Iowa Passed Two Healthcare Bills in One Week. Both Make Things Worse for Iowans.

Two healthcare bills passed the Iowa House in the same week. One makes it legal for your doctor to refuse to treat you. The other raised your health insurance premiums retroactively — meaning you already owe more money for January, February, and March and nobody sent you a notice.

Iowa Republicans called this progress. I am going to explain why it is not.

Your Doctor Can Now Say No — And Face Zero Consequences

House File 571 just passed the Iowa House 63-27 and is headed to Governor Reynolds' desk. When she signs it — and she will — Iowa will become one of the most permissive states in the country for allowing healthcare providers to turn patients away.

Under this bill any doctor, hospital, clinic, or insurance company can refuse to provide, pay for, or even refer a patient for care that conflicts with their religious or moral beliefs. They cannot be sued. They cannot face criminal charges. They cannot lose their license. The only exception is a life threatening emergency.

Think about what that means for women in Des Moines and Polk County seeking reproductive care. For transgender Iowans trying to access gender affirming treatment. For anyone in a rural county with one hospital and no alternatives.

Iowa already leads the nation in closing maternity wards. Iowa already has only 3.3 OB-GYNs per 10,000 women — well below the national average. Iowa's answer to that crisis was to pass a law giving the providers we have left more legal cover to turn patients away.

Your Premiums Went Up. Retroactively.

At the same time Republicans were passing HF 571, they were also passing House File 2739 — a bill that raises the premium tax on health maintenance organizations from 0.925% to 3.5%.

The reason Iowa needed this tax? A $90.6 million Medicaid deficit — caused in significant part by the federal "One Big Beautiful Bill" Act that Iowa's own Republican congressional delegation voted for.

Iowa Republicans voted for the federal legislation that created the shortfall. Then came home and passed a tax on health insurance companies to fill it. Those companies — Wellmark has already confirmed this — are passing the cost directly to their customers.

The number Wellmark's lobbyist gave lawmakers: $115 per person this year. For a family of four that is nearly $500 more in 2026. Retroactive to January 1st.

January already happened. You already owe it.

For Iowa employers who provide health benefits — and healthcare costs are already one of the largest line items in any company's budget — this is a mid-year surprise with no time to plan. Those costs get absorbed somewhere. Sometimes by the company. Often by the employee.

This Is a Polk County Problem Too

It is easy to think of healthcare access as a rural problem. But these bills affect every Iowan including those of us in Des Moines and Polk County.

When providers across Iowa have legal cover to refuse care, the patients they turn away don't disappear. They show up at the next nearest facility — which may be a Polk County hospital already operating at capacity. When health insurance premiums rise for employers across Iowa, the ripple effects reach every workplace — including right here in Des Moines.

And the structural Medicaid problem is not going away. Iowa faces a projected $600 million Medicaid shortfall over the next several years. This bill addresses nine months of it and does nothing about the rest.

Iowa Deserves Smarter Than This

Iowa cannot keep governing healthcare this way. Passing laws that reduce access while raising costs is not a healthcare strategy — it is a political one. Iowa families and Iowa businesses deserve leaders willing to make real decisions about real problems rather than patches that push the crisis forward one fiscal year at a time.

Read the full analysis on Medium: Iowa Just Made It Harder to Get Healthcare and More Expensive to Keep It

Rebecca Nicole Schweitzer is a Des Moines, Polk County, Iowa writer and community advocate. Read more at iowaraisedrebeccaschweitzerunfiltered.com and on Medium, Substack, X, and Bluesky.