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, and retroactive applicability provisions.

This bill creates a new health care-related tax on health maintenance organizations operating in Iowa, with revenues deposited into a new Medicaid managed care organization premiums health care tax fund. The tax rate begins at 3.5% for the first nine months of 2026 before dropping to 0.95% for the remainder of that year and all subsequent years, applying to payments made by these organizations for health care services and benefits. The legislation also establishes prepayment requirements, allowing organizations to pay estimated taxes in advance and receive credits or cash refunds if they overpay. Additionally, the bill includes provisions for tax collection, penalties for late payments, and the ability to offset certain assessments against this new tax liability.