A bill for an act relating to state finances by modifying the taxes imposed on health maintenance organizations, making transfers from the taxpayer relief fund, making and supplementing appropriations to the department of health and human services, and including effective date, contingent effective date, applicability, and retroactive applicability provisions.

This bill creates a new state tax on health maintenance organizations in Iowa, requiring them to pay a percentage of their taxable funds to a newly established Medicaid managed care organization premiums health care tax fund. The tax rate starts at 3.5% for the first nine months of 2026, then drops to 0.95% for the remainder of that year and all subsequent years. Organizations must make prepayments based on prior year earnings and face potential license suspension for non-payment. The bill also allows insurers to offset certain assessments against this new tax liability and includes provisions for tax refunds and examination periods.