A bill for an act relating to the establishment of a state-based exchange, creation of a state-based exchange fund, state innovation waivers, and including effective date provisions.

This bill establishes a state-based health insurance exchange in Iowa, creating a dedicated fund to support it. The insurance commissioner must apply for a federal waiver by December 2026 to operate the exchange, which would allow Iowa to manage health insurance marketplaces under federal law. The bill creates a state fund in the treasury using state appropriations, federal funds, user fees, and grants, and requires strict confidentiality for all exchange-related information, barring public disclosure except under specific exceptions. It directly affects Iowa residents seeking health insurance through the state exchange and the insurance division as the program administrator.