HF 405 requires most health insurance plans in Iowa to cap out-of-pocket costs for prescription insulin at $25 per prescription for up to a 31-day supply. It directly affects people with diabetes who use insulin and are covered under health insurance plans that provide prescription drug coverage. The bill sets this $25 limit for four types of insulin (rapid-acting, short-acting, intermediate-acting, and long-acting) and applies to plans issued or renewed on or after January 1, 2026. It excludes certain insurance types like Medicare supplements, workers’ compensation, and dental/vision plans. The Iowa Insurance Commissioner will implement rules to enforce this requirement.
This bill requires Medicaid plans and health carriers to treat nonopioid pain medications approved by the FDA equally with opioid drugs in coverage decisions. Specifically, nonopioid drugs cannot be labeled as "nonpreferred" if opioids are preferred, and must face no stricter coverage requirements (like prior authorization) than opioids. Health carriers must also create and submit "pain management access plans" covering at least two non-opioid prescription medications and three non-drug pain treatments (e.g., physical therapy), ensuring these options aren’t blocked by excessive barriers. The rules apply immediately upon FDA approval of a nonopioid drug, bypassing standard committee review for inclusion on preferred drug lists. This directly affects Medicaid managed care organizations and health insurance providers in Iowa.
This Iowa bill (HF 590) prohibits drug manufacturers and distributors from interfering with safety-net hospitals, clinics, and other covered entities acquiring or receiving 340B discounted drugs. It specifically bans manufacturers or distributors from denying, restricting, or hindering these transactions - except when federal health officials prohibit them. The law defines key terms like "340B drug," "distributor," and "manufacturer" based on federal Social Security Act standards. It directly affects drug companies and wholesalers operating in Iowa by requiring compliance with federal 340B program rules. The bill was introduced in February 2025 and remains pending.
HF 605 allows pharmacists in Iowa to dispense self-administered hormonal contraceptives (like pills, rings, or patches approved by the FDA) without a new prescription, using a standing order from the health department. Pharmacists must complete specific training, conduct a patient risk assessment, provide counseling on use/side effects, and refer patients if unsafe, while dispensing up to a 12-month supply at once. The bill also requires health insurance plans to cover these contraceptives without excluding them, similar to other outpatient prescription drugs. It explicitly excludes abortion-inducing drugs and mandates patient education on backup contraception and STI prevention.
HF 658 requires most health insurance plans in Iowa to cap out-of-pocket costs for prescription insulin at $25 per prescription for up to a 31-day supply. It applies to all covered insulin types (rapid-acting, short-acting, intermediate-acting, and long-acting) and affects people with diabetes who have insulin-covered plans. The cap takes effect for new or renewed policies starting January 1, 2026, but excludes specialized coverage like Medicare supplements, dental, or workers’ compensation plans. Plans may offer lower costs than $25 but cannot exceed this limit. This directly reduces financial burdens for Iowans managing diabetes through their insurance.
This bill requires Medicaid and health insurers to treat nonopioid pain medications equally with opioids in coverage. It prohibits designating nonopioid drugs as "nonpreferred" when opioids are preferred and bans stricter prior authorization or step therapy requirements for nonopioid drugs compared to opioids. Health insurers must develop a "pain management access plan" covering at least two FDA-approved non-opioid prescription medications (not controlled substances) and three non-drug pain treatments, without more restrictive rules for nonopioid options. The bill applies immediately upon FDA approval of a nonopioid pain drug, regardless of prior committee review. It affects Medicaid managed care organizations and health carriers offering coverage in Iowa.
HF 735 requires health insurers and pharmacy benefits managers in Iowa to include all payments made by a plan participant (or others on their behalf) when calculating their total out-of-pocket cost-sharing under health plans. It specifically protects Health Savings Account (HSA) eligibility by delaying HSA contribution calculations until after a participant meets the federal minimum deductible, except for preventive care services. The bill applies to most health benefit plans issued or renewed in Iowa on or after January 1, 2026, but excludes accident-only, Medicare supplement, dental, vision, and other specialized coverage. It directs Iowa’s insurance commissioner to create implementing rules under Chapter 17A.
SF 319, titled "The Patient’s Right to Save Act," requires health care providers to disclose the discounted cash price for each specific service they accept as payment. Providers must share this price in advance, including any variations based on timing, location, or patient income, and inform patients that cash payments may not be cheaper than insurance-negotiated rates. The bill mandates annual reviews of these prices and requires clear communication about cash payment options to both insured and uninsured patients before services are provided. It directly affects health care providers who accept cash payments, aiming to increase price transparency for consumers.
SF 264 creates a Prescription Drug Affordability Board in Iowa to address high prescription drug costs. The board, appointed by the governor with Senate confirmation, will review drug pricing and may recommend upper payment limits for prescription drugs affecting all Iowans, especially patients with illnesses, opioid crisis communities, and healthcare providers. Key provisions require the board to hold public meetings, accept public input, and enforce strict conflict-of-interest rules (e.g., members cannot receive over $5,000 annually from drug manufacturers). The bill establishes this mechanism to review drug costs but does not yet implement price controls.
This bill allows Iowa pharmacists to order and dispense FDA-approved self-administered hormonal contraceptives (like pills or patches) directly to patients under statewide protocols. It affects pharmacists and patients seeking contraceptive care without requiring a separate doctor's prescription. Key provisions include requiring the pharmacy board to develop state protocols with health department input, mandating record-keeping, and ensuring pharmacists provide written records to patients. The bill defines "self-administered hormonal contraceptives" as FDA-approved products solely for preventing pregnancy. This changes how contraceptives are accessed, expanding pharmacist authority within defined guidelines.
