Under the Golden Dome
Final Legislative Update
May 16, 2025
After a marathon 22-hour session, the 2025 legislative session finally ended on Thursday, May 15 at 6:30 a.m. almost two weeks after the statutory deadline. On an interesting note, in legislative time, it was still technically May 14 as the two chambers never adjourned. Either way, I’m just glad it’s over! Your intrepid lobbyist is not a big fan of working without sleep!
While it’s not unusual for the governor, Senate, and House to struggle to reach a budget agreement despite being in the same party, things were complicated this year by the carbon pipeline. Twelve Republican senators said they would not vote for any budgets on the Senate floor until they had a vote on a “clean” eminent domain bill that restricted its use by carbon pipelines. That position created drama rarely seen in public. Veteran lobbyists cannot remember a time when members of the same party (in this case Republican) attacked each other on the floor for their position on this legislation. This is a rare instance in which a bill passed a chamber without the majority of the majority party in support. Fourteen Democrats joined 13 Republicans to pass the legislation, paving the way for budget votes.
The legislature came in with a promise to address property taxes but attempts to find a solution that did not create “winners and losers” ultimately failed. After multiple versions, both chambers determined they would not have the support for a bill that would shift some of the property tax burden onto homeowners. This occurred because of the elimination of the residential rollback. Even with limits on city and county revenue generation and a larger homestead tax credit, this still created a large inequity between residential properties compared to ag land and commercial properties. Expect this issue to return for the 2026 legislative session.
The HHS budget bill did include policy language, some of which was eliminated and some which was modified. The original House version included language from two bills that passed that chamber. These bills would have allowed an ARNP or PA to testify at a commitment hearing on a mental health providers evaulation of a patient and would have required a comprehensive discharge plan for someone who had been involuntarily committed. Neither provision survived negotiations.
The original Senate proposal had language that would have prohibited the use of Medicaid funds for any treatment for an individual diagnosed with gender dysphoria. The final version modified this language to clarify that counseling treatment, regardless of the reason for the counseling, was excluded from this prohibition.
A full listing of bills on which IMHCA engaged this year is available in our bill tracker. Here’s a brief synopsis of the highlights
HF 303 – This bill changes prior authorization requirements by setting specific deadlines for determinations on requests and doing a review annually to eliminate unnecessary prior authorization requirements.
HF 875 – This bill requires an insurer to respond to a credentialing request within 56 days and to provide a written reason if the request is denied.
HF 972 – This bill combines the five health care loan repayment programs into a health care professional incentive program. A total of $8 million is provided through the education budget bill. This is a $300 million increase over the combined funding for all five programs. HHS will develop the rules to implement the new program.
SF 418 – This bill removes gender identity as a protected class under Iowa’s Civil Rights code. Governor Reynolds signed the bill into law on February 28.
SF 659 – This is the standings appropriation bill and includes two provisions of interest to IMHCA members. First, the bill includes language from that would declassify psylocibin as a controlled substance once the FDA approves it as a prescription drug for the treatment of mental health issues. Second, the bill recommends an interim study committee on subacute care and how to best deliver these services. The legislative council must approve any interim study council.
SJR9 – This is a constitutional amendment to allow a child or those with intellectual or developmental disabilities or mental illness to testify remotely. The amendment must be passed in the next general assembly (beginning in 2027) and then on the ballot in 2028.
Full Bill Tracker
HF13 Annual Automatic Increases in Medicaid Provider Reimbursement Rates
House File 13 establishes a system for annual automatic increases in the reimbursement rates for Medicaid providers in Iowa. The Department of Health and Human Services is required to adjust the reimbursement rates every July 1, applying either the percentage increase in the consumer price index for the Midwest region or a 2.5% increase, whichever is lower. This measure aims to ensure that Medicaid providers receive fair compensation that reflects inflation and cost of living adjustments. The bill overrides any existing laws regarding inflation factors or indexing of these rates, thereby streamlining the process for annual adjustments. This initiative is intended to support the sustainability of Medicaid services and providers in the state.
Registration: For
Status: Died 1st Funnel
HF61 Health Services Price Transparency Act
House File 61 requires health care providers to disclose the prices for the twenty-five most common health services they offer, while hospitals must disclose prices for the seventy-five most common inpatient and outpatient services. This information must be made available in a single document on their websites and updated regularly. The price disclosures are to be provided prior to any discounts and assume no medical complications. Additionally, a disclaimer must accompany the price information, clarifying that the prices are estimates and may vary based on individual circumstances. The legislation aims to improve consumer awareness and facilitate informed decision-making regarding health care services.
Registration: Undecided
Status: Died 1st Funnel
HF80 Prohibition of Disciplinary Actions for Name and Pronoun Usage in Schools
House File 80 aims to protect the rights of employees, contractors, and students in Iowa’s school districts and charter schools by prohibiting disciplinary actions related to the use of legal names and the failure to use personal pronouns. The bill ensures that individuals can address others using their legal names as listed in school records without fear of punishment. Additionally, it allows individuals to refrain from disclosing or using personal pronouns in official communications without facing disciplinary measures. Violations of this legislation can lead to civil actions, including reinstatement and damages for affected employees. The bill defines ‘disciplinary action’ broadly, encompassing various forms of punishment, including termination and suspension.
Registration: Against
Status: Died 1st Funnel
HF303 Prior Authorization Reform and Exemption Program in Health Benefit Plans
This legislation amends Iowa law concerning prior authorization and utilization review organizations. It sets specific deadlines for determinations on prior authorization requests, mandates acknowledgment of receipt, and requires annual reviews to eliminate unnecessary prior authorization requirements. The bill also mandates annual reporting requirements to the commissioner, including data on approval/denial rates, processing times, and the impact of eliminating prior authorizations. Finally, it stipulates that complaints against utilization review organizations are to be directed to the insurance division and are not considered public records.
Registration: For
Status: Passed both chambers, awaiting governor’s signature
HF383 Legislation to Reschedule Crystalline Polymorph Psilocybin
This Iowa House File 383 addresses the rescheduling of crystalline polymorph psilocybin, specifically COMP 360, upon FDA approval. It mandates the immediate removal of the drug from Schedule I controlled substances in Iowa once it receives FDA approval. The rescheduling will align with FDA recommendations and federal guidelines. Following rescheduling, the bill legalizes the prescription, distribution, and marketing of the pharmaceutical composition of crystalline polymorph psilocybin.
Registration: Undecided
Status: This language was included in the standing appropriations bill, SF 659 – Emily Piper
HF385 Legislation on Discharge Procedures for Involuntarily Committed Persons
House File 385 introduces significant changes to the discharge process for individuals involuntarily committed for mental health treatment. It mandates that facilities refer discharged individuals to administrative services organizations for evaluation and postdischarge services, assess suicide risk, and provide a 15-day supply of prescribed medications. Additionally, a comprehensive discharge report must be provided, detailing follow-up appointments and aftercare plans. The legislation aims to ensure continuity of care and support for individuals transitioning out of treatment, thereby addressing potential risks associated with discharge.
Registration: Undecided
Status: Died
HF509 Hawki Coverage Expansion for Autism Treatment and Program Repeal
House File 509 introduces significant changes to the autism support program in Iowa. It prohibits the Department of Health and Human Services from approving new applications for the program after July 1, 2025, while allowing continued treatment for those already enrolled until the program’s repeal on July 1, 2027. The bill also mandates the inclusion of applied behavior analysis services for autism treatment in qualified child health plans. Additionally, any remaining funds in the autism support fund upon repeal will be transferred to the Hawki trust fund. These changes aim to streamline autism treatment coverage under the Hawki program while phasing out the existing support program.
Registration: For
Status: Died 2nd Funnel
HF573 Amendments to Involuntary Commitment Procedures for Substance Use Disorders
House File 573 amends Iowa law regarding involuntary commitment proceedings for individuals with substance use disorders or mental health issues. It enables peace officers to take respondents into custody across county lines for placement in treatment facilities, and mandates law enforcement involvement when a committed individual leaves a facility without authorization. The bill also refines the application process for involuntary commitment, ensuring clerk assistance to applicants. These changes aim to improve the process of ensuring individuals receive court-ordered evaluations and treatments and ensures they are returned to care if they leave treatment without authorization.
Registration: Undecided
Status: Signed by Governor
HF602 Iowa Bill for Minor Witness Testimony via Closed-Circuit Equipment
House File 602 amends existing law to enable courts to take testimony from minor witnesses in a separate room, away from the physical presence of the defendant. This is intended to reduce trauma that may impair the minor’s ability to communicate effectively. The testimony will be transmitted to the courtroom via two-way, closed-circuit equipment, ensuring both audio and video feeds are available for viewing. The bill specifies that such measures can only be implemented upon a court’s specific finding of necessity for the minor’s protection. The presence in the room with the minor during testimony is limited to essential personnel and individuals deemed beneficial to the minor’s welfare.
Registration: For
Status: Died 2nd Funnel
HF875 Health Insurers’ Credentialing Process Amendments
Iowa House File 875 amends section 514F.6 of the Iowa Code, modifying the credentialing process for health insurers. The bill mandates health insurers to respond to credentialing requests from physicians, advanced registered nurse practitioners, or physician assistants within 56 calendar days. Additionally, it requires insurers to provide a written explanation for any denial of a credentialing request. The legislation renumbers a section regarding definitions, and does not change any of the definitions themselves.f
Registration: For
Status: Signed by Governor
HF968 Standardization of Licensure Fees in Iowa
House File 968 mandates the Department of Inspections, Appeals, and Licensing to consult with various state entities to propose standardized licensure fees for different tiers of licenses. The department is required to submit a regulatory analysis of the proposed rules within 18 months of the bill’s effective date, ensuring that the fees are uniformly applied across applicable licenses. This initiative is part of a broader effort to streamline the licensure process and enhance regulatory efficiency in Iowa.
Registration: Undecided
Status: Died
HF978 Iowa Psilocybin Production and Administration Act
House File 978 establishes a comprehensive regulatory framework for the medical use of psilocybin in Iowa. It defines key terms, creates a licensing board, and sets forth requirements for psilocybin production establishments, qualified medical psilocybin providers, and qualified therapy providers. The bill includes provisions for inventory control, criminal background checks, and an electronic verification system to track psilocybin recommendations. It also protects providers from federal penalties and includes non-discrimination provisions for patients. The Department of Health and Human Services is tasked with conducting a study on other psychedelic compounds, and adopting rules pursuant to chapter 17A to allow for the production and sale of consumable goods containing psilocybin and psilocybin product. Finally, the bill ensures that contracts related to psilocybin production, sale, and administration are enforceable under state law.
Registration: Watching
Status: Died
HF1049 FY2026 Health and Human Services and Veterans Affairs Appropriations Act
House File 1049 appropriates funds for the Department of Veterans Affairs and the Department of Health and Human Services for the fiscal year 2025-2026. It covers a wide range of services including veteran affairs, aging and disability services, behavioral health, public health, community access and eligibility, medical assistance, and family well-being programs. The bill allocates funds from both the general fund and federal grants, such as TANF, to support these initiatives. Key provisions include funding for the Iowa Veterans Home, elder abuse prevention, substance use disorder treatment, Medicaid reimbursement, child protective services, and state-operated specialty care facilities. The legislation also addresses reimbursement rates for various healthcare providers, nursing facility payment methodologies, and personal needs allowances for individuals in long-term care. Additionally, it establishes a framework for a hospital directed payment program and modifies the allocation of beer and liquor control fund revenues to support behavioral health initiatives.
Registration: Undecided
SCR3 Resolution Rejecting Obergefell v. Hodges and Advocating for States’ Rights on Marriage
This concurrent resolution expresses the Iowa General Assembly’s rejection of the Supreme Court’s decision in Obergefell v. Hodges, which legalized same-sex marriage nationwide. It argues that the decision is at odds with the Constitution and the principles upon which the United States was founded, asserting it undermines the concept of individual freedom and state’s rights. The resolution advocates for restoring the authority to regulate marriage to the states and calls upon the Supreme Court to reverse its decision, reinstating the traditional definition of marriage. It also requests that copies of the resolution be distributed to the Supreme Court of the United States.
Registration: Against
Status: Died
SF418 Iowa Senate File 418: Regulation of Sex and Gender Terminology in Law
Senate File 418 aims to clarify the definitions of sex and gender within Iowa law, asserting that ‘sex’ refers strictly to biological classifications of male and female as determined at birth. The bill removes references to gender identity in various legal contexts, thereby reinforcing traditional definitions of gender roles and relationships. It mandates that vital records reflect these definitions and prohibits discrimination based on sex while maintaining separate accommodations based on biological sex. The legislation also restricts educational curricula related to gender theory for younger students, emphasizing a biological understanding of sex over gender identity. Overall, the bill seeks to align state law with a specific interpretation of sex and gender, potentially impacting various sectors including education and healthcare.
Registration: Against
Status: Signed by Governor
SF474 Legislation on Youth Services and Behavioral Health Evaluations
Senate File 474 comprehensively amends Iowa law relating to services and support for youth involved in juvenile delinquency and child in need of assistance proceedings. The bill updates terminology, expands definitions, and modifies licensing requirements for psychiatric medical institutions for children. It revises the process for physical assessments and behavioral health evaluations, emphasizing outpatient services and parental notification. The bill also changes administrative oversight of juvenile court services and suspends HAWKI eligibility for inmates of public institutions, while ensuring benefit restoration upon discharge. Finally, the legislation addresses the use of protective locked environments in residential facilities and aims to enhance the interplay of youth systems, services, and supports.u
Registration: Undecided
Status: Signed by Governor
SF484 Expansion of Hawki Coverage for Applied Behavior Analysis Services
Senate File 484 proposes to amend existing law to add coverage for applied behavior analysis services for children under the Hawki program. The bill mandates the Department of Health and Human Services to submit a state plan amendment to the Centers for Medicare and Medicaid Services for approval. It also requires the medical assistance advisory council to adopt rules that ensure these services are included as a benefit in qualified child health plans. This initiative is intended to enhance access to necessary behavioral health services for children, aligning with federal regulations under Title XXI of the Social Security Act.
Registration: For
Status: Died 2nd funnel
SF583 Iowa School Safety Enhancement Act
Senate File 583 aims to bolster school safety by facilitating information sharing and establishing multidisciplinary school safety assessment teams. It mandates covered entities and schools to share necessary records and information about students at risk or posing a threat when acting as part of a safety assessment team. The bill enables the creation of multidisciplinary teams in school districts and accredited nonpublic schools, allowing them to coordinate resources and intervene in potential threat situations. Furthermore, it provides immunity to those acting in good faith to report or investigate threats, and it allows for the sharing of juvenile court and state court administrator records under specific conditions to ensure student safety.
Registration: For
Status: Signed by Governor
SF626 Iowa SF626: Federal Block Grant Appropriations and City Regulation Amendments
Senate File 626 appropriates federal funds to various Iowa departments and agencies for the fiscal years 2025-2026 and 2026-2027. The bill allocates moneys from federal block grants for programs related to substance abuse, mental health, maternal and child health, community services, and community development. It sets specific spending requirements and limitations for these funds, including administrative expenses and program allocations. Additionally, the bill amends city regulations regarding restrictions on developers and contractors, permitting such restrictions only when mandated by federal law. The legislation also outlines procedures for adjusting appropriations if federal funding levels change and designates numerous state entities as recipients of federal and nonstate funds.
Registration: Undecided
Status: Awaiting Governor’s Signature
Senate File 641 addresses various aspects of the Department of Health and Human Services’ responsibilities, including administrative services organizations, child foster care, abuse prevention, internal audits, and healthcare funding. It refines definitions and processes related to mental health services and child welfare, emphasizing the role of kinship caregivers and individual licensees. The bill enhances training requirements for foster parents, modifies confidentiality rules, and strengthens financial oversight in cases of dependent adult abuse. Furthermore, it ensures internal audits adhere to professional standards and allocates funds for the transition to a new behavioral health services system. Finally, the legislation clarifies health maintenance organization premium tax rates.
Registration: Undecided
Status: Awaiting Governor’s Signature
Senate File 647 provides appropriations to Iowa’s education system for the fiscal year 2025-2026, covering the Department for the Blind, Department of Education, and State Board of Regents. It allocates funds to various educational programs, including early childhood services, career and technical education, student achievement initiatives, and STEM programs. The bill establishes a court reporter equipment grant program and modifies existing tuition grant programs by creating new funds and transferring existing moneys. Furthermore, it amends sections related to college student aid commission programs, ensuring that interest or earnings on fund moneys can be used for program administration.f
Registration: For
Status: Awaiting Governor’s Signature
SJR9 Iowa Constitutional Amendment on Witness Confrontation Rights
Senate Joint Resolution 9 proposes a constitutional amendment to the Iowa Constitution, modifying Article I to include Section 10A, entitled “Protection of children and other witnesses.” This amendment would allow the state to limit the right of an accused to confront child witnesses under the age of eighteen, as well as witnesses with mental illnesses, intellectual disabilities, or other developmental disabilities. This aims to protect vulnerable witnesses during legal proceedings. The proposed amendment will be presented to the next general assembly and published before the election.
Registration: For
Status: Passed both chambers; Needs to pass both chambers again next session