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  CERTIFICATE OF NEED INTELLIGENCE BRIEF: IOWA
  The Rojas Report | conlaws.rojasreport.com/states/iowa/
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  State:    Iowa (IA)
  Score:    90/100
  Tier:     Highly Restrictive
  Rank:     37 of 51 jurisdictions

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  SUMMARY
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  Explore Iowa's highly restrictive Certificate of Need (CON) laws, scoring
90/100. Learn about its impact on healthcare services, market competition, and
reform efforts.

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  SCOPE OF REGULATION
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  * Nursing Facilities
  * Any new beds
  * Ambulatory Surgery Centers (ASCs)
  * Major Medical Equipment

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  APPLICATION PROCESS
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  Iowa's strict CON laws have fostered a market dominated by a few large
health systems. UnityPoint Health and MercyOne face limited competition, which
can lead to higher prices and fewer choices for consumers. CON laws protect
these incumbents from new market entrants, securing their revenue streams at
the expense of innovation and patient choice.

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  REFORM STATUS
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  Iowa has seen no significant reform efforts in recent years. The powerful
hospital lobby and an entrenched bureaucracy have successfully resisted
attempts to modernize or repeal the state's CON laws. The status quo benefits
established players, leaving little political will for change.

  A full repeal of Iowa's CON laws could inject much-needed competition into
the market. This would likely lead to the development of more specialized,
lower-cost providers like ASCs, downward pressure on prices, and increased
innovation in care delivery for both urban and rural populations.

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  Source: The Rojas Report | conlaws.rojasreport.com/states/iowa/
  Data: Cicero Institute, NASHP, FTC, DOJ, CMS, state health departments
  Generated: April 2026
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