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.

Created a new 'Medicaid managed care organization premiums health care tax fund' in the state treasury to receive tax revenues.

Imposed a new 0.95% health care-related tax on HMOs for 2026 and subsequent years, with a temporary 3.5% rate for 2026 if the bill is passed.

Exempted Health Maintenance Organizations from the standard premium tax under section 432.1, replacing it with the new HMO-specific tax.

Established prepayment schedules (June 1 and August 15) and a five-year statute of limitations for tax audits and assessments.

Defined 'taxable funds' for HMOs as payments received for health care services and payments made to providers, with specific exclusions for federal government contracts.

Created a new 'Medicaid managed care organization premiums health care tax fund' in the state treasury to collect the new HMO tax.

Established a specific tax rate of 0.95% effective January 1, 2026, replacing the draft's provision for a higher initial rate that would drop later in the year.

Mandated a prepayment schedule requiring HMOs to remit half their estimated tax liability by June 1 and the remaining half by August 15.

Added HMOs to the definition of 'Carrier' under Section 514E.1, aligning their tax treatment with other insurers for certain provisions.

Authorized the insurance commissioner to suspend or revoke an HMO's license if it fails to pay the new health care-related tax by the due date.

Converted the legislative text from a draft format with line numbers and committee markings into a clean, signed enrolled bill with the Governor's signature and official formatting.