Health care providers and institutions may opt out of providing services they believe violate their conscience, under a law Gov. Kim Reynolds has signed.
House File 571, signed into law Tuesday, May 19, gives a health practitioner or institution the right to refuse a service that contravenes their conscience and shields them from discrimination over their decision.
The law defines “conscience” as ethical, moral or religious beliefs or principles held by a health care provider or institution. It takes effect July 1.
Iowa House Republicans passed the legislation in a 63-27 party-line vote in March. It first passed the chamber in 2025, but was kept alive and passed by the Senate earlier in March with an amendment removing conscience protections for insurance companies.
Other states are weighing medical ‘conscience’ laws
Medical conscience objection laws have long existed at the state and federal levels, mostly geared toward protecting providers who refuse to perform an abortion or sterilization procedure, although Iowa’s law is more broad.
Critics say a recent slate of measures passed or introduced in statehouses across the U.S. have gone further to undermine patient care and diminish the standard of care people receive.
The Guttmacher Institute, a research and policy organization that advocates for reproductive rights, tracked 21 bills implementing or expanding conscience clauses introduced in statehouses and two that became law in 2023.
A 2023 Montana law, for example, gave broad legal protections to health care practitioners who won’t prescribe marijuana or participate in procedures and treatments such as abortion, medically assisted death or gender-affirming care that violate their ethical, moral or religious beliefs or principles.
Does Iowa’s law specify services providers can deny based on conscience?
Iowa’s law does not outline specific services but maintains that a practitioner or institution can not be held “civilly, criminally or administratively liable” for their exercise of conscience.
It also protects the rights of religion-based practitioners to make employment and admitting decisions that align with their religious beliefs.
Health practitioners still have to provide emergency medical services.
The law bars interference with a health care provider’s or institution’s exercise of conscience.
A provider alleging injury by unlawful interference may bring a civil action and a court may give injunctive relief, reinstate their previous positions or licenses and award monetary damages.
How will the law affect health care access?
Lawmakers who championed the measure say it shields providers from discrimination while the state struggles to recruit and retain medical professionals. Critics warn of reduced access to care.
Rep. Bill Gustoff, R-Des Moines, said during House debate the legislation would protect medical professionals who are reluctant to practice in certain fields because they face hostility over their beliefs.
“This is one more step we can take to ensure people can still receive the care they need while not driving them from the medical field for fear of actual persecution, just for exercising the reasonable right of conscience,” Gustoff said.
Rep. Austin Baeth, D-Des Moines, a practicing physician, countered that the policy would add another hurdle for patients to access to care, especially in rural areas where there already are fewer providers.
“There are no guardrails on what is conscience and what is just discrimination,” Baeth said. “This bill does not have a good purpose that is real. It only opens up for multiple harms and discrimination, and when that happens in the medical field, people go without lifesaving care.”
Marissa Payne covers the Iowa Statehouse and politics for the Register. Reach her by email at mjpayne@registermedia.com. Follow her on X at @marissajpayne.
This article originally appeared on Des Moines Register: Iowa law lets health workers refuse services on conscience grounds
Reporting by Marissa Payne, Des Moines Register / Des Moines Register
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