All Roll Calls
Yes: 108 • No: 122
IowaHF 273991st General Assembly (2025–2026)HouseWALLET
A bill for an act relating to state finances by modifying the taxes imposed on health maintenance organizations, making transfers from the taxpayer relief fund, making and supplementing appropriations to the department of health and human services, and including effective date, contingent effective date, and retroactive applicability provisions. (Formerly HSB 762.) Contingent effective date, effective 03/25/2026, 07/01/2026. Applicability date: 01/01/2026.
Sponsored By: COMMITTEE ON WAYS AND MEANS
Signed by Governor
appropriations
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 2 benefits, 0 costs, 3 mixed.
Budget transfer and caps on later transfers
The law transfers $347,013,889 from the taxpayer relief fund to the state general fund. For FY 2026, the general fund spending limit includes 100% of this transfer. For FY 2027 and FY 2028, transfers from the taxpayer relief fund are capped at 50% of the gap between the adjusted revenue estimate and the net general fund appropriation. Starting in FY 2027, when a transfer is expected, the state raises the spending limit by the amount expected to be transferred.
Extra $89 million for Medicaid care
The state provides $89 million for Medicaid for July 1, 2025–June 30, 2026. The money supports reimbursements and related costs. Any unused funds stay available through the end of the next year.
Insurer credits for assessment payments
Insurers can credit 20% of certain assessment payments against their premium or health care-related taxes each year for five years. If an insurer stops doing business, any unused credit can be claimed in that final year. Money not needed for credits is sent to the state general fund.
New HMO tax to fund Medicaid
Beginning January 1, 2026, HMOs that do business in Iowa pay a health care tax of 0.95% on the applicable share of their taxable funds. It applies to all HMOs, including those that run Medicaid plans. HMOs that pay this tax are not also charged the regular insurance premium tax, and the old HMO premium tax law is repealed. The law defines what counts as taxable funds and excludes some federal payments. Taxes go into a new Medicaid managed care tax fund. For January 1–September 30, 2026, a 3.5% rate applies after the state confirms federal approval. These rules apply to tax years that begin on or after January 1, 2026.
HMOs face prepayments and deadlines
Each year, HMOs must make two prepayments by June 1 and August 15. Each equals half of the annual rate times last year’s taxable funds. Prepayments reduce the final bill, and cash refunds are allowed if the HMO cannot use the credits. The annual tax is due by March 1 of the next year, and licenses can be suspended or revoked for nonpayment. The commissioner can audit returns for five years, with no time limit for fraud or when no return is filed.
Sponsors & Cosponsors
Sponsor
COMMITTEE ON WAYS AND MEANS
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
Senate vote • 3/24/2026
Passed Senate
Yes: 26 • No: 19
legislature vote • 3/19/2026
Amendment H-8241 to amendment H-8234
Yes: 29 • No: 63
House vote • 3/19/2026
Passed House
Yes: 53 • No: 40
Actions Timeline
Signed by Governor.
3/25/2026GovernorReported correctly enrolled, signed by Speaker and President, and sent to Governor.
3/25/2026SenateMessage from Senate.
3/25/2026SenateNOBA: Final
3/24/2026legislatureNOBA: House Floor
3/24/2026HouseImmediate message.
3/24/2026legislaturePassed Senate, yeas 26, nays 19.
3/24/2026SenateSubstituted for SF 2464.
3/24/2026legislatureExplanation of vote.
3/24/2026legislatureExplanation of vote.
3/24/2026legislatureExplanation of vote.
3/24/2026legislatureExplanation of vote.
3/24/2026legislatureExplanation of vote.
3/24/2026legislatureExplanation of vote.
3/24/2026legislatureExplanation of vote.
3/24/2026legislatureRead first time, attached to SF 2464.
3/23/2026legislatureMessage from House.
3/23/2026HouseImmediate message.
3/19/2026legislaturePassed House, yeas 53, nays 40.
3/19/2026HouseAmendment H-8234 adopted, as amended.
3/19/2026legislatureAmendment H-8241 to amendment H-8234, yeas 29, nays 63, filed, lost.
3/19/2026legislatureAmendment H-8243 to amendment H-8234 filed, adopted.
3/19/2026legislatureAmendment H-8242 to amendment H-8234 filed, withdrawn.
3/19/2026legislatureAmendment H-8233, yeas 29, nays 62, lost.
3/19/2026legislatureAmendment H-8240 to amendment H-8233, yeas 27, nays 64, filed, lost.
3/19/2026legislature
Bill Text
As Introduced
Enrolled
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