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Bill > SF220
IA SF220
IA SF220A bill for an act relating to protections for medical practitioners, health care institutions, and health care payors including those related to the exercise of conscience, whistleblower activities, and free speech, and providing penalties.
summary
Introduced
02/05/2025
02/05/2025
In Committee
06/16/2025
06/16/2025
Crossed Over
Passed
Dead
05/03/2026
05/03/2026
Introduced Session
91st General Assembly
Bill Summary
This bill relates to protections for medical practitioners (practitioner), health care institutions (institution), and health care payors (payor), involving exercise of conscience, whistleblower activities, and free speech. The bill provides definitions for “conscience”, “discrimination”, “health care institution”, “health care payor”, “health care services”, “medical practitioner”, and “participate in a health care service”. The bill provides that a practitioner, institution, or payor has the right not to participate in or pay for a health care service (service) that violates the practitioner’s, institution’s, or payor’s conscience. A practitioner, institution, or payor who refuses to participate in a service due to exercise of conscience shall not be discriminated against for refusing to participate. The bill is not to be construed to relieve a practitioner, institution, or payor of the requirement under federal law to provide emergency medical services to certain individuals. The bill provides that a practitioner, institution, or payor that holds itself out to the public as religion-based, as described in the bill, shall have the right to make employment, staffing, contracting, and admitting privilege decisions consistent with the entity’s religious beliefs. The bill provides that a practitioner, institution, or payor shall not be civilly, criminally, or administratively liable for the practitioner’s, institution’s, or payor’s exercise of conscience. An institution shall not be civilly, criminally, or administratively liable for the excise of conscience by a practitioner employed, contracted, or granted admitting privileges by the institution. The bill provides whistleblower protections by providing that a practitioner, institution, or payor shall not be discriminated against because the practitioner, institution, or payor takes certain actions, as described in the bill, relating to a suspected violation of the bill. The bill prohibits discrimination against a practitioner, institution, or payor because the practitioner, institution, or payor discloses information as described in the bill. The bill is not to be construed to exempt a person from the requirements of the federal Health Insurance Portability and Accountability Act. The bill also provides that the department of health and human services (HHS), a health professional licensing board, or any other state licensing or certifying entity of a practitioner, institution, or payor shall not reprimand, sanction, or revoke or threaten to revoke a license or certification of a practitioner, institution, or payor for engaging in speech, expressive activity (activity), or association protected under the first amendment unless HHS, the licensing board, or other licensing or certifying entity demonstrates by clear and convincing evidence that the speech, activity, or association was the direct cause of physical harm to a person with whom the practitioner, institution, or payor had a medical practitioner-patient or medical practitioner-client relationship within the three years immediately preceding the incident of physical harm. Within 21 days of receiving a complaint alleging a violation of speech, activity, or association as described in the bill, HHS, a licensing board, or other licensing or certifying entity shall provide the practitioner, institution, or payor with a copy of the complaint. If HHS, a licensing board, or other licensing or certifying entity fails to provide the complaint within 21 days, HHS, the licensing board, or other certifying entity shall pay the practitioner, institution, or payor an administrative penalty of $500 for each day of noncompliance. If HHS, a licensing board, or other licensing or certifying entity revokes or refuses to issue a certification or credential to a practitioner, institution, or payor who is in compliance with the bill and did not provide medical advice or treatment to a patient or client, the state shall not contract with, recognize, approve, or require the certification or credential issued or approved by HHS, the licensing board, or other licensing or certifying entity. The bill provides that it is unlawful for a person to interfere or attempt to interfere with the right not to participate in or pay for a service, or with the whistleblower or free speech rights and protections authorized under the bill. An institution, payor, or practitioner injured by unlawful interference under the bill is entitled to bring a civil action that, if successful, may result in relief as detailed in the bill. The bill shall not be construed to deny, abrogate, or impair a common law or statutory right, remedy, or prohibition. An additional burden or expense arising from another practitioner’s, institution’s, or payor’s exercise of conscience is not a defense to a violation of the bill. The bill prohibits a person from bringing a civil action against a person who declines to use or purchase a service from a practitioner, institution, or payor exercising their conscience. The bill includes a severability clause.
AI Summary
This bill, known as the "Medical Ethics Defense Act," establishes comprehensive protections for medical practitioners, health care institutions, and health care payors regarding their right to exercise conscience, engage in whistleblower activities, and exercise free speech. The legislation defines key terms like "conscience" (ethical, moral, or religious beliefs) and provides broad protections that allow medical professionals and institutions to decline participation in health care services that conflict with their conscience without facing discrimination or legal penalties. The bill specifically protects practitioners and institutions from civil, criminal, or administrative liability when they refuse to participate in services that violate their ethical principles, with a notable exception that emergency medical services must still be provided. Whistleblower protections are established, preventing adverse actions against individuals who report potential violations of laws, standards of care, or public safety concerns. The bill also includes free speech protections, preventing licensing boards from reprimanding or revoking credentials based on protected speech unless clear evidence shows the speech directly caused physical harm. Additionally, the legislation creates mechanisms for legal recourse if someone unlawfully interferes with these conscience rights, including potential injunctive relief, monetary damages, and attorney fees. The bill aims to balance individual conscience rights with patient care by ensuring that practitioners can make ethical choices without fear of professional retaliation while maintaining critical healthcare services.
Committee Categories
Justice
Sponsors (1)
Last Action
Senate Judiciary Subcommittee (10:00:00 1/22/2026 Room 315) (on 01/22/2026)
Bill Topics
Civil Rights, Minority Issues, and Civil Liberties
- ‐ Freedom of Speech and Religion
Health
- ‐ Regulation of Doctors and Health Facilities
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location | Created |
|---|---|---|
| State Bill Page | https://www.legis.iowa.gov/legislation/BillBook?ga=91&ba=SF220 | 02/05/2025 |
| BillText | https://www.legis.iowa.gov/docs/publications/LGI/91/attachments/SF220.html | 02/05/2025 |
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