Iowa Legislature Passes Patients First Insurance Reform Legislation with Overwhelming Bipartisan Support

The Iowa Hospital Association (IHA) today announced a major legislative victory for Iowa patients and health care providers as the Iowa Legislature passed IHA’s Patients First insurance reform legislation with broad bipartisan support.

The bill passed the Iowa House of Representatives on March 3 by a vote of 94–1 and the Iowa Senate on March 4 by a vote of 44–0.

“I first want to express appreciation to our bill sponsors, Rep. Austin Harris (Appanoose), Rep. David Young (Dallas), and Sen. Kara Warme (Story), for championing this important legislation. This legislation is a major step forward for Iowa patients and the hospitals and health systems that serve them,” said Chris Mitchell, IHA President & CEO. “The Patients First reforms allow hospitals to focus resources where they belong – on patient care, not paperwork. By establishing clearer standards and improving accountability for insurers, Iowa lawmakers have prioritized timely access to care. We are grateful for the overwhelming bipartisan support.”  

The Patients First legislation includes several reforms aimed at improving transparency, accountability, and patient access to care. Key provisions include:

• Audit Standards – The legislation establishes clear and enforceable timelines for insurers to initiate audits, process provider appeals and reach final resolution.

• Peer-to-Peer Reviews – The bill sets standards for how insurers conduct peer-to-peer reviews and requires reviewers to have appropriate clinical qualifications.

• Prior Authorization Reform – The legislation eliminates prior authorization requirements for cancer screening services as well as emergent conditions that present during an inpatient stay.

• Prohibition on Out-of-Network Penalties – The legislation prohibits insurers from financially penalizing hospitals for affiliating with, referring to or collaborating with out-of-network providers, and prohibits “take-it-or-leave-it” contracting practices.

IHA leaders emphasized the legislation’s success reflects months of advocacy by hospital and health system leaders across Iowa. Throughout the session, hospital leaders shared data and real-world examples illustrating how administrative barriers can delay patient care.

“Hospital leaders across Iowa made their voices heard – and we are grateful our legislators listened,” Mitchell said. “This victory demonstrates the power of a unified health care community advocating for patients first. Together, we are reimagining health care in Iowa to deliver life-changing outcomes for the patients and communities we serve.”

The legislation now advances to the Governor’s desk.