State Policy Developments in Rural Iowa Health care

Iowa employers carry much of the cost of providing health care through the benefits they extend to employees and their families. Access to high-quality, affordable health care remains essential for a strong and reliable workforce.

When ABI’s Public Policy team testifies at the Capitol, we often describe a “typical” ABI member: a manufacturer with fewer than 100 employees, often located in a suburban, exurban, or rural community. With this profile in mind, it’s easy to see why rural health care was a top priority for Governor Kim Reynolds and the Iowa Legislature during the 2025 session.

The discussion began with Governor Reynolds’ Condition of the State Address, where she proposed sweeping rural health care legislation. The measure, later passed with near-unanimous, bipartisan support, became House File 972.

Key provisions of HF 972 include:

• Expanding loan repayment programs and pursuing federal funds to create new medical residency slots.

• Strengthening maternal health services.

• Streamlining the approval process for new health care facilities through changes to the certificate of need process.

• Revamping financial incentive programs to encourage health care workforce education and training.

• Developing a “hub-and-spoke” delivery system to connect rural providers with regional specialists, ensuring rural Iowans can access advanced care.

• Creating more residency opportunities for Iowans pursuing advanced medical degrees, increasing the likelihood they remain in-state to practice.

In addition to HF 972, legislators advanced SF 383, a bill designed to fix prices for pharmacy services. The stated goal was to help small, independent rural pharmacies, many of which serve ABI members and their employees in those communities. ABI testified to the importance of supporting these pharmacies during the legislative session. The law now faces a federal lawsuit alleging it may be preempted by federal legislation and infringes on protected commercial speech.