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STATE OF IOWA
KIM REYNOLDS
GOVERNOR
May 19,2026
The Honorable Paul Pate
Secretaiy of State of Iowa
State Capitol
Des Moines, Iowa 50319
Dear Mr. Secretary,
I hereby transmit:
House File 571, an Act relating to protections for medical practitioners and health care
institutions, including those related to the exercise of conscience, whistleblower
activities, and free speech, and providing penalties.
The above House File is hereby approved on this date.
Sincerely,
Kwn Reynolds
Governor of lowaj
cc: Secretary of the Senate
Clerk of the House
STATE CAPITOL DES MOINES, IOWA 50319 515.281.5211 WWW.GOVERNOR.IOWA.GOV
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House Pile 571
AN ACT
RELATING TO PROTECTIONS FOR MEDICAL PRACTITIONERS AND HEALTH
CARE INSTITUTIONS, INCLUDING THOSE RELATED TO THE EXERCISE
OF CONSCIENCE, WHISTLEBLOWER ACTIVITIES, AND FREE SPEECH,
AND PROVIDING PENALTIES.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
Section 1. SHORT TITLE. This Act shall be known and may be
cited as the ^Medical Ethics Defense Act".
Sec. 2. NEW SECTION. 135S.1 Definitions.
As used in this chapter, unless the context otherwise
requires:
1. a, ^Conscience'' means the ethical, moral, or religious
beliefs or principles held by a medical practitioner or health
care institution.
b. With respect to persons who are institutions,
corporations, or other legal entities, '^conscience" is
determined by reference to that entity's governing documents
including but not limited to published ethical, moral, or
religious guidelines or directives, mission statements,
constitutions, articles of incorporation, bylaws, policies, or
regulations.
2. ''^Discrimination" means an adverse action, including but
not limited to any penalty, disciplinary, or retaliatory action
taken against, or a threat of adverse action communicated
to, a medical practitioner or health care institution as a
result of the refusal of the medical practitioner or health
House File 571, p. 2
care institution to participate in a health care service on
the basis of conscience. "^Discrimination'' not does include
the negotiation or purchase of insurance or a health care
service by a nongovernmental entity or individual, the refusal
to use or purchase insurance or a health care service by
a nongovernmental entity or individual, or a health care
institution's good-faith effort to accommodate a medical
practitioner's or health care institution's exercise of
conscience.
3. ""Health care institution" means an organization,
corporation, partnership, association, agency, network, sole
proprietorship, joint venture, or other entity that provides
a health care service.
4. ""Health care service" means medical research and medical
care provided to a patient or client at any time during the
patient's or client's course of treatment, including but
not limited to testing; diagnosis; record making; referral;
prescribing, dispensing, or administering any drug, medication,
or device; therapy or counseling; and preparation or
arrangement for a surgical procedure.
5. ""Medical practitioner" means a person who facilitates
or participates, or who is asked to facilitate or participate
in a health care service, including but not limited to a
health-related professional licensed by a board designated in
section 147.13, and any other person licensed, certified, or
otherwise authorized or permitted by the laws of this state
to administer a health care service in the ordinary course
of business or in the practice of a profession. ""Medical
practitioner" includes any student enrolled in an educational
institution who is a prospective medical practitioner,
6. ""Participate in a health care service" means to provide,
perform, assist with, facilitate, refer for, provide counseling
for, advise with regard to, admit for the purposes of
providing, or take part in a health care service in any way.
Sec. 3. NEW SECTION. 135S.2 Exercise of conscience for
health care institutions and medical practitioners — exception.
1. a» A medical practitioner or health care institution
has the right not to participate in or pay for a health care
service that violates the medical practitioner's or health
House File 571, p. 3
care institution's conscience. A medical practitioner shall
inform the medical practitioner's employer of the nature of the
medical's practitioner's objection based on the practitioner's
conscience. This paragraph shall not be construed to waive or
modify a duty a medical practitioner or health care institution
may have to participate in a health care service that does not
violate the medical practitioner's conscience.
b, A medical practitioner or health care institution who
refuses to participate in a health care service under this
section shall not be discriminated against for the medical
practitioner's or health care institution's exercise of
conscience.
2. This section shall not be construed to relieve a health
care institution of the requirement to provide emergency
medical services to individuals as required under 42 U.S.C.
§1395dd.
3. Notwithstanding any other provision of this chapter to
the contrary, a medical practitioner or health care institution
that holds itself out to the public as religion-based, states
in the entity's governing documents that the entity has a
religious purpose or mission, and that has internal operating
policies or procedures that implement the entity's religious
beliefs, shall have the right to make employment, staffing,
contracting, and admitting privilege decisions consistent with
the entity's religious beliefs.
Sec. 4. NEW SECTION. 135S.3 Exercise of conscience ^
immunity.
1. A medical practitioner or health care institution shall
not be civilly, criminally, or administratively liable for the
medical practitioner's or health care institution's good-faith
exercise of conscience.
2. A health care institution shall not be civilly,
criminally, or administratively liable for the good-faith
exercise of conscience by a medical practitioner employed,
contracted, or granted admitting privileges by the health care
institution.
Sec. 5. NEW SECTION. 135S.4 Whistleblower protections.
1. A medical practitioner or health care institution shall
not be discriminated against because the medical practitioner
House File 571, p. 4
or health care institution does any of the following:
a. Provides, causes to be provided, or intends to provide
or cause to be provided information relating to a suspected
violation of this chapter to the medical practitioner's or
health care institution's employer, the attorney general, any
state agency charged with protecting health care rights of
conscience, the United States department of health and human
services, the United States commission on civil rights, or any
other federal agency charged with protecting health care rights
of conscience.
b. Testifies or intends to testify in a proceeding
concerning a violation of this chapter.
c. Assists or participates, or intends to assist or
participate, in a proceeding under this chapter.
2. It shall be unlawful to discriminate against a medical
practitioner or health care institution because the medical
practitioner or health care institution discloses information
that the medical practitioner or health care institution
reasonably believes evidences any of the following:
a, A violation of any law or rule.
b» A violation of any standard of care or ethical guidelines
for the provision of any health care service.
c. Gross mismanagement, a gross waste of funds, an abuse
of authority, practices or methods of treatment that may put a
patient or client health at risk, or a substantial and specific
danger to public health or safety.
3. This section shall not be construed to exempt a
person from the requirements of the federal Health Insurance
Portability and Accountability Act of 1996, Pub. L. No.
104-191, including amendments thereto and regulations
promulgated thereunder, or any other applicable confidentiality
and patient or client privacy requirements.
Sec. 6. NEW SECTION. 135S.5 Free speech protections —
notification of complaints — penalty.
1. The department of health and human services, a licensing
board designated under chapter 147, or any other state
licensing or certifying entity of a medical practitioner
shall not reprimand, sanction, or revoke or threaten to
revoke a license or certification of a medical practitioner
House File 571r p. 5
or health care institution who is licensed or certified
by the department, licensing board, or other licensing or
certifying entity, for engaging in speech, expressive activity,
or association protected under the first amendment to the
Constitution of the United States, unless the department,
licensing board, or other licensing or certifying entity
demonstrates by clear and convincing evidence that the medical
practitioner's or health care institution's speech, expressive
activity, or association was the direct cause of physical harm
to a person with whom the medical practitioner or health care
institution had a medical practitioner-patient or medical
practitioner-client relationship within the three years
immediately preceding the incident of physical harm.
2. a. Within twenty-one days of receipt of a complaint
that alleges a violation of speech, expressive activity, or
association protected under subsection 1 that may result
in revocation of a medical practitioner's or health care
institution's license, certification, or registration, the
department, licensing board, or other licensing or certifying
entity shall provide the medical practitioner or health care
institution with a copy of the complaint.
b. If the department, licensing board, or other licensing
or certifying entity fails to provide a copy of the complaint
to the medical practitioner or health care institution within
twenty-one days of receipt, the department, licensing board,
or other certifying entity shall pay the medical practitioner
or health care institution an administrative penalty of five
hundred dollars for each day of noncompliance.
3. The state shall not contract with, recognize, approve,
or require a medical practitioner or health care institution
to obtain a certification or credential issued or approved
by the department of health and human services, a licensing
board designated under chapter 147, or any other licensing or
certifying entity of a medical practitioner or health care
institution that revokes or refuses to issue a certification
or credential to the medical practitioner or health care
institution if the medical practitioner or health care
institution is in compliance with this chapter and did not
provide medical advice or treatment to a patient or client.
House Pile 571, p. 6
Sec. 7. NEW SECTION. 135S.6 Unlawful interference —
relief.
1. It is unlawful for a person to interfere or attempt to
interfere with the exercise of conscience not to participate in
a health care service, or in the whistleblower or free speech
rights and protections under this chapter, whether by duress,
coercion, or any other means.
2. A health care institution or medical practitioner that
alleges injury by unlawful interference by a person under
this chapter may bring a civil action in a court of competent
jurisdiction. If a court of competent jurisdiction finds a
person liable under this section, the court may order any of
the following;
a. Injunctive relief, when appropriate, including but not
limited to reinstatement of a medical practitioner to the
medical practitioner's previous position, or reinstatement
or reactivation of licensure or certification of a medical
practitioner, or reactivation or reinstatement of licensure of
a health care institution.
b. Monetary damages for injuries suffered.
c. Reasonable costs and attorney fees.
3. The rights, remedies, and prohibitions contained in this
chapter shall be in addition to and cumulative of any other
right, remedy, or prohibition accorded by common law or state
or federal law. This chapter shall not be construed to deny,
abrogate, or impair any such common law or statutory right,
remedy, or prohibition.
4. Any additional burden or expense to another medical
practitioner or health care institution arising from the
exercise of conscience pursuant to this chapter shall not be a
defense to a violation of this chapter.
5. A person shall not bring a civil action against a person
who declines to use or purchase a health care service from a
medical practitioner or health care institution because of the
medical practitioner's or health care institution's exercise of
conscience under this chapter.
Sec. 8. NEW SECTION. 135S.7 Severability.
If any provision of this chapter or its application to any
person or circumstance is held invalid, the invalidity shall
House File 571, p. 7
not affect other provisions or applications of this chapter
which can be given effect without the invalid provision or
application, and to this end the provisions of this chapter are
severable.
PAT GRASSLJ
Speaker oc the House
AMY SIN^AIR
President of the Senate
I hereby certify that this bill originated in the House and
is known as House File 571, Ninety-first General Assembly.
Approved , 2026
MEJSHAN NELSON
Chief Cl^k of the House
:iM\|^EYNOLDS
Governor