Iowa 2025-2026 Regular Session Status: Enacted

SF 2190 — A bill for an act relating to the use of the titles physician assistant and physician associate.

Last action — Signed by Governor.

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed Senate
  4. ✓
    Passed House
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced February 04, 2026. Enacted.

Signed by Governor Kim Reynolds (Republican) on April 09, 2026.

Prognosis

Likely to advance 70% · moderate confidence

Where this bill stands today.

Odds of enactment

High

How often bills like it became law.

  • Enacted

    Current position in the legislative process.

  • 1 sponsor

    1 primary, 0 co-sponsors signed on.

  • Cleared a recorded vote

    Passed 3 recorded votes so far.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Bill Text

What changed in the latest version

95 added · 114 removed

Plain-language change summary

The recent changes to Senate File 2190 primarily replace the term "physician assistant" with "physician associate," which reflects a shift in the professional terminology used in healthcare. This adjustment is important as it aims to make the title more inclusive and representative of the role, aligning with national trends in the profession. Additionally, the bill includes provisions allowing agencies to update administrative rules accordingly, ensuring consistency across regulations. This clarity fosters a better understanding of the profession and may enhance the perception and recognition of physician associates.

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S T A T E O F I O W A K I M R E Y N O L D S G O V E R N O R April09,2026 The Honomble Paul Pate SecretaryofStateofIowa StateCapitol Des Moines,Iowa50319 DearMr.Secretary, Iherebytransmit:
Senate File 2190 - Enrolled Senate File 2190 AN ACT RELATING TO THE USE OF THE TITLES PHYSICIAN ASSISTANT AND PHYSICIAN ASSOCIATE.
SenateFile2190,anActrelatingtotheuseofthetitlesphysicianassistantand physician associate.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
The aboveSenateFileisherebyapprovedonthisdate.
SmArely, annWynolds Governor ofIowa cc:
SecretaryoftheSenate Clerk of the House STATE CAPITOL DES MOINES,IOWA 50319 515.281.5211WWW.GOVERNOR.IOWA.GOV ISSONBDSmliioHT m i x MAINTAI iiiiTniiiimsnnin^iiiiiiimiiiiiHiifiiHil g i :
n i :
r a l a s s k m b i .
v m aimiimaini raiflHHwnsiniinonininBaiiniftiDiiiiHMuiiiiniiinni S e n a t e F i l e 2 1 9 0 A N A C T R E L A T I N G T O T H E U S E O F T H E T I T L E S P H Y S I C I A N A S S I S T A N T A N D P H Y S I C I A N A S S O C I A T E .
B E I T E N A C T E D B Y T H E G E N E R A L A S S E M B L Y O F T H E S T A T E O F I O W A :
Section 147.74, subsection 17, Code 2026, is a m e n d e d t o r e a d a s f o l l o w s :
Section 147.74, subsection 17, Code 2026, is amended to read as follows:
A person who qualifies for licensure as a physician asaiatant licensed associate under chapter 148C may use the words ^physician aaaistant associate^^ after the person's name or signify the same by the use of the letters ""P.A." after the person's name.
A person who qualifies for licensure as a physician assistant licensed associate under chapter 148C may use the words “physician assistant associate” after the person’s name or signify the same by the use of the letters “P.A.” after the person’s name.
S e c , 2 .
Sec.
P H Y S I C I A N A S S I S T A N T T I T L E C H A N G E .
2.
PHYSICIAN ASSISTANT TITLE CHANGE.
Notwithstanding any provision of law to the contrary, a l l r e f e r e n c e s i n the I o w a C o d e and I o w a A d m i n i s t r a t i v e Code to ^physician assistant" shall be revised to ^"physician associate".
Notwithstanding any provision of law to the contrary, all references in the Iowa Code and Iowa Administrative Code to “physician assistant” shall be revised to “physician associate”.
The terms ^^physician assistant", ^physician associate", and ^^P.A." are synonymous, and all rights and responsibilities of a physician assistant under current law are unaffected by the change in title to ^physician associate".
The terms “physician assistant”, “physician associate”, and “P.A.” are synonymous, and all rights and responsibilities of a physician assistant under current law are unaffected by the change in title to “physician associate”.
All persons or entities employing, coordinating treatment with, following orders from, training, educating, or contracting with a person licensed as a physician assistant or educating individuals in an accredited physician assistant or physician associate education program, including but not limited to a hospital or other health care facility, physician, third-party payer, the federal government, and malpractice Senate Pile 2190, p.
All persons or entities employing, coordinating treatment with, following orders from, training, educating, or contracting with a person licensed as a physician assistant or educating individuals in an accredited physician assistant or physician associate education program, including but not limited to a hospital or other health care facility, physician, third-party payor, the federal government, and malpractice Senate File 2190, p.
2 insurance carriers, shall continue the relationship without interruption or alteration as a result of the change in title to "^physician associate".
2 insurance carriers, shall continue the relationship without interruption or alteration as a result of the change in title to “physician associate”.
A person or entity shall not discriminate against an individual in contracting with the individual, employment, or otherwise solely as a result of the individual's use of the title ^^physician associate".
A person or entity shall not discriminate against an individual in contracting with the individual, employment, or otherwise solely as a result of the individual’s use of the title “physician associate”.
During the time before the title '^physician associate" enters common usage, a person eligible for licensure under chapter 148C may use the title ^physician assistant", ^^physician associate", or ^^P.A.".
During the time before the title “physician associate” enters common usage, a person eligible for licensure under chapter 148C may use the title “physician assistant”, “physician associate”, or “P.A.”.
A person or entity interacting with a person using the title ^^physician associate" is entitled to rely on the person having all rights and responsibilities of a physician assistant.
A person or entity interacting with a person using the title “physician associate” is entitled to rely on the person having all rights and responsibilities of a physician assistant.
The change in title from ^^physician assistant" to ^physician associate" does not expand or alter the scope of practice of a person licensed under chapter 148C.
The change in title from “physician assistant” to “physician associate” does not expand or alter the scope of practice of a person licensed under chapter 148C.
Not later than January 1, 2027, each agency shall, as soon as practicable and in the most cost-efficient manner possible, make amendments to active versions of sub-regulatory guidance, documents, and forms to reflect the change in title from ^'physician assistant" to ^physician associate".
Not later than January 1, 2027, each agency shall, as soon as practicable and in the most cost-efficient manner possible, make amendments to active versions of sub-regulatory guidance, documents, and forms to reflect the change in title from “physician assistant” to “physician associate”.
S e c .
Sec.
3C O D E E D ID I R E C — IT E R M I N OC H A N G E S .
3.
CODE EDITOR DIRECTIVE —— TERMINOLOGY CHANGES.
The Code editor is directed to change all references to ^^physician assistant" and its derivatives to ^physician associate" and its derivatives, as appropriate, wherever they appear in the Code, including in sections 90A.1, 90A.8, 96.5, 124E.2, 135.1, 135.17, 135.24, 135.39D, 135.105D, 135.146, 135.190A, 135.194, 135B.1, 135B.7, 135G.1, 135G.3, 135H.3, 135J.1, 135P.1, 136A.2, 136C.3, 137.105, 139A.2, 139A.8, 139A.22, 139A.35, 139A.41, 141A.1, 141A.5, 141A.6, 141A.7, 142C.8, 144.26, 144.28, 144A.2, 144A.4, 144A.7A, 144B.1, 144B.5, 144B.6, 144D.1, 144D.2, 144D.3, 144D.4, 144F.2, 147.1, 147.2, 147.13, 147.14, 147.77, 147.107, 147.136, 147.136A, 147.138, 147A.1, 147A.8, 147A.9, 147A.10, 147A.13, 148C.1, 148C.2, 148C.3, 148C.4, 148C.5, 148C.8, 148C.9, 148C.11, 148C.13, 148F.7, 148G.1, 148H.4, 152.1, 152B.1, 152C.9, 152D.4, 152D.7, 154C.7, 154D.4, 154F.2, 155A.3, 155A.23, 189A.6, 225.9, 225.12, 225.15, 225.16, 228.1, 229.22, 232.68, 232.71B, 232.78, 232.79, 232.95, 233.1, 234,22, 235A.13, 237A.5, 237A.13, 249.3, Senate File 2190, p.
The Code editor is directed to change all references to “physician assistant” and its derivatives to “physician associate” and its derivatives, as appropriate, wherever they appear in the Code, including in sections 90A.1, 90A.8, 96.5, 124E.2, 135.1, 135.17, 135.24, 135.39D, 135.105D, 135.146, 135.190A, 135.194, 135B.1, 135B.7, 135G.1, 135G.3, 135H.3, 135J.1, 135P.1, 136A.2, 136C.3, 137.105, 139A.2, 139A.8, 139A.22, 139A.35, 139A.41, 141A.1, 141A.5, 141A.6, 141A.7, 142C.8, 144.26, 144.28, 144A.2, 144A.4, 144A.7A, 144B.1, 144B.5, 144B.6, 144D.1, 144D.2, 144D.3, 144D.4, 144F.2, 147.1, 147.2, 147.13, 147.14, 147.77, 147.107, 147.136, 147.136A, 147.138, 147A.1, 147A.8, 147A.9, 147A.10, 147A.13, 148C.1, 148C.2, 148C.3, 148C.4, 148C.5, 148C.8, 148C.9, 148C.11, 148C.13, 148F.7, 148G.1, 148H.4, 152.1, 152B.1, 152C.9, 152D.4, 152D.7, 154C.7, 154D.4, 154F.2, 155A.3, 155A.23, 189A.6, 225.9, 225.12, 225.15, 225.16, 228.1, 229.22, 232.68, 232.71B, 232.78, 232.79, 232.95, 233.1, 234.22, 235A.13, 237A.5, 237A.13, 249.3, Senate File 2190, p.
3 249A.4, 249A,4B, 249N.2, 252E.1, 256.222, 272C.1, 272C.2C, 280.13C, 280.16, 280A.1, 321.34, 321.186, 321.375, 321.446, 321J.7, 321J.11, 321L.2, 321L.2A, 411.5, 462A.14A, 489.1101, 489.1102, 489.1105, 496C.2, 496C.4, 496C.7, 514C.11, 514C.17, 514C.18, 5140.20, 5140.25, 5140.28, 514F.6, 614.1, 622.10, 668A.1, 669.2, 702.8, 707A.1, 730.5, and 915.46.
3 249A.4, 249A.4B, 249N.2, 252E.1, 256.222, 272C.1, 272C.2C, 280.13C, 280.16, 280A.1, 321.34, 321.186, 321.375, 321.446, 321J.7, 321J.11, 321L.2, 321L.2A, 411.5, 462A.14A, 489.1101, 489.1102, 489.1105, 496C.2, 496C.4, 496C.7, 514C.11, 514C.17, 514C.18, 514C.20, 514C.25, 514C.28, 514F.6, 614.1, 622.10, 668A.1, 669.2, 702.8, 707A.1, 730.5, and 915.46.
S e c .
Sec.
4 A M E N D M E N T S T O A D M I N I S T R A T I V E R U L E S .
4.
AMENDMENTS TO ADMINISTRATIVE RULES.
Such amendments shall be limited to updating the term ^^physician assistant" and its derivatives to ^^physioian associate" and corresponding derivatives.
Such amendments shall be limited to updating the term “physician assistant” and its derivatives to “physician associate” and corresponding derivatives.
AMY SINCL^R PAT GRASSLJ President of the Senate Speaker of the House I hereby certify that this bill originated in the Senate and is known as Senate File 2190, Ninety-first General Assembly.
______________________________ ______________________________ AMY SINCLAIR PAT GRASSLEY President of the Senate Speaker of the House I hereby certify that this bill originated in the Senate and is known as Senate File 2190, Ninety-first General Assembly.
W .C H A R S M I T H S O N Secretary €?*\he Senate Approved 2026
______________________________ W.
CHARLES SMITHSON Secretary of the Senate Approved _______________, 2026 ______________________________ KIM REYNOLDS Governor
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Action History

  1. Signed by Governor.

  2. Reported correctly enrolled, signed by President and Speaker, and sent to Governor.

  3. Message from House.

  4. Explanation of vote.

  5. Immediate message.

  6. Explanation of vote.

  7. Passed House, yeas 90, nays 0.

  8. Substituted for HF 2269.

  9. Read first time, passed on file.

  10. Message from Senate.

  11. Immediate message.

  12. Passed Senate, yeas 37, nays 7.

  13. Committee report, approving bill.

  14. Introduced, placed on calendar.

Sponsors

  • COMMITTEE ON HEALTH AND HUMAN SERVICES · Primary

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 149 not signed on · 7 voted No

Sponsors (1)

  • COMMITTEE ON HEALTH AND HUMAN SERVICES

Co-sponsors (0)

None.

Not signed on (149)

149 members have not signed on to this bill.

Show all 149 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Shall the bill pass?

Passed 37 Yea · 7 Nay · 6 Other
Party YeaNayPresentNot Voting
Democrat 14103
Republican 24603
Total 38706
% of votes cast 75%14%0%12%
How each member voted (51)
Member Party Vote
Art Staed Democrat Yea
Catelin Drey Democrat Yea
Cindy Winckler Democrat Yea
Herman C. Quirmbach Democrat Yea
Izaah Knox Democrat Yea
Janet Petersen Democrat Not Voting
Janice Weiner Democrat Yea
Liz Bennett Democrat Yea
Matt Blake Democrat Yea
Mike Zimmer Democrat Yea
Molly Donahue Democrat Yea
Renee Hardman Democrat Not Voting
Sarah Trone Garriott Democrat Yea
Sarah Trone Garriott Democrat Yea
Thomas Townsend Democrat Yea
Tony Bisignano Democrat Yea
William A. Dotzler Jr. Democrat Nay
Zach Wahls Democrat Not Voting
Adrian Dickey Republican Yea
Amy Sinclair Republican Yea
Annette Sweeney Republican Yea
Carrie Koelker Republican Yea
Charlie McClintock Republican Yea
Cherielynn Westrich Republican Nay
Dan Dawson Republican Yea
Dan Zumbach Republican Yea
Dave Sires Republican Nay
David D. Rowley Republican Not Voting
Dawn Driscoll Republican Yea
Dennis Guth Republican Yea
Doug Campbell Republican Nay
Jack Whitver Republican Not Voting
Jason Schultz Republican Yea
Jeff Reichman Republican Yea
Jeff Taylor Republican Yea
Jesse Green Republican Yea
Julian B. Garrett Republican Not Voting
Kara Warme Republican Yea
Ken Rozenboom Republican Yea
Kerry Gruenhagen Republican Yea
Kevin Alons Republican Nay
Lynn Evans Republican Yea
Mark Costello Republican Yea
Mark S. Lofgren Republican Nay
Mike Bousselot Republican Yea
Mike Klimesh Republican Yea
Mike Pike Republican Yea
Sandy Salmon Republican Nay
Scott Webster Republican Yea
Tim Kraayenbrink Republican Yea
Tom Shipley Republican Yea

Official roll call →

Shall the bill pass?

Passed 93 Yea · 0 Nay · 7 Other
Party YeaNayPresentNot Voting
Unaffiliated 41003
Republican 35002
Democrat 17002
Total 93007
% of votes cast 93%0%0%7%
How each member voted (100)
Member Party Vote
Abdul-Samad — Yea
Anderson — Yea
Bacon — Yea
Baxter — Yea
Best — Yea
Brink — Yea
Cahill — Yea
Cohoon — Yea
Deyoe — Yea
Dolecheck — Yea
Forbes — Yea
Fry — Yea
Graber — Yea
Gustafson — Yea
Hall — Yea
Hansen — Yea
Hein — Yea
Hite — Yea
Hunter — Yea
Isenhart — Yea
Jacobsen — Yea
Kerr — Yea
Klein — Yea
Mascher — Yea
Maxwell — Yea
McConkey — Yea
Oldson — Yea
Osmundson — Yea
Paustian — Yea
Prichard — Yea
Running-Marquardt — Yea
Sexton — Yea
Shipley — Yea
Steckman — Yea
Sunde — Yea
Thede — Yea
Thorup — Yea
Wolfe — Yea
Worthan — Yea
Gobble — Yea
Bohannan — Not Voting
Bush — Not Voting
Mitchell — Not Voting
Thompson, P. — Yea
Amy Nielsen Democrat Yea
Art Staed Democrat Yea
Beth Wessel-Kroeschell Democrat Yea
Bob Kressig Democrat Yea
Brian Meyer Democrat Yea
Cindy Winckler Democrat Yea
David Jacoby Democrat Not Voting
Eric J. Gjerde Democrat Yea
Jennifer Konfrst Democrat Yea
Kenan Judge Democrat Yea
Lindsay James Democrat Not Voting
Liz Bennett Democrat Yea
Molly Donahue Democrat Yea
Monica Kurth Democrat Yea
Rick L. Olson Democrat Yea
Ross Wilburn Democrat Yea
Ruth Ann Gaines Democrat Yea
Timi M. Brown-Powers Democrat Yea
Tracy A. Ehlert Democrat Yea
Ann Meyer Republican Yea
Bobby Kaufmann Republican Yea
Brent Siegrist Republican Yea
Brian K. Lohse Republican Yea
Brooke Boden Republican Yea
Carter F. Nordman Republican Yea
Chad Ingels Republican Yea
Charlie McClintock Republican Not Voting
Cherielynn Westrich Republican Yea
Craig Steven Williams Republican Yea
David Sieck Republican Yea
Dean Fisher Republican Yea
Dr. Steven P. Bradley Republican Yea
Eddie Andrews Republican Yea
Gary M. Mohr Republican Yea
Henry Stone Republican Yea
Jacob Bossman Republican Yea
Jane Bloomingdale Republican Yea
Jennifer J. Smith Republican Yea
John H. Wills Republican Yea
Jon Dunwell Republican Yea
Mark Cisneros Republican Yea
Matt W. Windschitl Republican Yea
Megan Jones Republican Yea
Michael R. Bergan Republican Yea
Mike Bousselot Republican Yea
Norlin G. Mommsen Republican Yea
Pat Grassley Republican Yea
Ray Sorensen Republican Yea
Sandy Salmon Republican Yea
Shannon Latham Republican Yea
Shannon Lundgren Republican Not Voting
Skyler Wheeler Republican Yea
Steven C. Holt Republican Yea
Thomas Gerhold Republican Yea
Thomas Jay Moore Republican Yea
Thomas M. Jeneary Republican Yea

Official roll call →

Shall the bill pass?

Passed 46 Yea · 0 Nay · 4 Other
Party YeaNayPresentNot Voting
Republican 21003
Democrat 6000
Unaffiliated 20001
Total 47004
% of votes cast 92%0%0%8%
How each member voted (51)
Member Party Vote
Bolkcom — Yea
Boulton — Yea
Brown — Yea
Celsi — Yea
Chapman — Yea
Cournoyer — Yea
Edler — Yea
Giddens — Yea
Goodwin — Yea
Hogg — Yea
Jochum — Yea
Kinney — Yea
Lykam — Yea
Mathis — Yea
Nunn — Yea
Ragan — Yea
Shipley — Yea
Trone — Yea
Zaun — Yea
Carlin — Not Voting
Taylor, T. — Yea
Herman C. Quirmbach Democrat Yea
Janet Petersen Democrat Yea
Sarah Trone Garriott Democrat Yea
Tony Bisignano Democrat Yea
William A. Dotzler Jr. Democrat Yea
Zach Wahls Democrat Yea
Adrian Dickey Republican Yea
Amy Sinclair Republican Not Voting
Annette Sweeney Republican Yea
Carrie Koelker Republican Yea
Craig P. Johnson Republican Not Voting
Craig Steven Williams Republican Yea
Dan Dawson Republican Not Voting
Dan Zumbach Republican Yea
David D. Rowley Republican Yea
Dawn Driscoll Republican Yea
Dennis Guth Republican Yea
Jack Whitver Republican Yea
Jason Schultz Republican Yea
Jeff Reichman Republican Yea
Jeff Taylor Republican Yea
Jennifer J. Smith Republican Yea
Jennifer J. Smith Republican Yea
Jesse Green Republican Yea
Julian B. Garrett Republican Yea
Ken Rozenboom Republican Yea
Mark Costello Republican Yea
Mark S. Lofgren Republican Yea
Mike Klimesh Republican Yea
Tim Kraayenbrink Republican Yea

Official roll call →

Subjects

healthcare labor
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Frequently asked questions

Who sponsors SF 2190?
SF 2190 is sponsored by COMMITTEE ON HEALTH AND HUMAN SERVICES.
What is the current status of SF 2190?
This bill has been enacted into law. Introduced February 04, 2026. Enacted.
Where can I track SF 2190?
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