IowaHF 57191st General Assembly (2025–2026)House

A bill for an act relating to protections for medical practitioners and health care institutions, including those related to the exercise of conscience, whistleblower activities, and free speech, and providing penalties. (Formerly HSB 139.) Effective date: 07/01/2026.

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Bill Overview

Analyzed Economic Effects

6 provisions identified: 2 benefits, 0 costs, 4 mixed.

Patients can decline conscience-objecting providers’ services

Beginning July 1, 2026, people cannot be sued for declining to use or buy a health care service because of a provider’s exercise of conscience under this law. This protection covers decisions involving either a practitioner or a health care institution. It does not require anyone to buy or use the service.

Health workers gain whistleblower protections

Beginning July 1, 2026, Iowa practitioners and health institutions gain protection from discrimination for reporting suspected violations of this law. Protection also covers plans to report and help with related proceedings. Good-faith disclosures to employers or state or federal health-care-rights bodies cover reasonably suspected legal, care-standard, or ethics violations. They also cover gross mismanagement, waste, abuse of authority, risky treatment, and substantial, specific public-health or safety dangers. Federal health privacy rules and other confidentiality duties still apply.

Provider speech gains safeguards, boards face penalties

Beginning July 1, 2026, covered Iowa licensing bodies cannot punish providers or institutions for First Amendment-protected speech, expression, or association. An exception requires clear and convincing evidence of direct physical harm to someone who was their patient or client within the three years before the incident. For complaints alleging protected-speech violations that could lead to license, certification, or registration loss, bodies must provide a copy within 21 days. Late notice requires payment to the affected provider or institution of $500 for each day of noncompliance. Iowa also cannot contract with, recognize, approve, or require credentials from entities that revoke or deny them in violation of this law, when the provider complies with the law and gave no medical advice or treatment.

Providers can sue over rights interference

Beginning July 1, 2026, people cannot use coercion or other means to interfere with providers’ protected conscience, whistleblower, or speech rights. Attempts to interfere are also barred, and injured practitioners or institutions can sue. Courts can award damages, reasonable costs and attorney fees, and orders such as job reinstatement or credential reactivation. Added costs or burdens caused by a conscience objection cannot serve as a defense. These remedies add to other legal remedies.

Providers gain rights to refuse care

Beginning July 1, 2026, Iowa health practitioners, including trainees, and health care institutions can refuse to participate in or pay for services that violate their ethical, moral, or religious beliefs. The law protects them from discrimination, but excludes specified nongovernmental insurance or service transactions and good-faith accommodation efforts. Practitioners must tell employers the nature of their objection; duties for other services and federal emergency-care duties remain. Good-faith conscience actions carry no civil, criminal, or administrative liability, including institutional protection for employed, contracted, or admitted practitioners. These rights can limit patients’ access to services and legal remedies.

Religious health institutions control staffing choices

Beginning July 1, 2026, qualifying Iowa religious health institutions can base hiring, staffing, contracts, and admitting privileges on religious beliefs. They must publicly identify as religion-based and state a religious purpose or mission in their governing documents. They must also have internal policies or procedures that put those beliefs into practice. This gives institutions more control over these decisions and can limit workers’ and practitioners’ job opportunities.

Sponsors & Cosponsors

Sponsor

COMMITTEE ON JUDICIARY
Affiliation unavailable

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 157 • No: 75

House vote • 3/23/2026

Passed House

Yes: 63 • No: 27

Senate vote • 3/9/2026

Passed Senate

Yes: 30 • No: 16

House vote • 3/26/2025