Friday marked the 110th day of legislative session – the end of legislative per diem and the targeted date for adjournment. With the budget and several policy priorities still unresolved, the legislature now heads into overtime.
With the legislature now officially past its targeted adjournment date, the window of time to take action on HF 592 and SF 557 – the companion bills to enact a $1 million hard cap on noneconomic damages – is rapidly closing. As we’ve reported previously, the problem remains a handful of holdout votes in the House. Throughout session, IMS has coordinated with our coalition partners to strategically dial up grassroots and lobbying pressure at critical junctures and dial it back as swing votes show signs of issue fatigue that threatens to cause them to shutdown on further consideration of supporting a hard cap. Over the past few weeks, we have maintained a steady stream of internal and external contacts to keep the issue in front of these holdout House members, while working behind the scenes on a series of political strategies to get the bill through that chamber.
This period of session is traditionally when closed-door deals are made between the two chambers, with the Governor’s Office, and amongst members of the same chamber. We saw these dynamics on display this week with the impassioned and messy House consideration and passage of the vaccine passport bill. House passage of this controversial bill over the strident objections of a handful of House Republicans demonstrates that there is still a will in that chamber to move bills like our hard cap legislation, where there are strongly-held beliefs both in support and opposition within the majority caucus. IMS continues to explore ever possible angle to engineer a similar deal to pass HF 592.
This week saw the introduction of a rare pair of companion leadership bills intended to prevent vaccine passports in the state of Iowa. HF 889 and SF 610 would prevent any governmental entity from issuing an ID denoting whether or not an individual has received the COVID-19 vaccine and it would prevent any business or government entity from requiring proof of COVID-19 vaccination as a condition for entry. Of note to the healthcare community, the bill includes an exemption IMS pushed for in previous iterations of this ban to exempt healthcare facilities from this ban. Under the exemption, healthcare providers can still require patients, visitors, and staff to provide proof of vaccination status and impose limitations or additional infection control protocols to limit the spread of COVID-19.
Inclusion of the medical exemption in these bills proved to be a flashpoint for the antivaccine community who turned up in force to speak in-person at the House subcommittee hearing for HF 889 on Monday. Throughout the week, these advocates and their champions in the House pushed to strip the medical exemption from the bill. Barring removal of this exemption, the advocates argued that the bill should be scrapped entirely or stripped back to solely the first division banning state issuance of a vaccine passport. After a lengthy, heated House Republican caucus on Wednesday, the House took up HF 889 on Wednesday evening. In a rare public display of caucus division, the majority party successfully opposed attempts by fellow House Republicans to strip the medical exemption, to strip the entirety of the second division banning non-healthcare entities from requiring proof of vaccination, and to resurrect another antivaccine measure to limit employer’s ability to require that employees receive the COVID-19 vaccine.
HF 889 ultimately passed the House in its original form with a handful of House Republicans voting against the measure and a handful of House Democrats breaking with their own caucus to vote in support of the bill. The bill now moves to the Senate where SF 610 passed out of committee on Tuesday and is now awaiting floor debate. It is expected that this fast-tracked leadership bill will soon be on its way to the Governor’s desk with the medical exemption intact.
Pharmacist Statewide Protocols
On Wednesday, the Senate completed action on SF 296 – the bill to expand pharmacist statewide protocols. You may recall earlier this session, we reported that the House had amended the original proposal to strip authority for pharmacists to administer pediatric immunizations to patients over the age of three. On Wednesday, the Senate voted to accept this House change and send SF 296 to the governor for signature. Under the final bill, pharmacists gain the authority to administer point-of-care testing and treatment for flu, strep, and COVID-19. They also gain the authority to enter into a collaborative practice agreement with any authorized prescriber. Previously this authority was limited to only pharmacist-physician agreements.
Under the federal Public Health Emergency (PHE) declaration pharmacists retain the ability to administer pediatric immunizations for the duration of the pandemic, at which time the authority will revert to existing Iowa law. Another piece of legislation currently awaiting the governor’s signature legislation – HF 514 – would codify the authority for pharmacists to delegate vaccine administration to pharmacy support staff. This authority has also been temporarily implemented as part of the federal PHE declaration.