Iowa Gov. Reynolds signed HF571 letting doctors, hospitals, and insurers refuse care on conscience grounds

On May 19, 2026, Iowa Gov. Kim Reynolds signed House File 571, the "Medical Ethics Defense Act," into law. The statute lets medical practitioners, health care institutions — including hospitals, clinics, pharmacies, and medical schools — and health care payors decline to participate in health care services on the basis of conscience, ethical, moral, or religious objection, and shields those entities from civil liability, disciplinary action, and other penalties for exercising the exemption. It also carries whistleblower and free-speech protections for medical professionals.

The bill passed the Iowa House 63-27 on March 23, 2026, and the Senate 30-16 on March 9, 2026, before Reynolds signed it as part of a batch of health-related bills. The law took effect July 1, 2026. Its title describes protections for medical practitioners, health care institutions, and health care payors relating to the exercise of conscience, whistleblower activities, and free speech, and it provides penalties for retaliation against protected refusals.

Reporting and opponents said the conscience exemption reaches contested services such as gender-transition procedures and abortion. Rep. Austin Baeth, a physician-legislator, warned that the law contains no guardrails distinguishing a genuine conscience objection from discrimination and would let patients — LGBTQ+ Iowans among them — be denied care. Supporters, including advocacy groups that pressed for the measure, framed it as protecting medical professionals from being forced to act against their beliefs.