Bill
HF 1049
Funds Iowa DVA and HHS for aging, disability, behavioral health, and Medicaid, with policy limits like banning Medicaid coverage for sex‑reassignment procedures.
Note: the document you provided for H.F. 1049 is an appropriations and policy omnibus for the Department of Veterans Affairs and the Department of Health and Human Services (state fiscal year 2025–2026). It does NOT appear to concern school library aid despite the title you supplied. Below is a concise, factual summary of the actual bill text and major amendments shown in the provided materials.
Summary — H.F. 1049 (Appropriations to Veterans Affairs and Health & Human Services), 2025–2026
Purpose and intent
- Provide FY2025–2026 appropriations from the state general fund and other specified funds to the Department of Veterans Affairs (DVA) and the Department of Health and Human Services (HHS).
- Fund aging, disability, behavioral health, public health, community access and eligibility programs, medical assistance (Medicaid) and other health‑related programs; set certain programmatic policy provisions and reporting requirements; and authorize related transfers and trust‑fund uses.
- Include policy directions (e.g., reimbursement methodology work, limitations on some Medicaidcovered procedures) and supplemental one‑time and ongoing appropriations through amendments.
Key appropriations and provisions (selected items excerpted)
- Department of Veterans Affairs
- Administration: $1,369,205 (15.00 FTE)
- Iowa Veterans Home: $8,145,736 (monthly billing and reporting requirements included)
- Home Ownership Assistance (transfer to Iowa Finance Authority): $2,200,000
- Department of Health and Human Services (selected divisions)
- Aging & Disability Services: $19,208,180 (88.00 FTE); includes funding for area agencies on aging, elder abuse prevention programs, and specified set‑asides (e.g., $949,282 for family support center component).
- Behavioral Health: $24,442,121 (71.00 FTE); includes $300,000 for children’s behavioral health system supports and $950,000 for an integrated substance use disorder managed care system.
- Appropriations from other sources: sports wagering receipts fund, pharmaceutical settlement account, quality assurance trust fund, hospital health care access trust fund (specific amounts exist elsewhere in full text).
- Policy and program provisions
- Directions to HHS to develop nursing facility reimbursement methodology for Medicaid.
- Prohibits use of medical assistance appropriations to reimburse sex‑reassignment surgeries or associated procedures (including hormone therapy or interventions intended to alter sex characteristics) — a programmatic restriction included in the bill.
- Requirements to submit documentation to CMS as needed for federal approvals/waivers (specifics truncated in excerpt).
- Authorizes transfers (e.g., beer and liquor control fund → behavioral health fund), nonreversion and reporting requirements, emergency rule authority, and a hospital directed payment program.
- Noted amendments (filed/considered)
- Amendment H‑1333 (Medicaid waiting lists): would appropriate an amount sufficient to eliminate Medicaid home-and-community‑based services (HCBS) waiver waiting lists as of June 30, 2025, as calculated by the state Medicaid forecasting group, and require inclusion of these amounts in the first forecasting report for FY2026.
- Amendment H‑1334 (Pediatric cancer research): would appropriate annually an amount equal to the state population (per July 1 Census estimate) to the State Board of Regents for pediatric cancer research at University of Iowa Hospitals and Clinics, with annual reporting by Oct. 1.
Who is affected
- Veterans and residents of the Iowa Veterans Home.
- Older Iowans and people with disabilities who use aging and disability services and area agencies on aging.
- Individuals receiving behavioral health and substance use disorder services, including children receiving behavioral health supports.
- Medicaid beneficiaries, nursing facilities, hospitals, and providers impacted by reimbursement methodology changes and limits on covered procedures.
- University of Iowa hospitals (if pediatric cancer research appropriation is included) and individuals on HCBS waiver waiting lists (if H‑1333 is adopted).
Procedural and timeline highlights
- Introduced: May 12, 2025 (House).
- Committee referral: Education Finance (then Appropriations); a committee report shows “to adopt and re‑refer to Taxes” earlier in the record.
- Floor action: Passed House (63–28) on May 13, 2025; passed Senate (31–15) on May 14, 2025.
- Enrolled and sent to Governor: May 22, 2025.
- Signed by Governor: June 11, 2025.
- Companion bill: S.F. 1201.
Limitations
- This summary is based on the excerpt and enrolled text provided. The bill is an omnibus appropriations act containing many additional line items, fund transfers, and statutory edits not fully reproduced here. For complete statute language, appropriation schedules, and exact dollar amounts for all programs, consult the enrolled bill/chaptered law (Chapter 169) and associated fiscal notes.
Compiled from official sources — confirm details with the bill’s official record.
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