Overview
Iowa has been active in introducing state market initiatives as part of the state’s healthcare reform efforts. In 2019, legislators pursued a bill establishing a single-payer system for the state. The proposed system, called the Healthy Iowa Program, would have provided comprehensive universal single-payer healthcare coverage and a healthcare cost control system for the benefit of all residents of Iowa. In another notable effort, the state pursued an act in 2018 that would establish a public option for Iowa residents by implementing a state-run Medicaid program. This plan would have allowed Iowans to pay a premium to the state and get the same coverage as Medicaid patients. Although unsuccessful in their respective sessions, Iowa’s latest attempts at state-level reform can be seen as laying the groundwork for future efforts.
To control healthcare costs, Iowa protects consumers from some surprise medical bills by requiring insurers to cover all charges provided to an enrollee for emergency services, including those provided by out-of-network professionals and facilities. Additionally, Iowa’s telehealth law provides coverage parity, requiring insurers to provide the same level of coverage for telemedicine as in-person visits.
In the provider market, Iowa has limited oversight of certain non-profit corporations by requiring court approval for public benefit or religious corporations prior to a merger with a for-profit corporation. In 2020, Iowa’s certificate of need law, which requires healthcare providers to obtain state approval before opening a new facility, survived a legal challenge in the 8th Circuit after being attacked as anticompetitive and unconstitutional.
See below for an overview of existing Iowa state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).
State Action
Latest Legislative Session: 1/9/2023 - 5/17/2023 (2023-2024 term). *Current session bill updates are ongoing. Check back weekly for updates.
HB 2408 (see companion bill SB 2238) – Iowa
Introduced: 2024 Status: In Process
A bill for an act relating to prescription drug affordability, including the creation of a prescription drug affordability board.
HB 93 (formerly known as HSB 8) – Iowa
Introduced: 2023 Status: In Process
An Act prohibiting specified provisions (limitations on competition) in agreements between employers and certain mental health professionals and including effective date provisions.
HF 13 (replaced by HF 144) – Iowa
Introduced: 2023 Status: Inactive / Dead
A bill for an act relating to rural emergency hospitals, including licensing requirements and fees, making penalties applicable, providing emergency rulemaking authority, and including applicability and effective date provisions.(See HF 144.)
HF 135 – Iowa
Introduced: 2019 Status: Inactive / Dead
A bill for an act relating to long-term services and supports and certain capitation rates under the Medicaid program, and including effective date provisions.
HF 144 (replaced HF 13) – Iowa
Introduced: 2023 Status: In Process
A bill for an act relating to rural emergency hospitals, including licensing requirements and fees, making penalties applicable, providing emergency rulemaking authority, and including applicability and effective date provisions.(Formerly HF 13.)
Iowa Code § 148C.4. Services performed by physician assistants: Physician Assistants – Iowa
Introduced: Status: Enacted
A physician assistant may provide any legal medical service for which the physician assistant has been prepared by the physician assistant’s education, training, or experience and is competent to perform.
Download
Iowa Code § 155A.13. Pharmacy license: Iowa Pharmacy Practice Act – Iowa
Introduced: Status: Enacted
The board shall adopt rules for the issuance of a special or limited-use pharmacy license to a telepharmacy site.
Download
Iowa Code § 155A.28. Label of prescription drugs — interchangeable biological product list: Iowa Pharmacy Practice Act – Iowa
Introduced: Status: Enacted
The board shall maintain a link on its internet site to the current list of all biological products that the United States food and drug administration has determined to be interchangeable biological products.
Download
Iowa Code § 155A.3. Definitions: Iowa Pharmacy Practice Act – Iowa
Introduced: Status: Enacted
If an authorized prescriber prescribes a biological product, the pharmacist may exercise professional judgment in the economic interest of the patient by selecting a biological product that is an interchangeable biological product for the biological …
Download
Iowa Code § 155A.33. Delegation of technical functions: Iowa Pharmacy Practice Act – Iowa
Introduced: Status: Enacted
The board shall adopt rules for the issuance of a special or limited-use pharmacy license to a telepharmacy site.
Download
Pharm. Care Mgmt. Ass’n v. Gerhart – Iowa
District Court: Southern District of Iowa Status: Decided
Trade association representing pharmacy benefits managers (PBM) brought action against State of Iowa, seeking declaration that statute that regulated how PBMs established generic drug pricing …
United States et al. v. Anthem, Inc., and Cigna Corp. – California, Colorado, Connecticut, District of Columbia, Federal, Georgia, Iowa, Maine, Maryland, New Hampshire, New York, Tennessee, Virginia
District Court: District of Columbia Status: Decided
On April 28, 2017, the D.C. Circuit Court of Appeals affirmed the District Court’s decision to block the proposed $54 billion merger between Anthem and …
Federal Trade Commission and State of Idaho v. St. Luke’s Health System, Ltd and Saltzer Medical Group, P.A. – California, Connecticut, Delaware, Idaho, Illinois, Iowa, Kentucky, Maine, Maryland, Mississippi, Montana, Nevada, New Mexico, Oregon, Pennsylvania, Tennessee, Washington
District Court: District of Idaho Status: Decided
In March 2013, the FTC and the Idaho Attorney General filed a joint complaint challenging the merger betweenSt. Luke’s Health System, Idaho’s largest health system, …
In re: Suboxone Antitrust Litigation (State of Wisconsin, et al. v. Indivior Inc, et al.) – Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin
District Court: E.D. Pennsylvania Status: Pending
In September 2016, 35 state attorneys general and the District of Columbia brought a multi-district case against pharmaceutical manufacturer Indivior, MonoSol RX et al., alleging …
In Re: Generic Pharmaceuticals Pricing Antitrust Litigation – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from 48 states, Puerto Rico, and the District of Columbia, as well as classes of private plaintiffs that filed an antitrust …
Additional Resources
STATE BUDGET
Iowa’s fiscal year begins July 1st and ends June 30th of the following year. To view Iowa’s budget bill and information by agency, click here.
REGULATION & ENFORCEMENT
- Iowa was one of 16 states to file an amicus brief supporting the FTC’s winning position in the Ninth Circuit appeal of St. Luke’s Health Care Sys. v. FTC, No. 14-35173 (March 7, 2014), decided February 10, 2015. The States’ brief stated that the acceleration of health care costs due to the growth of large health care provider systems had become a matter of grave concern for the states.
KEY RESOURCES