Des Moines, Iowa — Iowa’s legislature took a firm stand Monday against foreign adversaries gaining a foothold in the state’s health care system. The Iowa House passed a bill unanimously that would bar citizens and entities from China, Russia, and North Korea from holding licenses to own or operate nursing homes and hospitals in the state.
Senate File 572, which had already cleared the Iowa Senate in 2025, now heads to Gov. Kim Reynolds for her signature. If signed, Iowa would become one of the first states to explicitly ban adversary nations from operating long-term care facilities within its borders.
What the Bill Actually Does
The measure targets citizens, businesses, and government or political entities from China, Russia, and North Korea — prohibiting them from being licensed to own and run health care facilities, including nursing homes. Iowa lawmakers passed it without a single dissenting vote, a rare show of bipartisan agreement in an otherwise divided session.
“Ownership transparency in long-term care isn’t just a regulatory issue — it’s a safety issue,” one state Republican floor manager noted during floor debate.
The vote wasn’t entirely without friction. Democrats introduced two amendments that ultimately failed. One, from Rep. Josh Turek of Council Bluffs, would have extended the foreign ownership restrictions to include private equity funds and real estate investment trusts. Turek cited research finding that PE-owned nursing homes were more likely to close or declare bankruptcy, and often delivered worse patient outcomes.
“Private equity in health care only leads to neglect and worse patient outcomes, all while costing the taxpayer more,” Turek said.
Republicans pushed back. Rep. John Wills argued that blocking private equity buyers could leave financially struggling facilities with no realistic path to new ownership or outside funding — a concern operators in rural Iowa know well.
A second amendment from Rep. J.D. Scholten, which would have applied the foreign ownership ban to meatpacking plants as well, also failed.
Why It Matters for Nursing Homes Nationally
Foreign ownership of health care assets has become a growing concern across the U.S. The Iowa bill reflects broader anxieties about national security and the vulnerability of elder care infrastructure to foreign control. Nursing homes are particularly sensitive given the populations they serve and the federal reimbursement dollars that flow through them.
States have been increasingly active in scrutinizing who owns these facilities. Virginia recently passed a law requiring state review of nursing home ownership changes, a move advocates called long overdue. Iowa is now going further, drawing a hard line against nations designated as adversaries.
Iowa isn’t the first to float these restrictions, but it’s among the first to send them to a governor’s desk. The bill’s unanimous passage in both chambers signals that bipartisan consensus is possible on at least some aspects of nursing home regulation — even as the industry remains split over issues like private equity and Medicaid funding.
Reynolds has not publicly committed to signing the measure, but its unanimous passage leaves her with little political reason to hold back.
What’s Next
The bill awaits the governor’s signature. If enacted, facilities operating under foreign adversary ownership would need to divest or face loss of their state license. The measure does not explicitly include a grandfather clause, though lawmakers have indicated the intent is to prevent future acquisitions rather than immediately dismantle existing arrangements.
Iowa nursing home operators and advocates are watching closely. For an industry that’s spent years fighting battles over staffing mandates, Medicaid reimbursement, and private equity scrutiny, foreign ownership has largely been a quieter concern — until now.
