Iowa 2025-2026 Regular Session Status: Enacted

HF 972 — A bill for an act relating to health care including a funding model for the rural health care system; the elimination of several health care-related award, grant, residency, and fellowship programs; establishment of a health care professional incentive program; Medicaid graduate medical education; the health facilities council; and the Iowa health information network, making appropriations, and including effective date provisions.

Last action — NOBA: Final

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

This bill has been enacted into law. Introduced March 21, 2025. Enacted.

Signed by Governor Kim Reynolds (Republican) on May 28, 2025.

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 2 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

82 added · 379 removed

Plain-language change summary

The recently amended Bill HF 972 retained its focus on healthcare, including funding models for rural healthcare, but it has eliminated multiple programs aimed at awards, grants, residencies, and fellowships. Instead, the bill introduces a new healthcare professional incentive program. This change is significant because it shifts resources towards encouraging healthcare professionals to work in rural areas, addressing workforce shortages while streamlining existing healthcare programs.

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House File 972 - Introduced HOUSE FILE 972 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO HF 754) (SUCCESSOR TO HSB 191) A BILL FOR An Act relating to health care including a funding model for the rural health care system;
House File 972 - Enrolled House File 972 AN ACT RELATING TO HEALTH CARE INCLUDING A FUNDING MODEL FOR THE RURAL HEALTH CARE SYSTEM;
the elimination of several health care-related award, grant, residency, and fellowship programs;
THE ELIMINATION OF SEVERAL HEALTH CARE-RELATED AWARD, GRANT, RESIDENCY, AND FELLOWSHIP PROGRAMS;
establishment of a health care professional incentive program;
ESTABLISHMENT OF A HEALTH CARE PROFESSIONAL INCENTIVE PROGRAM;
Medicaid graduate medical education;
MEDICAID GRADUATE MEDICAL EDUCATION;
the health facilities council;
THE HEALTH FACILITIES COUNCIL;
and the Iowa health information network, making appropriations, and including effective date provisions.
AND THE IOWA HEALTH INFORMATION NETWORK, MAKING APPROPRIATIONS, AND INCLUDING EFFECTIVE DATE PROVISIONS.
TLSB 1555HZ (3) 91 lh/ko H.F.
House File 972, p.
972 DIVISION I HEALTH CARE HUB-AND-SPOKE PARTNERSHIP FUNDING MODEL Section 1.
2 DIVISION I HEALTH CARE HUB-AND-SPOKE PARTNERSHIP FUNDING MODEL Section 1.
The department of health and human services shall make loan repayments pursuant to a loan repayment program contract, including a United States department of health and human LSB 1555HZ (3) 91 -1- lh/ko 1/41 H.F.
The department of health and human services shall make loan repayments pursuant to a loan repayment program contract, including a United States department of health and human services state loan repayment program contract, executed on or before December 31, 2025, under the primary care provider loan repayment program in section 135.107, Code 2025, if the recipient remains in compliance with all obligations under the House File 972, p.
972 services state loan repayment program contract, executed on or before December 31, 2025, under the primary care provider loan repayment program in section 135.107, Code 2025, if the recipient remains in compliance with all obligations under the loan repayment program contract.
3 loan repayment program contract.
The college student aid commission shall make loan repayments pursuant to a program agreement entered into on or before June 30, 2025, by an eligible student and the commission under the rural Iowa primary care loan repayment program LSB 1555HZ (3) 91 -2- lh/ko 2/41 H.F.
The college student aid commission shall make loan repayments pursuant to a program agreement entered into on or before June 30, 2025, by an eligible student and the commission under the rural Iowa primary care loan repayment program in section 256.221, Code 2025, if the student remains in compliance with all obligations under the program agreement.
972 in section 256.221, Code 2025, if the student remains in compliance with all obligations under the program agreement.
3.
House File 972, p.
4 3.
The college student aid commission shall create individual accounts for the deposit of any moneys encumbered or LSB 1555HZ (3) 91 -3- lh/ko 3/41 H.F.
The college student aid commission shall create individual accounts for the deposit of any moneys encumbered or obligated relating to a loan repayment or award funded under each of the following programs:
972 obligated relating to a loan repayment or award funded under each of the following programs:
Notwithstanding section 8.33, any balance in any of the accounts created under subsection 1 shall not revert but shall remain available for the duration of all applicable loan repayments and awards.
Notwithstanding section 8.33, any balance in any of the accounts created under subsection 1 shall not revert but House File 972, p.
5 shall remain available for the duration of all applicable loan repayments and awards.
(a) A federally guaranteed Stafford loan under the federal LSB 1555HZ (3) 91 -4- lh/ko 4/41 H.F.
(a) A federally guaranteed Stafford loan under the federal family education loan program or the federal direct loan program.
972 family education loan program or the federal direct loan program.
“Eligible health care profession” means health care occupational categories that are in high demand, as determined and maintained on a list by the department, and may include but are not limited to physicians, physician assistants, registered nurses, nurse practitioners, nurse educators, and mental health professionals.
“Eligible health care profession” means health care occupational categories that are in high demand, as determined and maintained on a list by the department, and may include but are not limited to physicians, physician assistants, registered House File 972, p.
6 nurses, nurse practitioners, nurse educators, and mental health professionals.
(2) If practicing part-time, which means at least one thousand five hundred sixty hours of work in a calendar year, including all paid holidays, vacations, sick time, and other paid leave, an eligible health care professional must practice LSB 1555HZ (3) 91 -5- lh/ko 5/41 H.F.
(2) If practicing part-time, which means at least one thousand five hundred sixty hours of work in a calendar year, including all paid holidays, vacations, sick time, and other paid leave, an eligible health care professional must practice for seven years.
972 for seven years.
An eligible health care professional shall be ineligible for the program if the eligible health care professional is currently participating in, or has participated in, any of the following:
An eligible health care professional shall be ineligible for the program if the eligible health care professional is currently participating in, or has participated House File 972, p.
7 in, any of the following:
The applicant shall LSB 1555HZ (3) 91 -6- lh/ko 6/41 H.F.
The applicant shall elect to receive an award as either a loan repayment or an income bonus if selected for the program, and shall submit any additional information requested by the commission.
972 elect to receive an award as either a loan repayment or an income bonus if selected for the program, and shall submit any additional information requested by the commission.
Upon verifying the eligible health care professional is in compliance with all terms of the program agreement executed pursuant to subsection 5, paragraph “c”, the commission shall pay the eligible health care professional’s award annually as follows:
Upon verifying the eligible health care professional is House File 972, p.
8 in compliance with all terms of the program agreement executed pursuant to subsection 5, paragraph “c”, the commission shall pay the eligible health care professional’s award annually as follows:
(b) An amount equal to fifteen percent of the aggregate LSB 1555HZ (3) 91 -7- lh/ko 7/41 H.F.
(b) An amount equal to fifteen percent of the aggregate award shall be paid to the eligible health care professional after the completion of the second year, the third year, and the fourth year of the eligible health care professional’s employment obligation.
972 award shall be paid to the eligible health care professional after the completion of the second year, the third year, and the fourth year of the eligible health care professional’s employment obligation.
Notwithstanding section 12C.7, subsection 2, interest or earnings on moneys in the fund shall be credited to the fund and may be utilized by the commission for administrative costs.
House File 972, p.
9 Notwithstanding section 12C.7, subsection 2, interest or earnings on moneys in the fund shall be credited to the fund and may be utilized by the commission for administrative costs.
This division of this Act, being LSB 1555HZ (3) 91 -8- lh/ko 8/41 H.F.
This division of this Act, being deemed of immediate importance, takes effect upon enactment.
972 deemed of immediate importance, takes effect upon enactment.
Moneys in the trust fund shall be used, subject to their appropriation by the general assembly, by the department to reimburse participating hospitals the medical assistance program upper payment limit for inpatient and outpatient LSB 1555HZ (3) 91 -9- lh/ko 9/41 H.F.
Moneys in the trust fund shall be used, subject to House File 972, p.
972 hospital services as calculated in this section.
10 their appropriation by the general assembly, by the department to reimburse participating hospitals the medical assistance program upper payment limit for inpatient and outpatient hospital services as calculated in this section.
The department of health and human services shall fund LSB 1555HZ (3) 91 -10- lh/ko 10/41 H.F.
The department of health and human services shall fund a fellowship position pursuant to a program agreement entered House File 972, p.
972 a fellowship position pursuant to a program agreement entered into on or before June 30, 2025, by a participating teaching hospital and a participating fellow under the state-funded family medicine obstetrics fellowship program in section 135.193, Code 2025, if the participating fellow remains in compliance with all obligations under the program agreement.
11 into on or before June 30, 2025, by a participating teaching hospital and a participating fellow under the state-funded family medicine obstetrics fellowship program in section 135.193, Code 2025, if the participating fellow remains in compliance with all obligations under the program agreement.
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The nurse residency state matching grants program LSB 1555HZ (3) 91 -11- lh/ko 11/41 H.F.
The nurse residency state matching grants program account created in section 135.175, subsection 5, paragraph “b”, Code 2025.
972 account created in section 135.175, subsection 5, paragraph “b”, Code 2025.
5.
House File 972, p.
12 5.
LSB 1555HZ (3) 91 -12- lh/ko 12/41 H.F.
d.
972 d.
(3) 2022 Iowa Acts, chapter 1131, section 3, subsection 4, paragraph “j”, as amended by 2024 Iowa Acts, chapter 1157, section 23.
(3) 2022 Iowa Acts, chapter 1131, section 3, subsection 4, paragraph “j”, as amended by 2024 Iowa Acts, chapter 1157, House File 972, p.
13 section 23.
LSB 1555HZ (3) 91 -13- lh/ko 13/41 H.F.
DIVISION VII ELIMINATION OF THE STATE-FUNDED PSYCHIATRY RESIDENCY AND FELLOWSHIP POSITIONS —— UNIVERSITY OF IOWA HOSPITALS AND CLINICS Sec.
972 DIVISION VII ELIMINATION OF THE STATE-FUNDED PSYCHIATRY RESIDENCY AND FELLOWSHIP POSITIONS —— UNIVERSITY OF IOWA HOSPITALS AND CLINICS Sec.
Sec.
House File 972, p.
14 Sec.
Notwithstanding section 8.33 or any other provision to the contrary, any unobligated or unencumbered moneys in the psychiatry residency and fellowship LSB 1555HZ (3) 91 -14- lh/ko 14/41 H.F.
Notwithstanding section 8.33 or any other provision to the contrary, any unobligated or unencumbered moneys in the psychiatry residency and fellowship positions fund created in section 135.180, Code 2025, shall not revert but are appropriated to the department of health and human services to fund Medicaid graduate medical education efforts.
972 positions fund created in section 135.180, Code 2025, shall not revert but are appropriated to the department of health and human services to fund Medicaid graduate medical education efforts.
“Department” means the department of health and human services.
“Department” means the department of health and human House File 972, p.
15 services.
LSB 1555HZ (3) 91 -15- lh/ko 15/41 H.F.
r.
972 r.
b.
House File 972, p.
16 b.
The department shall complete its formal review of the application within ninety days after acceptance of the application, except as otherwise provided by section 10A.722 135.71, subsection 4.
The department shall complete its formal review of the application within ninety days after acceptance of the application, except as otherwise provided by section 10A.722 135.71 , subsection 4.
The council department shall issue written findings stating the basis for its decision on the application, and the department shall send copies of the council’s decision and the written LSB 1555HZ (3) 91 -16- lh/ko 16/41 H.F.
The council department shall issue written findings stating the basis for its decision on the application, and the department shall send copies of the council’s decision and the written findings supporting the decision to the applicant and to any other person who so requests.
972 findings supporting the decision to the applicant and to any other person who so requests.
10A.721 Period for which certificate is valid —— extension or revocation.
10A.721 Period for which certificate is valid —— extension House File 972, p.
17 or revocation.
The certificate of need may LSB 1555HZ (3) 91 -17- lh/ko 17/41 H.F.
The certificate of need may be extended by the council department for additional periods of time as are reasonably necessary to expeditiously complete the project, but may be revoked by the council department at the end of the first or any subsequent certification period for insufficient progress in developing the project.
972 be extended by the council department for additional periods of time as are reasonably necessary to expeditiously complete the project, but may be revoked by the council department at the end of the first or any subsequent certification period for insufficient progress in developing the project.
The department may reduce, alter, or waive a penalty upon the party showing good faith compliance with the department’s request to immediately cease and desist from conduct in violation of this section.
The department may House File 972, p.
18 reduce, alter, or waive a penalty upon the party showing good faith compliance with the department’s request to immediately cease and desist from conduct in violation of this section.
Members of the state banking council, the Iowa ethics and LSB 1555HZ (3) 91 -18- lh/ko 18/41 H.F.
Members of the state banking council, the Iowa ethics and campaign disclosure board, the credit union review board, the economic development authority, the employment appeal board, the environmental protection commission, the health facilities council, the Iowa finance authority, the Iowa public employees’ retirement system investment board, the Iowa lottery commission created in section 99G.8, the natural resource commission, the board of parole, the state racing and gaming commission, the state board of regents, the transportation commission, the office of consumer advocate, the utilities commission, the Iowa telecommunications and technology commission, and any full-time members of other boards and commissions as defined under section 7E.4 who receive an annual salary for their service on the board or commission.
972 campaign disclosure board, the credit union review board, the economic development authority, the employment appeal board, the environmental protection commission, the health facilities council, the Iowa finance authority, the Iowa public employees’ retirement system investment board, the Iowa lottery commission created in section 99G.8, the natural resource commission, the board of parole, the state racing and gaming commission, the state board of regents, the transportation commission, the office of consumer advocate, the utilities commission, the Iowa telecommunications and technology commission, and any full-time members of other boards and commissions as defined under section 7E.4 who receive an annual salary for their service on the board or commission.
(8) Members of the state transportation commission, and the board of parole, and the state health facilities council .
(8) Members of the state transportation commission, and the board of parole, and the state health facilities council.
j.
House File 972, p.
19 j.
LSB 1555HZ (3) 91 -19- lh/ko 19/41 H.F.
l.
972 l.
A new institutional health service or changed institutional health service shall not be offered or developed in this state without prior application to the department for and receipt of a certificate of need, pursuant to this LSB 1555HZ (3) 91 -20- lh/ko 20/41 H.F.
A new institutional health service or changed institutional health service shall not be offered or developed in this state without prior application to the department for and receipt of a certificate of need, pursuant to this part subchapter.
972 part subchapter.
The application shall be made upon forms furnished or prescribed by the department and shall contain House File 972, p.
The application shall be made upon forms furnished or prescribed by the department and shall contain such information as the department may require under this part subchapter.
20 such information as the department may require under this part subchapter.
Private offices and private clinics of an individual physician, dentist, or other practitioner or group of health LSB 1555HZ (3) 91 -21- lh/ko 21/41 H.F.
Private offices and private clinics of an individual physician, dentist, or other practitioner or group of health care providers, except as provided by section 10A.711 135.61, subsection 17, paragraphs “g”, “h”, and “m”, and section 10A.711 135.61, subsections 2 and 19.
972 care providers, except as provided by section 10A.711 135.61, subsection 17, paragraphs “g”, “h”, and “m”, and section 10A.711 135.61, subsections 2 and 19.
A residential care facility, as defined in section 135C.1, including a residential care facility for persons with an intellectual disability, notwithstanding any provision in this part subchapter to the contrary.
A residential care facility, as defined in section 135C.1, including a residential care facility for persons with an intellectual disability, notwithstanding any provision in House File 972, p.
21 this part subchapter to the contrary.
The construction, modification, or replacement of nonpatient care services, including parking facilities, heating, ventilation and air conditioning systems, computers, telephone systems, medical office buildings, and other projects of a similar nature, notwithstanding any provision in this part LSB 1555HZ (3) 91 -22- lh/ko 22/41 H.F.
The construction, modification, or replacement of nonpatient care services, including parking facilities, heating, ventilation and air conditioning systems, computers, telephone systems, medical office buildings, and other projects of a similar nature, notwithstanding any provision in this part subchapter to the contrary.
972 subchapter to the contrary.
(2) If these conditions are not met, the redistribution of beds by the hospital is subject to review as a new institutional health service or changed institutional health service pursuant to section 10A.711 135.61, subsection 17, paragraph “d”, and is subject to sanctions under section 10A.723 135.72.
House File 972, p.
22 (2) If these conditions are not met, the redistribution of beds by the hospital is subject to review as a new institutional health service or changed institutional health service pursuant to section 10A.711 135.61, subsection 17, paragraph “d”, and is subject to sanctions under section 10A.723 135.72 .
(2) If these conditions are not met, the institutional health facility is subject to review as a “new institutional LSB 1555HZ (3) 91 -23- lh/ko 23/41 H.F.
(2) If these conditions are not met, the institutional health facility is subject to review as a “new institutional health service” or “changed institutional health service” under section 10A.711 135.61, subsection 17, paragraph “d”, and is subject to sanctions under section 10A.723 135.72.
972 health service” or “changed institutional health service” under section 10A.711 135.61, subsection 17, paragraph “d”, and is subject to sanctions under section 10A.723 135.72.
The replacement or modernization of any institutional health facility if the replacement or modernization does not add new health services or additional bed capacity for existing health services, notwithstanding any provision in this part subchapter to the contrary.
The replacement or modernization of any institutional health facility if the replacement or modernization does not add new health services or additional bed capacity for existing health services, notwithstanding any provision in this House File 972, p.
23 part subchapter to the contrary.
This part subchapter shall not be construed to be applicable to a health care facility operated by and for the exclusive use of members of a religious order, which does LSB 1555HZ (3) 91 -24- lh/ko 24/41 H.F.
This part subchapter shall not be construed to be applicable to a health care facility operated by and for the exclusive use of members of a religious order, which does not admit more than two individuals to the facility from the general public, and which was in operation prior to July 1, 1986.
972 not admit more than two individuals to the facility from the general public, and which was in operation prior to July 1, 1986.
Section 10A.715, subsection 2, Code 2025, is amended to read as follows:
Section 10A.715, subsection 2, Code 2025, is House File 972, p.
24 amended to read as follows:
The department shall LSB 1555HZ (3) 91 -25- lh/ko 25/41 H.F.
The department shall promptly return to the applicant any rejected application, with an explanation of the reasons for its rejection.
972 promptly return to the applicant any rejected application, with an explanation of the reasons for its rejection.
Criteria for determining when it is not feasible to complete formal review of an application for a certificate of need within the time limits specified in section 10A.719 135.68 .
Criteria for determining when it is not feasible to complete formal review of an application for a certificate House File 972, p.
25 of need within the time limits specified in section 10A.719 135.68.
Any party constructing a new institutional health facility or an addition to or renovation of an existing LSB 1555HZ (3) 91 -26- lh/ko 26/41 H.F.
Any party constructing a new institutional health facility or an addition to or renovation of an existing institutional health facility without first obtaining a certificate of need or, in the case of a mobile health service, ascertaining that the mobile health service has received certificate of need approval, as required by this part subchapter , shall be denied licensure or change of licensure by the appropriate responsible licensing agency of this state.
972 institutional health facility without first obtaining a certificate of need or, in the case of a mobile health service, ascertaining that the mobile health service has received certificate of need approval, as required by this part subchapter , shall be denied licensure or change of licensure by the appropriate responsible licensing agency of this state.
The department shall, where appropriate, provide for modification, consistent with the purposes of this part subchapter, of reporting requirements to correctly reflect the differences among hospitals and among health care facilities referred to in subsection 2, and to avoid otherwise unduly burdensome costs in meeting the requirements of uniform methods of financial reporting.
The department shall, where appropriate, provide for modification, consistent with the purposes of this part House File 972, p.
26 subchapter , of reporting requirements to correctly reflect the differences among hospitals and among health care facilities referred to in subsection 2, and to avoid otherwise unduly burdensome costs in meeting the requirements of uniform methods of financial reporting.
Where more than one licensed hospital or health care facility is operated by the reporting organization, LSB 1555HZ (3) 91 -27- lh/ko 27/41 H.F.
Where more than one licensed hospital or health care facility is operated by the reporting organization, the information required by this section shall be reported separately for each licensed hospital or health care facility.
972 the information required by this section shall be reported separately for each licensed hospital or health care facility.
The department shall compile all relevant financial and utilization data in order to have available the statistical information necessary to properly monitor hospital and health care facility charges and costs.
The department shall compile all relevant financial and House File 972, p.
Such data shall include necessary operating expenses, appropriate expenses incurred for rendering services to patients who cannot or do not pay, all LSB 1555HZ (3) 91 -28- lh/ko 28/41 H.F.
27 utilization data in order to have available the statistical information necessary to properly monitor hospital and health care facility charges and costs.
972 properly incurred interest charges, and reasonable depreciation expenses based on the expected useful life of the property and equipment involved.
Such data shall include necessary operating expenses, appropriate expenses incurred for rendering services to patients who cannot or do not pay, all properly incurred interest charges, and reasonable depreciation expenses based on the expected useful life of the property and equipment involved.
No state or federal funds appropriated or available to the department shall be used for any such pilot LSB 1555HZ (3) 91 -29- lh/ko 29/41 H.F.
No state or federal funds appropriated or House File 972, p.
972 program.
28 available to the department shall be used for any such pilot program.
1246, §206, and which include all of the LSB 1555HZ (3) 91 -30- lh/ko 30/41 H.F.
1246, §206, and which include all of the following provisions:
972 following provisions:
3.
House File 972, p.
29 3.
“Health care provider” means an emergency medical care LSB 1555HZ (3) 91 -31- lh/ko 31/41 H.F.
“Health care provider” means an emergency medical care provider as defined in chapter 147A or a person licensed or registered under chapter 148, 148C, 148D, or 152 who is providing or who is attempting to provide emergency medical services, as defined in section 147A.1, or who is providing or who is attempting to provide health services as defined in section 10A.711 135.61 in a hospital.
972 provider as defined in chapter 147A or a person licensed or registered under chapter 148, 148C, 148D, or 152 who is providing or who is attempting to provide emergency medical services, as defined in section 147A.1, or who is providing or who is attempting to provide health services as defined in section 10A.711 135.61 in a hospital.
A person who commits an assault under this section against a health care provider in House File 972, p.
A person who commits an assault under this section against a health care provider in a hospital, or at the scene or during out-of-hospital patient transportation in an ambulance, is presumed to know that the person against whom the assault is committed is a health care provider.
30 a hospital, or at the scene or during out-of-hospital patient transportation in an ambulance, is presumed to know that the person against whom the assault is committed is a health care provider.
NEW SUBSECTION.
NEW SUBSECTION .
The network, through the designated entity complying with chapter 490, 496C, and 504 and reporting as required under this chapter, operates in an entrepreneurial and businesslike manner in which it is accountable to all participants utilizing the LSB 1555HZ (3) 91 -32- lh/ko 32/41 H.F.
The network, through the designated entity complying with chapter 490, 496C, and 504 and reporting as required under this chapter, operates in an entrepreneurial and businesslike manner in which it is accountable to all participants utilizing the network’s products and services.
972 network’s products and services.
The designated entity shall be established for the purpose of administering and governing the statewide Iowa health information network.
The designated entity shall be established for the purpose of administering and governing the House File 972, p.
31 statewide Iowa health information network.
Advise the department regarding the needs of participants LSB 1555HZ (3) 91 -33- lh/ko 33/41 H.F.
Advise the department regarding the needs of participants and nonparticipants relating to the exchange of health information.
972 and nonparticipants relating to the exchange of health information.
d.
House File 972, p.
32 d.
The board designated entity shall implement industry-accepted security standards, policies, and procedures to protect the transmission and receipt of protected health LSB 1555HZ (3) 91 -34- lh/ko 34/41 H.F.
The board designated entity shall implement industry-accepted security standards, policies, and procedures to protect the transmission and receipt of protected health information exchanged through the Iowa health information network, which shall, at a minimum, comply with HIPAA and shall include all of the following:
972 information exchanged through the Iowa health information network, which shall, at a minimum, comply with HIPAA and shall include all of the following:
b.
House File 972, p.
33 b.
EXPLANATION The inclusion of this explanation does not constitute agreement with the explanation’s substance by the members of the general assembly.
______________________________ ______________________________ PAT GRASSLEY AMY SINCLAIR Speaker of the House President of the Senate I hereby certify that this bill originated in the House and is known as House File 972, Ninety-first General Assembly.
This bill relates to health care including a funding model for Iowa’s rural health system;
______________________________ MEGHAN NELSON Chief Clerk of the House Approved _______________, 2025 ______________________________ KIM REYNOLDS Governor
health care-related award, grant, residency, and fellowship programs;
establishment of a health care incentive program;
Medicaid graduate medical education;
the health facilities council;
and the Iowa health information network.
DIVISION I.
This division requires the department of health and human services (HHS) to submit to the centers for Medicare and Medicaid services of the United States department of health and human services (CMS) a request for approval for a health LSB 1555HZ (3) 91 -35- lh/ko 35/41 H.F.
972 care hub-and-spoke partnership funding model for the purpose of improving Iowa’s rural health system.
The division takes effect upon enactment.
DIVISION II.
This division eliminates the primary care recruitment and retention endeavor (PRIMECARRE) and makes conforming changes.
The bill requires HHS to coordinate with the college student aid commission (commission) to administer the health care professional incentive program established in division IV of the bill.
PRIMECARRE includes the health care workforce and community support grant program and the primary care provider loan repayment program to recruit and retain primary care providers in rural communities.
Current law requires HHS to encourage local boards to adopt a plan including that health facilities may seek technical assistance or apply for matching grants for plan development.
The bill removes the instruction for health facilities to apply for matching grants for plan development.
HHS is required to make loan repayments pursuant to a loan repayment program contract including a United States department of health and human services state loan repayment program contract executed on or before December 31, 2025, under the primary care provider loan repayment program if a recipient is in compliance with the loan repayment program contract.
HHS shall create an account for the deposit of encumbered or obligated moneys relating to the primary care provider loan repayment program as described in the bill.
DIVISION III.
This division eliminates certain health care-related programs.
The rural Iowa primary care loan repayment program (Code section 256.221) is eliminated.
The program provides loan repayment for medical students who agree to practice as physicians in certain service areas.
The health care professional recruitment program (Code section 256.223) is also eliminated.
The program provides loan repayment for students who graduate from a certain institution LSB 1555HZ (3) 91 -36- lh/ko 36/41 H.F.
972 and become licensed as a health care professional.
In addition, the health care award program (Code section 256.224) is eliminated.
The program provides financial awards to registered nurses, advanced registered nurse practitioners, physician assistants, and nurse educators who practice in certain areas or teach in this state.
Finally, the mental health professional loan repayment program (Code section 256.225) is eliminated.
The program provides loan repayment for mental health professionals who agree to practice in certain practice areas.
For all of the eliminated programs, the college student aid commission (commission) is required to make loan repayments and provide annual awards pursuant to program agreements and contracts entered into on or before June 30, 2025, as detailed in the bill.
All unencumbered and unobligated moneys in the eliminated programs’ funds shall be transferred to the health care professional incentive program fund (program fund) created in division IV.
The commission shall create accounts for the deposit of encumbered and obligated moneys for each eliminated program as detailed in the division.
Upon the expiration of all program agreement, contract, and award disbursement periods, any unencumbered and unobligated moneys in the accounts shall be deposited in the program fund created in division IV.
DIVISION IV.
This division establishes a health care professional incentive program (incentive program) to recruit and retain eligible health care professionals (professionals) in eligible health care professions (profession) in certain areas of the state by offering an award of a loan repayment or an income bonus.
The commission, in coordination with HHS, shall administer the incentive program as detailed in the division.
A professional is ineligible for the incentive program if the professional is currently participating in or has participated in certain health care-related award programs as identified in divisions II and III.
The commission shall LSB 1555HZ (3) 91 -37- lh/ko 37/41 H.F.
972 give priority to an applicant fulfilling a full-time employment obligation.
The incentive program award shall be distributed annually by the commission as detailed in the division.
At least every five years, the commission, in consultation with HHS, shall establish a list of professions, and the aggregate award amounts, not to exceed $200,000, for each profession.
A program fund is created and moneys in the program fund are appropriated to the commission to be used for the incentive program.
The moneys deposited in the program fund shall not revert and shall remain in the program fund at the end of the fiscal year.
The commission may use the interest and earnings on the moneys in the fund for administrative costs.
All moneys received by HHS or the commission from the health care-related programs eliminated in divisions II and III shall be deposited into the program fund.
The commission, in coordination with HHS, shall adopt rules to administer the incentive program.
The division takes effect upon enactment.
DIVISION V.
This division requires HHS to submit to CMS a request for approval for a Medicaid supplemental enhanced payment for the purposes of maximizing federal funding opportunities for graduate medical education, and to increase the number of medical residencies in the state.
Upon receipt of federal approval, HHS shall notify the general assembly and the Code editor.
The division takes effect upon enactment.
DIVISION VI.
This division eliminates certain health care-related grant, residency, and fellowship programs.
Current law provides that the fulfilling Iowa’s need for dentists matching grant program may receive moneys through the health care workforce shortage fund or the fulfilling Iowa’s need for dentists matching grant program account (Code section 135.175).
The division eliminates the fund and the account.
The health care workforce support initiative (Code section 135.175) is eliminated.
The initiative provides for the coordination and support of various efforts to address the LSB 1555HZ (3) 91 -38- lh/ko 38/41 H.F.
972 health care workforce shortage in the state.
Additionally, the medical residency training state matching grants program (Code section 135.176) is eliminated.
The program provides matching state funding to sponsors of accredited graduate medical education residency programs in the state to establish, expand, or support medical residency training programs.
The nurse residency state matching grants program (Code section 135.178) is also eliminated.
The program provides matching state funding to sponsors of nurse residency programs in the state to establish, expand, or support nurse residency programs.
Moreover, the state-funded family medicine obstetrics fellowship program (Code section 135.193) is eliminated.
The program provides funding for fellowships to increase access to family medicine obstetrics practitioners in rural and underserved areas of the state.
For all of the programs eliminated in the division, HHS is required to provide matching state funding and fund residency and fellowship positions awarded on or before June 30, 2025, as detailed in the bill.
All unencumbered and unobligated moneys related to the programs eliminated in the division shall be transferred to HHS to fund Medicaid graduate medical education efforts.
HHS shall create accounts for the deposit of encumbered and obligated moneys for each eliminated program as detailed in the division.
Upon the expiration of all grant, residency, and fellowship periods, any unencumbered and unobligated moneys in the account shall be appropriated to HHS for Medicaid graduate medical education efforts.
The division takes effect upon the date that HHS notifies the general assembly and the Code editor of the receipt of federal approval for a Medicaid supplemental enhanced payment for the purposes of maximizing federal funding opportunities for graduate medical education, and to increase the number of LSB 1555HZ (3) 91 -39- lh/ko 39/41 H.F.
972 medical residencies in the state.
DIVISION VII.
This division eliminates the state-funded psychiatry residency and fellowship positions (positions) (Code section 135.180) administered by the university of Iowa hospitals and clinics (U of I).
The positions provide financial support for up to seven residents and up to two fellows annually.
The board of regents (regents) shall direct the U of I to distribute moneys for positions approved and awarded on or before June 30, 2025, until all residents and fellows have completed or left the positions.
The regents must also direct the U of I to create an account for the deposit of moneys encumbered and obligated relating to the positions.
Upon the expiration of all residency and fellowship periods, any unencumbered and unobligated moneys in the account shall be appropriated to HHS for Medicaid graduate medical education efforts.
Any unobligated or unencumbered moneys in the psychiatry residency and fellowship positions fund are also appropriated to HHS to fund Medicaid graduate medical education efforts.
The division takes effect upon the date that HHS notifies the general assembly and the Code editor of the receipt of federal approval for a Medicaid supplemental enhanced payment for the purposes of maximizing federal funding opportunities for graduate medical education, and to increase the number of medical residencies in the state.
DIVISION VIII.
This division eliminates the health facilities council, and transfers the council’s duties to HHS.
DIVISION IX.
This division makes conforming changes to the Code related to the elimination of health facilities council and the transfer of the applicable Code sections.
DIVISION X.
This division eliminates the board of directors (board) that governs and administers the Iowa health information network (network) and transfers the board’s administrative duties to the designated entity.
Current law requires the designated entity to be a nonprofit corporation.
LSB 1555HZ (3) 91 -40- lh/ko 40/41 H.F.
972 The bill eliminates the requirement that the corporation be nonprofit.
The division creates an exchange advisory committee (committee), appointed by the director of HHS, to govern the network and the designated entity.
The division requires HHS to conduct a competitive process every eight years to select a designated entity.
Current law prohibits a single industry from being disproportionately represented as voting members of the board, and requires the director of HHS and the director of the Medicaid program or the directors’ designees to act as voting members.
The commissioner of insurance is required to serve on the board as a nonvoting member, and individuals serving in a nonvoting capacity on the board are not included in the total number of authorized members on the board.
The division strikes these member requirements.
Current law requires the board to ensure the designated entity enters into contracts with each state agency necessary for state reporting requirements, and to develop, implement, and enforce a single patient identifier or alternative mechanism to share secure patient information that is utilized by all health care professionals.
The division eliminates these duties for the committee.
The division requires the committee to advise HHS regarding the needs relating to the exchange of health information, and to ensure HHS develops, and the designated entity complies with, the standards, requirements, policies, and procedures related to the network.
LSB 1555HZ (3) 91 -41- lh/ko 41/41
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Action History

  1. NOBA: Final

  2. Signed by Governor.

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

  4. Message from Senate.

  5. Immediate message.

  6. Passed Senate, yeas 41, nays 4.

  7. Substituted for SF 618.

  8. Explanation of vote.

  9. Attached to SF 618.

  10. NOBA: House Floor

  11. Read first time, passed on file.

  12. Message from House.

  13. Immediate message.

  14. Passed House, yeas 95, nays 1.

  15. NOBA: House Full Approps

  16. Introduced, placed on Appropriations calendar.

Sponsors

  • COMMITTEE ON APPROPRIATIONS · Primary

Sponsorship breakdown

Export CSV (upgrade) →

1 sponsors · 0 co-sponsors · 149 not signed on · 4 voted No

Sponsors (1)

  • COMMITTEE ON APPROPRIATIONS

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 41 Yea · 4 Nay · 5 Other
Party YeaNayPresentNot Voting
Republican 32001
Democrat 10303
Unaffiliated 0101
Total 42405
% of votes cast 82%8%0%10%
How each member voted (51)
Member Party Vote
Celsi — Nay
De Witt — Not Voting
Art Staed Democrat Yea
Cindy Winckler Democrat Nay
Herman C. Quirmbach Democrat Yea
Izaah Knox Democrat Not Voting
Janet Petersen Democrat Yea
Janice Weiner Democrat Yea
Liz Bennett Democrat Yea
Matt Blake Democrat Yea
Mike Zimmer Democrat Not Voting
Molly Donahue Democrat Yea
Sarah Trone Garriott Democrat Yea
Sarah Trone Garriott Democrat Yea
Thomas Townsend Democrat Nay
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 Yea
Dan Dawson Republican Yea
Dan Zumbach Republican Yea
Dave Sires Republican Yea
David D. Rowley Republican Yea
Dawn Driscoll Republican Yea
Dennis Guth Republican Yea
Doug Campbell Republican Yea
Jack Whitver Republican Yea
Jason Schultz Republican Yea
Jeff Reichman Republican Yea
Jeff Taylor Republican Yea
Jesse Green Republican Yea
Julian B. Garrett Republican Yea
Kara Warme Republican Yea
Ken Rozenboom Republican Yea
Kerry Gruenhagen Republican Yea
Kevin Alons Republican Yea
Lynn Evans Republican Yea
Mark Costello Republican Yea
Mark S. Lofgren Republican Yea
Mike Bousselot Republican Yea
Mike Klimesh Republican Yea
Mike Pike Republican Not Voting
Sandy Salmon Republican Yea
Scott Webster Republican Yea
Tim Kraayenbrink Republican Yea
Tom Shipley Republican Yea

Official roll call →

Shall the bill pass?

Passed 95 Yea · 1 Nay · 4 Other
Party YeaNayPresentNot Voting
Democrat 30101
Unaffiliated 5000
Republican 63003
Total 98104
% of votes cast 95%1%0%4%
How each member voted (103)
Member Party Vote
Jr. — Yea
Kniff — Yea
Scheetz — Yea
Sexton — Yea
Speaker — Yea
Adam Zabner Democrat Yea
Aime Wichtendahl Democrat Yea
Amy Nielsen Democrat Yea
Austin Baeth Democrat Yea
Beth Wessel-Kroeschell Democrat Yea
Bob Kressig Democrat Yea
Brian Meyer Democrat Yea
Daniel Gosa Democrat Yea
David Jacoby Democrat Yea
Dr. Megan L. Srinivas Democrat Yea
Elinor A. Levin Democrat Nay
Elizabeth Wilson Democrat Yea
Eric J. Gjerde Democrat Yea
Heather Matson Democrat Yea
J.D. Scholten Democrat Yea
Jeff Cooling Democrat Yea
Jennifer Konfrst Democrat Yea
Jerome Amos Jr. Democrat Yea
Josh Turek Democrat Yea
Ken Croken Democrat Yea
Kenan Judge Democrat Yea
Larry McBurney Democrat Yea
Lindsay James Democrat Yea
Mary Lee Madison Democrat Yea
Monica Kurth Democrat Yea
Rick L. Olson Democrat Yea
Rob Johnson Democrat Yea
Ross Wilburn Democrat Yea
Ruth Ann Gaines Democrat Not Voting
Sean Bagniewski Democrat Yea
Timi M. Brown-Powers Democrat Yea
Tracy A. Ehlert Democrat Yea
Ann Meyer Republican Yea
Austin Harris Republican Yea
Barb Kniff McCulla Republican Yea
Bill Gustoff Republican Yea
Blaine C. Watkins Republican Yea
Bob Henderson Republican Yea
Bobby Kaufmann Republican Yea
Brent Siegrist Republican Not Voting
Brett Barker Republican Yea
Brian K. Lohse Republican Yea
Brooke Boden Republican Yea
Carter F. Nordman Republican Yea
Chad Behn Republican Yea
Chad Ingels Republican Yea
Charley Thomson Republican Yea
Christian A. Hermanson Republican Yea
Cindy Golding Republican Yea
Craig P. Johnson Republican Yea
Craig Steven Williams Republican Yea
Dan Gehlbach Republican Yea
David E. Young Republican Yea
David L. Blom Republican Yea
David Sieck Republican Yea
Dean Fisher Republican Yea
Derek Wulf Republican Yea
Devon Wood Republican Yea
Dr. Steven P. Bradley Republican Yea
Eddie Andrews Republican Yea
Gary M. Mohr Republican Yea
Hans C. Wilz Republican Not Voting
Heather Hora Republican Yea
Helena Hayes Republican Yea
Henry Stone Republican Yea
Jacob Bossman Republican Yea
Jane Bloomingdale Republican Yea
Jason Gearhart Republican Yea
Jennifer J. Smith Republican Yea
John H. Wills Republican Yea
Jon Dunwell Republican Yea
Joshua Meggers Republican Yea
Judd Lawler Republican Yea
Mark Cisneros Republican Yea
Mark I. Thompson Republican Yea
Matt W. Windschitl Republican Yea
Matthew Rinker Republican Yea
Megan Jones Republican Yea
Michael R. Bergan Republican Yea
Mike Vondran Republican Yea
Norlin G. Mommsen Republican Yea
Pat Grassley Republican Yea
Ray Sorensen Republican Yea
Ryan Weldon Republican Yea
Sam Wengryn Republican Yea
Samantha Fett Republican Not Voting
Shannon Latham Republican Yea
Shannon Lundgren Republican Yea
Skyler Wheeler Republican Yea
Steven C. Holt Republican Yea
Taylor R. Collins Republican Yea
Thomas Gerhold Republican Yea
Thomas Jay Moore Republican Yea
Thomas M. Jeneary Republican Yea
Tom Determann Republican Yea
Tom Shipley Republican Yea
Travis M. Sitzmann Republican Yea
Zach Dieken Republican Yea

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

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HF 972 is sponsored by COMMITTEE ON APPROPRIATIONS.
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This bill has been enacted into law. Introduced March 21, 2025. Enacted.
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