Iowa secured a temporary, one-year waiver of NEMT and was required to evaluate the impact of the waiver on access to care (CMS 2014b). In its September 2014 request to continue the exclusion in year two, the state reported that enrollees are using services and therefore access has not been affected without NEMT. Even so, almost half (between 42 and 49 percent) of enrollees needed assistance, either from a friend or family member or through public transportation, to get to a health care visit in the last six months, and between 8 and 18 percent always needed assistance.



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