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HF 2434 Iowa House · 2025-2026 Regular Session

A bill for an act relating to insurance coverage for health care services provided pursuant to a referral by an out-of-network primary care provider.

HF 2434 requires insurance companies in Iowa to cover health care services referred by an out-of-network primary care provider (PCP) without charging higher out-of-pocket costs than for in-network referrals. It directly affects patients who rely on PCPs not in their insurance network, ensuring they face the same deductible, copay, or coinsurance as if the PCP were in-network. The law prohibits insurers from denying coverage solely based on the PCP’s network status and allows them to verify if the patient has a direct primary care agreement with that PCP. This bill takes effect July 1, 2026, and applies to referrals made after that date.
Issues: ✓ HealthcareSupports HealthcareRequires insurers to cover out-of-network PCP referrals at in-network cost levels, improving patient access and protecting rights without higher out-of-pocket costs.95% confidence
Bill status signed all 5 stages cleared
Introduction
Feb 2026
Committee Review
Mar 2026
House Passage
Apr 2026
Senate Passage
Apr 2026
Signed into Law
Apr 2026
Introduced Feb 12, 2026 Signed Apr 16, 2026
Maddy AI version diff · 4 comparisons

What changed between versions

Enrolled with Governor's Action → Reprinted · 4 edits
MODERATE
The bill was reprinted from its final enrolled version to a committee reprint format, adding metadata like committee attribution and amendment dates while removing the Governor's signature and official filing details. The substantive policy text regarding insurance coverage for out-of-network primary care referrals remains unchanged in its core provisions.
Scope change
No change to the bill's scope or applicability; the text governing insurance requirements is identical to the enrolled version.
TECHNICAL

Added header identifying the bill as a successor to HSB 506 and noting it was amended and passed by the House on February 25, 2026.

Included page numbers and committee attribution (Committee on Health and Human Services) in the header.

Removed the Governor's signature block, Speaker, and Senate President certification lines from the enrolled version.

Condensed the definitions section into a single block of text with paragraph numbering instead of the line-by-line vertical format used in the enrolled version.

Floor votes · Senate Apr 6, 2026

How they voted

46–0
Passed · 3 other
Total votes 49
Apr 6, 2026
D Democratic15
14 Yea 1
93% Yea
R Republican34
32 Yea 2
94% Yea
Vote distribution
All Yea All Nay Mixed No data
Full legislative history

Actions timeline

Total actions
25
Key actions
11
Committee
4
Amendments
5
Apr 16, 2026
Signed into law
Signed by Governor.
lower
Apr 7, 2026
Lower · Passed
Passed House, yeas 92, nays 0.
lower
Apr 7, 2026
Lower · Passed
House concurred in Senate amendment H-8304.
lower
Apr 6, 2026
Introduced
Senate amendment H-8304 filed.
lower
Apr 6, 2026
Upper · Passed
Passed Senate, yeas 47, nays 0.
upper
Apr 6, 2026
Upper · Passed
Amendment S-5117 adopted.
upper
Mar 19, 2026
Introduced
Amendment S-5117 filed.
upper
Mar 19, 2026
Upper · Passed
Committee report, recommending amendment and passage.
upper
Mar 9, 2026
Legislature · Passed
Subcommittee recommends passage.
legislature
Mar 5, 2026
Legislature · Passed
Subcommittee Meeting: 03/09/2026 12:30PM Room G15.
legislature
Mar 3, 2026
Upper · Passed
Subcommittee: Warme, Driscoll, and Knox.
upper
Feb 25, 2026
Lower · Passed
Passed House, yeas 92, nays 0.
lower
Feb 25, 2026
Lower · Passed
Amendment H-8030 adopted.
lower
Feb 24, 2026
Introduced
Amendment H-8030 filed.
lower
Feb 12, 2026
Introduced
Introduced, placed on calendar.
lower
0 primary · 0 co-sponsors

Sponsors

No sponsor information available.