid budget as structurally constrained, or establish that no 340B or FQHC-related measure passed; those earlier assertions have been removed.
KFF's survey of state Medicaid officials, fielded from January through March 2026 and published April 30, reports that Iowa plans to implement work requirements on December 1, 2026, one month before the federal January 1, 2027 start date. It also reports that Indiana and Iowa do not plan to adopt any of the four optional short-term hardship exceptions for high unemployment, natural disasters, hospitalization or nursing-facility admission, and extended travel for medical care.
The article does not provide an Iowa affected-population count, specify an Iowa state-plan-amendment route, or project Iowa health-center losses.
A March 28 report said Waterloo-based Peoples Community Health Clinic planned to open a federally qualified health center in the former MercyOne clinic at 200 Walnut Street in Traer around mid-April. MercyOne had closed the clinic in early December 2025; Tama County had no hospital or urgent-care center.
The Iowa Primary Care Association notified Peoples of the closure on December 10, and Peoples then met with nonprofit building owner North Tama Medical Associates. The article explains that FQHCs provide services regardless of ability to pay, offer sliding fees, and receive enhanced Medicaid and Medicare reimbursement.
It did not confirm that the Traer site had opened by publication or establish that those reimbursement features alone made the site financially sustainable.
Iowa Capital Dispatch reported on March 26 that Governor Reynolds signed HF 2739. The law raises the HMO premium-tax rate from 0.925% to 3.5% retroactively for January 1 through September 30, 2026, and then lowers it to 0.95% beginning in October.
The Medicaid Forecasting Group projected a $90.6 million shortfall in fiscal 2026 and a $167.6 million shortfall in fiscal 2027. The law also transfers $89 million from the general fund to Iowa HHS for Medicaid.
The article reports that insurers warned of possible premium increases; it does not establish an effect on FQHC managed-care rates or attribute the shortfalls to specific enrollment and cost causes.
Iowa Capital Dispatch reports that the state sued NuDak Ventures, doing business as NuCara Specialty Pharmacy, alleging that it failed to make required monthly payments under its Iowa HHS contract and owed more than $22 million generated through the AIDS Drug Assistance Program's 340B arrangement. The state alleged eight months of arrears, use of program income to pay other creditors, and inability to return the money; it terminated the contract March 6.
State Representative Brett Barker, NuCara's vice president of operations, said he had no knowledge of the matter and worked in a separate company division. The cited article does not establish a causal link to a later ADAP waiting list or predict how the lawsuit will change FQHC contract-pharmacy oversight.
Promise Community Health Center's January 30 first-year review says Hope Link served 53 patients in 2025 by creating a pathway to critical medications at no cost. The post emphasizes diabetes treatments, says mental-health medications were added midway through the year, and describes cardiovascular medications as an expected 2026 addition.
It credits the Dispensary of Hope with connecting manufacturer-donated medications to the program and WellPoint with funding medication purchases. The stated $700-to-more-than-$1,000 monthly range describes the cost of some diabetes drugs before Hope Link access, not measured savings for each participant.
The source does not publish eligibility rules, an unduplicated-patient method, medication or fill counts, program spending, diabetes-versus-mental-health subgroup counts, aggregate adherence or A1c measures, or independently measured outcomes; the cardiovascular addition is planned, not realized.
Iowa HHS's January 2026 legislative report says that, as of December 1, 2025, 54 facilities had obstetric units and 43 obstetric units had closed since 2000. It notes that two units closed during 2024.
For 2024 births, the report counts 248 OB-GYN physicians, 243 family-medicine physicians, 106 certified nurse-midwives, and other provider groups; certified nurse-midwives attended 13.8% of births. The report does not say Iowa leads the nation in closures, provide Medicaid-versus-commercial maternity reimbursement rates, connect later federal legislation to additional closures, or quantify demand shifted to FQHCs.
Siouxland Community Health Center's 2025 annual report lists 341 total employees, 59 new employees welcomed, five employees retired and five new providers. It names dentist Anthony Baird, DDS, and nurse practitioners Chelsea Jones, DNP, FNP-C; Tammi Matt, ARNP, FNP-C; Amy Strim, ARNP, CDCES; and David Tillman, FNP-C.
The human-resources section separately says Siouxland introduced a new employee health-insurance plan and raised starting pay from $15 to $18 per hour. These are organization-reported labels; the report does not define an average or year-end headcount, full-time equivalents, exact hire or start dates, whether roles were additions or replacements, departures beyond retirements, net headcount change, retention, turnover, vacancies, which roles receive the starting rate or new plan, provider panels, access changes or outcomes.
December 31 is a reporting-period normalization, not a workforce-event date.
Crescent Community Health Center’s 2025 Impact Report says it launched three specialty service lines: on-site dermatology one day per month through Medical Associates Clinic, digital optometry through Digital Optometrics, and pediatric behavioral-health care by telehealth. The report states that the three lines collectively supported 157 patients through 171 encounters in 2025.
It separately lists 65 dermatology visits, 82 digital eye exams—with 24 patients receiving early intervention or follow-up—and seven pediatric patients across 21 telehealth visits. The component encounter counts total 168 rather than 171; the report does not explain the difference.
It also does not give exact launch dates, staffing or FTE, appointment capacity, comparative wait times, costs or measured clinical outcomes, and visits or exams must not be treated as unduplicated patients.
KCRG reported on December 21, 2025 that the federal Medicaid work requirement would start January 1, 2027, not December 1, 2026 as the prior summary stated. Eastern Iowa Health Center said seven in ten of its patients used Iowa Medicaid and expected about 2,000 unduplicated patients to be affected.
Its CEO said 14% of patients were uninsured and that, if that share doubled, the center stood to lose $3 million in 2027; this was a conditional projection, not an observed loss. The article also said EIHC would continue treating people unable to pay and expected additional demand.
All Care Health Center’s November 26 post says Dr. Miyares joined its dental team full-time in September 2025 and provides care in English and Spanish. A partial dental remodel added one operatory, and upgraded sterilization equipment accompanied the expanded team and clinical space.
All Care reports that these changes enabled it to serve 131 additional dental patients in October. The source does not state an exact remodel-completion or service-opening date, the prior patient baseline, whether the 131 patients were unduplicated, visit volume, other added staffing or FTE, operating hours, project cost, an observed wait-time change or clinical outcomes.
Iowa HHS launched its redesigned Behavioral Health and Disability Services Systems on July 1, 2025. The release says the Behavioral Health Service System offers access to mental-health, substance-use, problem-gambling, and disability support services statewide, including for Iowans without insurance or with limited coverage.
The Iowa Primary Care Association serves as the Behavioral Health Administrative Service Organization and handles administrative tasks, while Your Life Iowa provides 24-hour support and connections to system navigators. The release does not say that 32 former regions were consolidated into seven districts or quantify a resulting increase in FQHC service access.
The Commonwealth Fund analysis was published May 30, 2025 and modeled the version of H.R. 1 passed by the U.S. House on May 22, before enactment of the final federal law.
Across Medicaid-expansion states, it estimated that nearly 5.6 million working-age community-health-center Medicaid patients could lose coverage and that health centers could lose nearly $32 billion in revenue over five years under a high-manual-reporting scenario. The model also reports a lower estimated revenue-loss range beginning near $15.7 billion and assumes that 65% of disenrolled patients continue seeking health-center care while uninsured.
The cited article does not provide the Iowa-specific 14-center or 254,000-patient figures used in the earlier summary, and its estimates should not be presented as outcomes under the final enacted law.
The Legislative Services Agency's March 28, 2025 fiscal note estimated that approximately 32,000 people might lose Iowa Health and Wellness Plan coverage under the then-pending SF 615 work-requirement design. The estimate began with about 181,000 January 2025 enrollees, assumed about 158,000 were not medically exempt, assumed another 10% would qualify for bill exemptions, and applied Arkansas-derived assumptions that 24.8% of remaining people might fail work or reporting requirements and 10.5% of those losing coverage might regain it.
The note says HHS did not respond to multiple information requests and assumes federal approval. It does not support a December 1, 2026 start date or Iowa's later decision on optional hardship exceptions.
By patients (HRSA UDS 2024). Tap for the full profile.
| Organization | Patients | Sites | Uninsured | Revenue (990) | Resilience | District |
|---|---|---|---|---|---|---|
| Community Health Care, Inc. Davenport | 48,477 | 17 | 12.16% | $51M | Watch | IA-01 |
| Primary Health Care, Inc. Des Moines | 40,335 | 18 | 36.94% | $61M | Watch | IA-03 |
| Siouxland Community Health Center Sioux City | 34,745 | 4 | 17.97% | $54M | Stable | IA-04 |
| River Hills Community Health Center, Inc. Ottumwa | 21,850 | 32 | 17.25% | $30M | Stable | IA-03 |
| Community Health Centers of Southeastern Iowa Inc. West Burlington | 20,358 | 4 | 9.52% | $29M | Stable | IA-01 |
| Peoples Community Health Clinic, Inc. Waterloo | 17,998 | 4 | 21.94% | $25M | Stable | IA-02 |
| Eastern Iowa Health Center Cedar Rapids | 16,164 | 7 | 19.62% | $18M | Exposed | IA-02 |
| Community Health Center of Fort Dodge, Inc. Fort Dodge | 14,472 | 6 | 22.36% | $13M | Watch | IA-04 |
| Crescent Community Health Center Dubuque | 10,993 | 7 | 22.01% | $23M | Watch | IA-02 |
| Infinity Health Leon | 9,593 | 21 | 7.93% | $17M | Stable | IA-03 |
| District | Representative | Sites |
|---|---|---|
| IA-03 | Zachary Nunn | 51 |
| IA-01 | Mariannette Miller-Meeks | 32 |
| IA-04 | Randy Feenstra | 28 |
| IA-02 | Ashley Hinson | 19 |
Iowa ranks #33 by FQHC patients and #36 by organization count among the 57 national-breadth jurisdictions. All 14 centers depend on the federal Community Health Center Fund, authorized only through December 31, 2026.
State flywheel
Turn this state read into a directory scan, peer comparison, national context, or a recurring update habit.
Provider map
Iowa directory
Scan all 14 organizations and 30 ATS snapshot rows from 4 public career sources.
State Lab
Compare Iowa
Put this state next to peers and see what changes in expansion, payer mix, and funding risk.
Context
National overview
Zoom out to the expansion divide, CHC Fund cliff, and national operating picture.
Retention
Get weekly updates
Choose your state and role so future briefs start with the changes that matter to you.
FQHC data from the HRSA bulk-sites file + UDS 2024 + IRS 990. State policy profile via NACHC/KFF/AANP. Intelligence items cite primary sources. Federal items apply to all states; state items are Iowa-only. Updated 2026-06-30.