All Roll Calls
Yes: 136 • No: 5
IowaHF 97291st General Assembly (2025–2026)HouseWALLET
A bill for an act relating to health care including a funding model for the rural health care system; the elimination of several health care-related award, grant, residency, and fellowship programs; establishment of a health care professional incentive program; Medicaid graduate medical education; the health facilities council; and the Iowa health information network, making appropriations, and including effective date provisions. (Formerly HF 754, HSB 191.) Contingent effective date, effective 05/28/2025, 07/01/2025.
Sponsored By: COMMITTEE ON APPROPRIATIONS
Signed by Governor
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Bill Overview
Analyzed Economic Effects
7 provisions identified: 4 benefits, 1 costs, 2 mixed.
New health worker bonuses and loan help
Beginning July 1, 2025, Iowa runs one statewide incentive for health workers in shortage areas. You can choose loan repayment or an income bonus, up to $200,000. Full-time awards pay 20% after year 1, 15% after years 2–4, and 35% after year 5. Full-time means 2,080 hours a year for five years; part-time is prorated and requires seven years. People who already used certain past state loan or award programs are not eligible. A new fund holds the money, past unencumbered balances move into it, and DHHS and the student aid commission set rules and run the program. Each year, the commission sets how many awards per profession.
Your existing awards keep paying
If you had a contract or were selected by June 30, 2025, the state keeps making your loan payments or awards as long as you stay in compliance. DHHS also keeps paying primary care contracts signed by December 31, 2025. Sponsors awarded by June 30, 2025 keep getting state match until funded residents or fellows finish; liability cost matches run only through June 30, 2026. UI Hospitals and Clinics keep paying state‑funded psychiatry residents and fellows approved or awarded by June 30, 2025 until they finish or leave. Separate accounts hold your committed funds so they do not revert and can earn interest.
More Medicaid support for training and rural care
Iowa seeks federal approval for extra Medicaid payments to support graduate medical education and grow residency slots. The state also seeks approval for a rural hub‑and‑spoke funding model to strengthen care in rural Iowa. After required Medicaid payments, leftover trust fund money can cover Medicaid shortfalls, help the workforce effort, support uninsured Iowans, and back hospital access programs. Leftover balances in named workforce and psychiatry funds do not revert and are used for Medicaid graduate medical education. Agencies keep residency and fellowship money in separate accounts; after obligations end, any leftover goes to Medicaid GME.
Old state grants and residencies end
The law ends several old programs. These include rural Iowa primary care loan repayment, health care professional recruitment, health care awards, mental health professional loan repayment, medical and nurse residency matching grants, the workforce support initiative, the family medicine obstetrics fellowship, and the statute for state‑funded psychiatry residencies and fellowships. New applications under those laws stop. DHHS must apply set criteria when facilities seek any matching grants. The law also removes two subsections from Iowa Code section 135.107 as a procedural change.
Loan help to place dentists
The dentist placement program can use money from the workforce shortage fund or the dentists’ matching grant account. This helps repay dental school loans for dentists who serve in shortage or rural areas.
Stronger rules for health data exchange
DHHS picks a nonprofit, through competition at least every eight years, to run the statewide health information network. The operator must use industry‑standard security, follow the law, and offer patients a way to opt out. A new Exchange Advisory Committee, with at least one consumer and a majority of participants, advises DHHS and issues annual budget and usage reports.
Facility project approvals move to DHHS
The Health Facilities Council is eliminated. The Department of Health and Human Services now runs certificate‑of‑need approvals and enforcement. Hospitals and other facilities work with DHHS instead of the council.
Sponsors & Cosponsors
Sponsor
COMMITTEE ON APPROPRIATIONS
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
Senate vote • 5/13/2025
Passed Senate
Yes: 41 • No: 4
House vote • 3/26/2025
Passed House
Yes: 95 • No: 1
Actions Timeline
NOBA: Final
6/18/2025legislatureSigned by Governor.
5/28/2025GovernorReported correctly enrolled, signed by Speaker and President, and sent to Governor.
5/27/2025SenateMessage from Senate.
5/13/2025SenateImmediate message.
5/13/2025legislaturePassed Senate, yeas 41, nays 4.
5/13/2025SenateSubstituted for SF 618.
5/13/2025legislatureExplanation of vote.
4/22/2025legislatureAttached to SF 618.
4/3/2025legislatureNOBA: House Floor
3/28/2025HouseRead first time, passed on file.
3/27/2025legislatureMessage from House.
3/27/2025HouseImmediate message.
3/26/2025legislaturePassed House, yeas 95, nays 1.
3/26/2025HouseNOBA: House Full Approps
3/25/2025HouseIntroduced, placed on Appropriations calendar.
3/21/2025legislature
Bill Text
As Introduced
Enrolled
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