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Iowa names new Medicaid director as work requirements, spending cuts set to kick in
Appointment comes as Iowa adjusts to Medicaid spending cuts and eligibility changes
Jul. 31, 2025 2:09 pm, Updated: Aug. 4, 2025 2:02 pm
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Iowa's Department of Health and Human Services has appointed Wyoming Department of Health administrator Lee Grossman as the new director of Iowa Medicaid.
According to Iowa HHS, Grossman is an Iowa native who brings more than 14 years of experience from the Wyoming Department of Health, where he has served as Medicaid Director there since February 2023.
Grossman will begin his new role in early September, according to a news release.
Iowa Medicaid provides health coverage to more than 700,000 Iowans -- including children, low-income individuals, pregnant women, older adults and people with disabilities -- and operates with a budget of nearly $7 billion.
Grossman's appointment comes as new state and federal work requirements and eligibility changes are set to kick in.
Iowa HHS Director Kelly Garcia, in a statement, praised Grossman's leadership, expertise and commitment to rural health care access.
“I’m thrilled to welcome Lee back home to Iowa as he steps into this role,” Garcia said. “His leadership and invaluable expertise make him an ideal fit to guide our Medicaid team through this critical work at this critical time. As I’ve had the pleasure of getting to know Lee, what I see is deep Medicaid knowledge, a steady hand and a clear commitment to the people this program supports. Lee’s knowledge of building rural health care access will be an attribute perfectly focused for this moment.”
Grossman was selected following a comprehensive nationwide search launched following the departure of Elizabeth Matney in November of 2024. Matney was appointed as Iowa’s Medicaid director in April 2021. She also served as HHS chief operating officer and deputy director, and has since opened her own consulting business, Andeli Consulting.
Rebecca Curtiss has been serving as interim Iowa Medicaid Director.
Matney received a base salary of $183,851 at the end of the 2024 fiscal year, the most recent year for which records were readily available, according to the State Employee Salary Book. Curtiss received a base salary of $149,635 at the end of the same fiscal year as an HHS deputy administrator.
Grossman will be paid an annual salary of $217,173, according to HHS.
Grossman, in a statement, said: “It’s an honor to return to the state where I grew up and contribute in such a meaningful way. I look forward to working with this team that’s deeply committed to helping thousands of Iowans live healthier lives in the community of their choice.”
State and federal lawmakers this year have passed several changes to the joint federal and state program, impacting eligibility and requiring many recipients to work to keep their health care coverage.
Federal Medicaid spending will be reduced by $911 billion over the next 10 years under legislation passed by the Republican-led Congress and signed into law by President Donald Trump, according to the nonpartisan Congressional Budget Office.
Republicans contend that Medicaid spending will still grow over the next 10 years, and claim that recent expansions have made it harder for medical practices to accept new Medicaid patients and led to an unsustainable spending trajectory. They say the reforms will help focus resources on those who genuinely need assistance, improving access to care and ensuring Medicaid’s long-term financial stability.
An analysis by health policy organization KFF projects Iowa will see a decrease in federal Medicaid spending by $7 billion to $12 billion over the next decade.
The law requires able-bodied childless adults between the ages of 19 and 64 enrolled in Medicaid through the Affordable Care Act's expansion to prove they're either working, in school, or doing community service for 80 hours a month, unless they qualify for exceptions. Iowa has passed its own work requirement law, although it's unclear how the passage of the federal law will affect Iowa's law.
Experts caution that spending cuts may harm rural hospitals, despite a $50 billion stabilization fund for them.
Additionally, Iowa HSS is in the second year of “significant agency consolidation” as a “lifespan services agency and the State’s largest in both budget and number of employees,” according to a state job posting of the position.
“This new system design positions Medicaid in a cornerstone role beyond its foundational capacity as a major insurer in the state, to drive key population health outcomes and significant impacts to rural healthcare access, maternal health, and behavioral health system design,” according to the posting. “Iowa Medicaid is leading significant transformational efforts, including the launch of a redesigned home and community-based services waiver structure, and a co-designed model to launch” Certified Community Behavioral Health Clinics — a clinic model focused on providing comprehensive, coordinated and accessible behavioral health services to individuals and families.
CCBHCs are designed to improve access to care for mental health and substance use disorders, regardless of a person's ability to pay or where they live.
Comments: (319) 398-8499; tom.barton@thegazette.com
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