Gov. Kim Reynolds signed 13 bills into law Tuesday — including several that could impact Iowans’ access to reproductive healthcare.

House File 2788, the final bill debated in the Iowa Senate during the 2026 legislative session, is a measure restricting access to abortion-inducing medications through telehealth and mail-order prescription services. Under the new law, these medications, such as mifepristone, will have to be prescribed in person.

The law, which will officially take effect July 1, comes amid a national discussion on access to mifepristone, which is used to terminate pregnancies before 10 weeks and to treat miscarriages, via telehealth services. Mail-order and telehealth prescriptions for the abortion-inducing drug were temporarily restricted following a U.S. 5th Circuit Court of Appeals decision in early May in the federal lawsuit Louisiana v. Food and Drug Administration. The appeals court decision blocked an 2023 FDA rule allowing the drug to be prescribed and dispensed without an in-person visit with a healthcare provider.

The U.S. Supreme Court decided last week to let telehealth access to abortion medication continue under the current FDA rules as the lawsuit proceeds.

The recent U.S. Supreme Court decision is not expected to affect the enforcement of Iowa’s restriction on mail-order and telehealth prescription for these drugs. According to the Guttmacher Institute, 28 states have restrictions on abortion-inducing medications in place.

During debate on the measure, Republican state lawmakers said requiring in-person visits for prescribing these medications will ensure women’s safety by stopping “black market” abortion medications from entering the state. But Democrats and reproductive healthcare advocates said the law is a means for further restricting abortion access, and will make it extremely difficult for people in rural areas to access healthcare, particularly in areas of Iowa which face maternal and OB-GYN healthcare shortages.

The new law additionally specifies that medical treatment for miscarriages and ectopic pregnancies cannot be construed as abortion procedures.

New law requires parental consent for HPV

vaccines for minors

Another bill Reynolds signed Tuesday was Senate File 304, which removes a current carveout in Iowa law that had allowed minors to access vaccines related to sexually transmitted diseases and infections without their guardians’ permission. Parental consent is necessary for Iowans under age 18 to receive vaccinations in a majority of cases — but previously, the law allowed minors to independently consent to receive the human papillomavirus (HPV) and hepatitis B vaccines.

GOP lawmakers said the measure will bring state requirements for these vaccines in line with regulations on other vaccines, but Democrats said the exception in law was to specifically help children protect their health when in a situation where they cannot talk to their guardian about sexual activity, or in cases potentially involving sexual abuse.

Democrats and healthcare advocates also opposed the bill because it would restrict access to a cancer prevention tool during a time when the state faces high cancer rates.

Advocates representing healthcare providers and organizations told lawmakers HPV is linked with multiple forms of genital cancer, including cervical, penile, anal cancer and vaginal cancers. Studies have found the HPV vaccine in particular has been linked with much lower instances of cervical cancer, particularly when a person receives the vaccination before age 17.

Jackie Cale, Iowa government relations director of the American Cancer Society Cancer Action Network, sent a letter to Reynolds in April urging her to veto the proposal, saying it runs contrary to her efforts to address rising cancer rates in the state.

“We share your goal of reducing our cancer rates,” Cale wrote. “Unfortunately this change to state law will reduce access to proven cancer prevention tools and move us in the wrong direction. We encourage you to increase access to safe and effective forms of cancer prevention like the HPV vaccine as well as improve education and awareness rather than restrict such efforts.”

House File 571 was also signed into law. This measure, referred to as a “medical conscience” law, allows medical practitioners and health care organizations to refuse to participate in or pay for a health care service that goes against their “ethical, moral or religious beliefs or principles,” with exemptions made for emergency medical services. Entities that deny providing or paying for a service based on their beliefs could not be held civilly, criminally or administratively liable.