A bill for an act relating to the right to try Act.(See HF 802.)
HF 320 would expand Iowa’s “right to try” law, chapter 144E, to cover not only patients with terminal illnesses but also patients with life-threatening or severely debilitating illnesses. It also adds a new category of treatment called an “individualized investigational treatment,” defined as a drug, biological product, or device made exclusively for one patient based on that patient’s genetic profile. The bill specifically mentions individualized gene therapy, antisense oligonucleotides, and individualized neoantigen vaccines.
The bill updates the informed-consent requirements to match the broader eligibility and treatment categories. It requires patients to acknowledge the risks, the limits of FDA-approved alternatives, possible worsening of symptoms, the possibility that death could be hastened, and the financial consequences of treatment. It also clarifies that health plans, third-party administrators, governmental agencies, hospitals, and other facilities are generally not required to cover or provide these treatments, though they may do so voluntarily or if otherwise required by law or contract.
HF 320 would amend Iowa Code chapter 144E by broadening who may qualify for right-to-try access and by extending the statute to individualized, patient-specific investigational therapies. It would also make conforming changes to provisions governing manufacturer and facility rights, treatment coverage, liability for treatment-related debts, physician licensing protections, state interference, and the absence of a private cause of action. In practical terms, the bill would create a clearer legal pathway for access to certain experimental therapies while preserving the voluntary nature of manufacturer participation and limiting obligations on insurers, hospitals, and state agencies.
The available voting history suggests the bill had meaningful but not unanimous support in committee, passing the House Committee on Health and Human Services 14-6. No committee transcript is available, and the bill was later withdrawn, so there is no recorded floor debate or final enactment. Overall, the bill appears to have been viewed favorably by a majority of committee members, but with a substantial minority expressing reservations.
The main points of contention likely centered on the bill’s expansion from terminal illness to life-threatening or severely debilitating illness, which broadens access and may raise concerns about patient safety, evidentiary standards, and the scope of experimental use. Another likely issue is the inclusion of highly personalized genetic therapies, which are novel and may be costly, complex, and difficult to regulate or insure. Opponents may also have been concerned about reduced liability exposure, the lack of mandatory coverage, and the possibility that patients could bear significant out-of-pocket costs or lose hospice eligibility, while supporters likely emphasized patient autonomy and access to potentially life-saving treatments when standard options have failed.