Iowa House passes restrictions on foreign involvement in health care, ballot issues

by Robin Opsahl, Iowa Capital Dispatch
March 23, 2026

The Iowa House passed two measures Monday restricting foreign entities from health care ownership and ballot issue campaigns.

House File 2601, passed unanimously, requires that political committees advocating for or against a ballot measure to confirm with donors that they are not foreign nationals, and that the donor has not “knowingly or willfully” accepted more than $100,000 in total from one or multiple foreign nationals within four years before the contribution was made.

People who do not have U.S. citizenship or permanent residence, as well as businesses, organizations, and government or political entities owned or based outside of the U.S., would be banned from making, “directly or indirectly,” expenditures or contributions to ballot issues or paying another individual to contribute in their stead.

Political committees would be required to include an affirmation that they are abiding by this restriction in reports to the Iowa Ethics and Campaign Disclosure Board. Those found in violation of this measure would be subject to a serious misdemeanor charge and a minimum civil penalty of $10,000.

Rep. Jennifer Konfrst, D-Windsor Heights, introduced an amendment making multiple changes that she said would “create more sunlight” on campaign finance, including lowering the threshold of money spent by groups to be considered Political Action Committees (PACs) and expanding the definition of “communication” in reference to campaign laws.

“Campaign finance is a problem in our country,” Konfrst said. “There are some of us in this room who know better than others just how much campaign finance can cause the success or defeat of an otherwise strong candidate for office. And one of the first steps that we can do is add additional transparency to the process.”

The amendment was not adopted, but Democrats supported the overall bill moving through the House.

“If you want foreign nationals to meddle in our elections, vote no, but if you don’t want that, and you want to protect the integrity of our elections, vote yes,” Rep. Austin Harris, R-Moulton, said. The measure goes to the Senate for further consideration.

Ownership of health care facilities

Senate File 572, also passed unanimously, bans citizens of China, Russia and North Korea, as well as businesses and government entities of those countries, from being licensed to own and run health care facilities, such as hospitals and nursing homes, in the state.

Two amendments were introduced by Democrats. Rep. Josh Turek, D-Council Bluffs, introduced an amendment to prevent private equity funds and associated real estate investment trusts from acquiring health care facilities in Iowa. He cited research finding the worse outcomes for patients at some facilities owned by private equity, and that private equity-owned facilities were more likely to close or declare bankruptcy.

“Private equity in health care only leads to neglect and worse patient outcomes, all while costing the taxpayer more,” Turek said. “Ultimately, it leads to closures of health care facilities, something we absolutely cannot afford in a state with a severe health care crisis.”

Rep. John Wills, R-Spirit Lake, the floor manager for the bill, said, “my understanding is that if we were to take up this amendment, we would be leaving financially struggling hospitals, nursing homes, and other facilities struggling with no other likelihood of receiving funding, and no qualified buyers to purchase these sites.”

Turek’s amendment, as well as an amendment proposed by Rep. J.D. Scholten, D-Sioux City to apply the foreign ownership restrictions to meatpacking facilities, both failed.

After passing the House, the bill — which was approved by the Senate in 2025 — goes to Gov. Kim Reynolds.

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