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.

This bill creates a new health care-related tax on health maintenance organizations operating in Iowa, directing the collected funds to a new Medicaid managed care organization premiums health care tax fund. The tax rate starts at 3.5% for the first nine months of 2026 before dropping to 0.95% for the remainder of that year and continuing at that lower rate in subsequent years. Health maintenance organizations must pay the tax annually by March 1 and can make prepayments throughout the year to offset their liability. The legislation also includes provisions for tax refunds, penalties for late payments, and allows insurers to offset certain assessments against their tax liability.