Bills › 91st General Assembly
Relating to the establishment of a state-based exchange, creation of a state-based exchange fund, state innovation waivers, and including effective date provisions
Topics:Health careInsurance
Where it is now
- Done: IntroducedFebruary 11, 2026
- Done: SubcommitteeFebruary 11, 2026
- Stopped: House committeeDied when the General Assembly ended
- Next: Passes the House
- Next: Senate committeeFunnel: by March 20, 2026
- Next: Passes the Senate
- Next: To the Governor
- Next: Signed into law
Died when the session ended The 2026 session adjourned on May 3, 2026, the General Assembly’s last regular session. Bills that didn’t pass both chambers died. What’s a funnel?
What’s in it
AI summary Iowa could create its own marketplace for people to buy and manage health insurance. The insurance commissioner would apply for permission from the federal government to run this system and would manage a special fund to pay for it. This new system would also include rules to keep certain insurance records and investigations private.1
Read the official explanation
This bill relates to the establishment of a state-based exchange and the creation of a state-based exchange fund. The bill defines “state-based exchange” as a state, federal, or partnership exchange or marketplace operating in the state pursuant to section 1311 of the federal Patient Protection and Affordable Care Act, Pub. L. 111-148.18A on or before December 31, 2026. Under the bill, at the direction of the governor, the commissioner shall have the authority to create, establish, implement, administer, or otherwise operate a state-based exchange and, if the application for a state innovation is approved, shall do so in accordance with the approved state innovation waiver. _____ (fund) is created in the state treasury under the control of the insurance division (division) and shall consist of moneys appropriated by the general assembly and any other moneys that are lawfully available to the division to be used for purposes of the bill, including but not limited to moneys obtained or accepted by the division from the federal government, user fees, and grants. All documents, materials, complaints, investigations, or other information in the possession or control of the division for purposes of the state-based exchange, or for complying with federal requirements for a federal health insurance exchange, are confidential records not subject to subpoena or discovery, or admissible into evidence, as provided in the bill, unless an exception enumerated in the bill is applicable. The commissioner may adopt rules, including emergency rules, to administer the bill. The bill, being deemed of immediate importance, takes effect upon enactment.
House subcommittee
Named February 11, 2026. On February 12, 2026 it recommended passage.
Three legislators hear a bill first and recommend what the committee should do; it’s the best time to weigh in. How to take part