Healthcare (Insurance)

SF 552 requires Iowa's Department of Health and Human Services (HHS) and Department of Administrative Services (DAS) to review anti-obesity medications - including GLP-1 agonists - for use in two specific programs: the state's medical assistance program (Medicaid) and health insurance plans for state employees. The review must assess medication effectiveness for weight loss, impact on related health conditions (comorbidities), potential cost savings, recommended eligibility, and short- and long-term coverage costs. HHS and DAS must submit a report to the legislature by January 5, 2026, detailing their findings, proposed eligibility rules, and cost analysis. This bill does not change current coverage but mandates a formal review to inform future policy decisions.

HF 330 requires health insurance plans to cover evidence-based treatment for autism spectrum disorder (ASD) for individuals diagnosed with ASD. It directly affects people with ASD who have health insurance, mandating that insurers provide this coverage without excessive cost-sharing. The bill establishes specific requirements for insurance companies to include ASD treatment services in their coverage, applying to most health insurance plans. This law, signed by the Governor on June 11, 2025, ensures that individuals with ASD can access necessary treatment through their insurance.

This bill requires health insurance plans in Iowa to treat follow-up breast exams (supplemental and diagnostic) the same as routine screening mammograms for cost-sharing purposes. Specifically, plans cannot impose higher out-of-pocket costs (like copays or deductibles) for these follow-up exams than they do for standard screenings. It applies to all health insurance policies issued, renewed, or continued in Iowa after January 1, 2026. This change directly affects health insurers and patients seeking breast cancer screenings or follow-up care.