A state audit has found twice as many people as expected enrolled in a state health care program for low-income Iowans and the audit raises questions about the way the program is administered.   

The IowaCare program is for low-income Iowans between the ages of 19 and 64 who do not qualify for Medicaid.  About 14,000 people were expected to enroll in the program, but as of June 30, 2009, nearly 32,000 people were enrolled in IowaCare to get their health care.

The audit reviewed 75 applications for the insurance assistance. The audit found seven of the applications appeared “questionable” and two of the files did not include “proof of citizenship.” And two of the applicants had access to health care coverage through their employer, and the paper work didn’t explain why they were enrolled in the government-paid program. 

Among the auditors recommendations:  better bookkeeping and a premium increase for people who’re enrolled in the program. IowaCare recipients do pay a premium based on their income.  

State Auditor Dave Vaudt also questions the “hardship waivers” which allow IowaCare recipients to get the coverage, without paying the premium.  Vaudt says the program was designed so that IowaCare recipients would have “shared” financial responsibility and granted long-term “hardship waivers” violates the spirit of the program.