When Republicans took control of the Iowa House of Representatives in 1993, one of the biggest challenges facing them was the growing expense of the state’s welfare program. The cost of this public assistance program that year was $163,050,000 in state and federal funds. In April 1994, Iowa’s welfare caseload hit a peak of 40,659 families, receiving an average of $356 a month in benefits. The total amount of state and federal funds spent on welfare in that month was almost $14.5 million. Something had to be done to help Iowans get onto the employer’s payrolls and off of the welfare rolls.


Republicans recognized in 1993 that the state had to change its welfare program. Over the next two years, Iowa’s welfare system was dramatically reformed. Families signing up for assistance from the new Family Investment Program (FIP) entered into a written agreement with the state outlining the family’s needs, what job training supports will be provided, what actions the family will take and the time frame to be met so that the family can become financially self-supporting. This plan, known as the Family Investment Agreement, had to be worked out between the family and the state before assistance would be provided. Remaining eligibility for FIP assistance was contingent on meeting the conditions of the Family Investment Agreement.


The centerpiece of the new program was an emphasis on work. The FIP program imposed work requirements on most adults participating in the program. This was a change in welfare policy, and served as the model for the federal welfare reform legislation that became law in 1996.


It’s one thing to say people on welfare need to work. It is another thing to help them become part of the workforce, and that was another key component of Iowa’s welfare reform efforts. In addition to creating FIP, the state also created the Promise Jobs program to provide the work-training necessary to help these Iowans reach self-sufficiency. Promise Jobs provided FIP participants with a variety of skills training efforts, up to assistance with post-secondary education. A key component of Promise Jobs are Iowa’s community colleges, who have seen their funding in the past nine years rise by 31 percent.


Iowa’s efforts to transform its welfare program into a pathway to self-sufficiency began to have immediate success. Within five years of its passage, the average yearly enrollment had fallen from almost 39,000 families to under 23,000 in 1999. Even with temporary upticks in enrollment during recessions in the 2000’s, the number of Iowa families relying on this program for assistance has continued to decline. In Fiscal Year 2018, the average number of families on the program had fallen to 8,721 – just 22 percent of the FY 1994 figure.


It is hard to argue that Iowa’s welfare reform initiative, started in the mid-1990s, has been anything but a success. As more Iowans have moved back into the workforce, thanks to a commitment to skills training, the state has increased its support of working families through child care assistance. The Family Investment Program continues to be a great example to rest of the nation of how to help families become integral parts of the American economy.


Rural health care


Iowa is in need of physicians, especially in rural areas. According to the Association of American Medical Colleges, Iowa ranked 46th in 2016 for the total number of physicians active in patient care per 100,000 people.


The legislature is working on addressing this issue by bolstering two scholarship funds in the Education Budget this year. Both the Rural Primary Care Loan Repayment program and the Health Care Loan Repayment program were given increases, with the goal to provide more doctors and nurses the opportunity to be placed in in-need rural areas in the state in exchange for repayment on their school loans.


The Rural Primary Care Loan Repayment program provides loan repayment to medical students who agree to practice in an in-need rural area for at least five years. It was created in 2012 and funded for the first time in 2014. This year it received a $300,000 increase, taking the total amount from $1.13 million $1.43 million. The program currently funds about 42 doctors and the new funds, over time, would help place another seven doctors in these areas. Under the program, doctors receive $40,000 per year for five years, totaling $200,000 in loan repayment.


The Health Care Loan Repayment program is a similar program for advanced registered nurse practitioners, physician assistants or registered nurses working full-time in an in-need rural area. The fund was funded for the first time last year at $200,000, and will receive a $50,000 increase to $250,000 for next year. Under the program, recipients can receive up to $6,000 per year for a five-year commitment, totaling $30,000 in loan repayment.


For more information on these programs, visit:


- Rural Primary Care Loan Repayment: https://www.iowacollegeaid.gov/RuralIowaPrimaryCareLoanRepaymentProgram


- Health Care Loan Repayment: https://www.iowacollegeaid.gov/HealthCareLoanRepaymentProgram


If you have any questions or concerns, please contact me.


Home phone: 515-382-2352


E-mail: Dave.Deyoe@legis.iowa.gov