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Governor signs Medicaid work requirements, Opioid Settlement Fund bills into law

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Gov. Kim Reynolds, seen here in a file photo from May 2023, signed two dozen bills Friday. (Photo by Kathie Obradovich/Iowa Capital Dispatch)

Gov. Kim Reynolds signed more than 20 bills into law Friday, including funding for the state’s Opioid Settlement Fund and state-level Medicaid work requirements.

The governor has a little more than a week, until June 14, to sign the remaining bills passed during the 2025 legislative session into law. This week, the governor has held events signing multiple measures into law — including the reduction in Iowa’s unemployment insurance tax system. On Friday, she signed into law House File 969, a bill expanding the disability and death benefits for first responders like firefighters, emergency medical services responders and law enforcement officer to cover all forms of cancer.

This was not the only measure Reynolds signed into law Friday. She released a list of 24 new laws, which include some state spending provisions and other high-profile policies sent to her desk earlier this year.

Here are some of the bills signed into law:

Medicaid work requirements

As discussions — and conflicts — continue over the federal work requirement proposal for Medicaid coverage included in the GOP budget reconciliation bill, Reynolds signed Senate File 615, into law, a measure setting similar work requirements for the Iowa Medicaid program.

The requirements for at least 80 hours of work each month would apply to people receiving health coverage through the Iowa Health and Wellness Plan. IHAWP is the state’s expanded Medicaid program for low-income people between ages 19 to 64. There are exemptions to these work and reporting requirements for people with disabilities, serious illnesses or injuries, as well as those with children under age 6.

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The law directs the Iowa Department of Health and Human Services to seek a waiver to implement these requirements from the federal government. Iowa HHS has already submitted a waiver with a slightly different work requirement plan for IHAWP — one that sets a 100-hour per month work requirement, or for a person to be earn the equivalent in wages to working 100 hours a month at $7.25 per hour, or be enrolled in education or job skills programs to retain coverage.

Reynolds said in a statement on the bill signing, “it is priority of mine to ensure our government programs reflect a culture of work.”

“If you are an able-bodied adult who can work, you should work,” the governor said. “We need to return Medicaid back to its intended purpose—to provide coverage to the people who truly need it.”

Democrats and others critics have said the legislation will cut off health care coverage for eligible Iowans due to additional red tape, leading to a financial hit for rural hospitals and other health care centers.

The measure also contains a component that could have lasting impacts for Iowa’s expanded Medicaid program: If the federal government allows Iowa to implement work requirements, then later revokes approval, HHS would be directed to end IHAWP. The move to discontinue the program would require federal approval, and if the decision is not approved, Iowa HHS would be asked to pursue implementing an “alternative plan” under federal Medicaid administration guidelines.

Opioid Settlement Fund

After several years of stalled action, Reynolds approved the Legislature’s agreement on how to spend money from opioid lawsuit settlements.

House File 1038 distributes $29 million from the fund, money obtained in settlements for lawsuits by states against opioid manufacturers, distributors and pharmacies for their roles in the opioid epidemic. For several years, lawmakers in the Senate and House have failed to reach an agreement on how to spend the funds, which are obligated to go to opioid addiction treatment and prevention. But in the final hours of the 2025 legislative session, lawmakers agreed to a system that provides funding for specific organizations and programs that focus on addition treatment, recovery and prevention in fiscal year 2026.

In future years, money in the settlement fund will go to Iowa HHS and the Attorney General’s office — entities that will then decide how to allocate the money to organizations in the state. HHS will receive 75% of the funding each year and the AG’s office will receive 25%. While some lawmakers said they were frustrated with the money going to these state entities instead of being distributed directly by the Legislature, the bill passed with broad bipartisan support as get the funding into Iowa communities.

The governor thanked the Legislature for sending the bill to her desk in 2025.

“The opioid crisis continues to impact Iowa families,” Reynolds said in a statement. “I’m thankful the legislature reached an opioid settlement fund agreement this session to immediately distribute $29 million to providers and appropriate ongoing available funds to support early intervention, prevention, treatment, and recovery.”

Open records, meetings

The governor also signed House File 706, the bill setting higher penalties for violations of open meetings laws and requiring public officials t9 receive training on open meetings and records laws.

The bill was brought forward this year after a similar measure was vetoed in 2024 after a last-minute amendment was added that public records advocates had said would lead to unintended consequences. But Rep. Gary Mohr, R-Bettendorf, said adding heightened penalties and more training was still an important measure to pass as a means of addressing violations of these laws in Davenport related to the collapse of a six-story apartment building and alleged violations of open meeting laws in 2023.

The bill was also amended in 2025 by the Iowa Senate to include language add two types of records to the state’s list of confidential records — security camera footage from the Iowa Capitol and information from state employee identification card access systems.

Fetal development videos in Iowa classrooms

Senate File 175, also signed into law Friday, is a measure modeled after “Meet Baby Olivia” laws passed in other states. Though Iowa’s law does not reference the “Meet Baby Olivia” video developed by the anti-abortion group Live Action by name, it requires students in 5th through 12th grade human growth and development classes be shown ultrasound video and computer-generated rendering or animations depicting “the humanity of the unborn child by showing prenatal human development, starting at fertilization.”

The bill was amended by the House to include a provision banning materials in school classrooms on fetal development that come from an entity that performs or “promotes” abortion, or that contracts, affiliates, or makes referrals to organizations that perform or promote abortions.

Democratic lawmakers said this ban would mean material coming from reputable organizations and health care providers, like the Mayo Clinic or the University of Iowa Health System, could be excluded, as the ban would not exclude organizations that perform abortions in cases necessary to save the life of the mother.

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