Healthcare (Children's Health)

SF 242 requires Iowa health insurance companies to cover diagnosis and treatment for pediatric acute-onset neuropsychiatric syndrome (PANS), PANDAS (a strep-related subset of PANS), and postinfectious autoimmune encephalopathy as medically necessary. It mandates coverage for treatments like antibiotics, behavioral therapy, and immunotherapies without denying or delaying care based on prior treatment for these conditions or unrelated health issues. The law applies to most individual, group, and small group health insurance plans issued in Iowa on or after January 1, 2026, but excludes accident-only, dental, vision, and other specified coverage types. Insurance companies may still request treatment notes from healthcare providers to verify medical necessity.

HF 489 establishes a permanent annual state funding mechanism for pediatric cancer research at the University of Iowa Hospitals and Clinics. It appropriates money each fiscal year equal to Iowa's population count (from the prior July 1 U.S. Census estimate) from the general fund to the state board of regents, starting July 1, 2025. The bill requires the state board of regents to report annually by October 1 to the governor and legislature on how these funds were spent. This funding directly supports pediatric cancer research at the University of Iowa, with the amount automatically adjusting based on population changes.

This bill requires Iowa's Department of Health and Human Services to seek federal approval to expand Medicaid and CHIP coverage for mental health services provided in schools. It ensures all children enrolled in Iowa's Medicaid or CHIP programs - regardless of whether they have a special education plan - can access covered services without needing a formal mental health diagnosis. Covered services include individual, group, and family therapy, prevention services, evaluation, and case management. The bill also mandates collaboration with schools and federal technical assistance to implement these changes, particularly in rural and under-resourced districts.

This bill requires Iowa's children's health insurance program (CHIP) to cover applied behavior analysis (ABA) services for eligible children. It directs the Department of Health and Human Services to seek federal approval for this coverage expansion by submitting a state plan amendment to Medicare and Medicaid services. The change would directly affect children enrolled in CHIP who require ABA therapy, commonly used for developmental conditions like autism. The bill mandates that the medical assistance advisory council adopt rules to include ABA as a covered benefit in qualifying health plans under federal guidelines. It does not create new funding but modifies existing CHIP coverage to add this service.

SF 339 raises Iowa's Medicaid income eligibility threshold for pregnant women and infants from 215% to 375% of the federal poverty level. This change directly affects low-income pregnant women and infants whose families earn up to 375% of the federal poverty guideline, making them eligible for Medicaid coverage. The bill also requires Iowa to implement 12 months of continuous postpartum Medicaid coverage for qualifying pregnant women starting January 2026, and update infant eligibility rules accordingly. These changes align with federal requirements under the American Rescue Plan Act and aim to expand access to healthcare for this population.

SF 128 requires medical examiners investigating infant deaths (ages 0-3) to include specific immunization details on their investigation reports. The bill mandates that reports request the date and type of the decedent’s last immunization, including all types if multiple vaccines were administered at once. This change applies only to medical examiner forms used in these specific death investigations. The bill does not alter vaccination requirements or affect families directly, but adds a standard data point for medical examiners to collect during their investigations.