Understanding Iowa's MAHA Act (HF2676)

What Changed on July 1, 2026?

When Governor Kim Reynolds signed House File 2676—the Iowa Make America Healthy Again (MAHA) Act—into law, it became one of the most comprehensive health policy bills passed by the Iowa Legislature in recent years.

While much of the public discussion has centered around ivermectin, HF2676 reaches much further. The law includes changes to healthcare education, school nutrition, pharmacy access, emergency allergy response, student screen time, physical activity, mental healthcare, and food assistance programs. Some provisions took effect on July 1, 2026, while others will be phased in over the next two years.

This article provides an overview of the major changes and what they mean for Iowa families.

Better Nutrition Starts with Healthcare

One of the first sections of HF2676 focuses on nutrition—not in school cafeterias, but in healthcare.

Beginning July 1, 2026, physicians in several specialties must complete one hour of continuing education in nutrition and metabolic health every four years as part of their license renewal. Similar continuing education requirements were also added for physician assistants.

The legislation also looks ahead to future healthcare providers. Beginning July 1, 2028, Iowa medical schools and colleges of osteopathic medicine will be required to include at least 40 hours of nutrition and metabolic health instruction as part of their graduation requirements.

What This Means for Iowa Families

The Act places a greater emphasis on nutrition education for both current and future healthcare providers. While it doesn't change how physicians practice medicine, it encourages additional education on the role nutrition and metabolic health can play in preventing and managing chronic disease.

Expanded Pharmacy Access & Emergency Care

One of the most widely discussed provisions of HF2676 is the change to how adults may obtain ivermectin.

Beginning July 1, 2026, HF2676 authorizes pharmacists and pharmacies to distribute ivermectin for human use without requiring a prescription drug order. The law also provides protections from professional discipline and certain civil or criminal penalties for pharmacists who distribute ivermectin in accordance with the statute.

The legislation was written similarly to laws adopted in several other states that allow pharmacists to provide ivermectin directly to patients without first obtaining a prescription from a physician.

Will every pharmacy carry it?

Not necessarily.

While the law authorizes pharmacists to distribute ivermectin, it does not require every pharmacy to stock or dispense it. As with many pharmacy services, availability may vary based on inventory, company policy, and the professional judgment of the pharmacist. Patients may need to call ahead or contact more than one pharmacy to determine availability.

Is ivermectin now sitting on store shelves?

Not necessarily.

Although the law allows ivermectin to be obtained without a prescription drug order, many pharmacies may continue to keep it behind the pharmacy counter and provide it only after consultation with a pharmacist. Pharmacy procedures may vary from one location to another.

HF2676 also modernizes Iowa's emergency allergy response laws by recognizing newer epinephrine delivery systems and expanding liability protections for trained individuals who administer emergency allergy medication in good faith.

What This Means for Iowa Families

HF2676 expands access to ivermectin through participating pharmacies while also updating Iowa's emergency allergy response laws to reflect newer treatment options. If you're seeking ivermectin under the new law, it's a good idea to call your local pharmacy ahead of time to ask whether they stock the medication and are dispensing it under HF2676.

Healthier Schools

Several provisions of HF2676 focus on improving student wellness in Iowa schools.

Beginning this school year, digital instruction for students in kindergarten through fifth grade is generally limited to 60 minutes per school day, with exceptions for individualized education programs (IEPs), Section 504 plans, state assessments, teacher-led demonstrations, and computer science instruction. School districts must also adopt technology use policies, and parents may request additional reductions in digital instruction for their child.

The law also updates Iowa's physical activity requirements.

Elementary students will receive additional opportunities for movement during the school day, while middle and high school students continue to meet weekly physical activity expectations.

HF2676 also restores the Presidential Physical Fitness Test if federal guidance and materials become available.

Food Dyes in Schools

Another change won't take effect until the 2027–2028 school year.

Beginning then, schools participating in federal breakfast and lunch programs may no longer serve or sell foods containing certain artificial food dyes and additives identified in the Act.

What This Means for Iowa Families

HF2676 places a stronger emphasis on nutrition, physical activity, and balanced technology use in schools. While some changes begin immediately, others will be phased in over the next two years, giving schools time to prepare.

Expanding Access to Mental Healthcare

HF2676 also adopts the Psychology Interjurisdictional Compact (PSYPACT).

This allows qualified psychologists licensed in participating states to provide telepsychology and certain temporary in-person psychological services across state lines while maintaining professional oversight and accountability.

What This Means for Iowa Families

As more states join the compact, Iowans may have greater access to licensed psychologists, particularly through telehealth services.

Food Assistance Programs

HF2676 also includes provisions related to the Supplemental Nutrition Assistance Program (SNAP) and Summer EBT.

Rather than immediately changing eligible food purchases, the law directs Iowa to seek federal approval to implement healthier food standards within SNAP. Because these changes require approval from the federal government, they will not automatically take effect on July 1.

What This Means for Iowa Families

The SNAP provisions are different from most of the rest of HF2676. Before any changes can be implemented, Iowa must first receive approval from the U.S. Department of Agriculture.

Looking Ahead

Not every provision of HF2676 became effective on July 1, 2026.

July 1, 2026

• Nutrition continuing education requirements

• Pharmacy access to ivermectin

• Emergency allergy response updates

• Student technology standards

• Physical activity requirements

• PSYPACT

2027–2028 School Year

• School food ingredient restrictions

July 1, 2028

• Medical school nutrition curriculum requirements

  
  

Final Thoughts

HF2676 is a broad piece of legislation that touches many aspects of health and wellness in Iowa. While this article highlights the major provisions, many sections include additional details, exceptions, and implementation timelines.