Several influential business organizations in Iowa are urging Gov. Kim Reynolds to veto a bill that would reform the operations of pharmacy benefit managers (PBMs) in the state — a move they warn could impose hundreds of millions in new costs on employers and consumers.

Why it matters: PBMs — middleman companies that negotiate drug prices on behalf of health insurers — are under scrutiny from pharmacies and lawmakers nationwide for reimbursing pharmacies at rates lower than the cost of acquiring medications.

• Senate File 383, which passed both chambers with bipartisan support, aims to regulate their practices in response to a wave of pharmacy closures across Iowa.

Catch up quick: The legislation includes a $10.68 minimum dispensing fee to be paid to pharmacies by PBMs, a provision supporters say is crucial to keeping small-town pharmacies afloat.

• More than 200 have closed in Iowa since 2014, including a record 31 last year, according to the Iowa Pharmacy Association.

Driving the news: The Iowa Association of Business and Industry (ABI), Iowa Bankers Association, Iowa Business Council and National Federation of Independent Business jointly issued a statement soon after the bill passed the Iowa Senate late Monday, calling it the costliest health care mandate in state history.

• The version of the bill that's now before Reynolds could cost Iowans an additional $340 million annually via higher costs for prescription drugs and insurance, they estimate.

Stunning stat: Hy-Vee, Iowa's largest pharmacy retailer, is projected to receive an additional $66 million annually under the bill, according to ABI, which used data from the Kaiser Family Foundation for its estimate.

Zoom in: Hy-Vee deferred Axios' request for comment to the Iowa Pharmacy Association, which accused the opponents of using scare tactics and questionable math.

• The bill could instead help Iowans save on prescription drugs and protect access to local pharmacies like other states have done, Kate Gainer, CEO of the association, tells Axios.

What's next: Reynolds has not indicated whether she will sign or veto the bill.

Read more: All 50 states have acted

Crestview School of Inquiry students are the GOAT (greatest of all time) — so the City of Clive brought actual goats yesterday to celebrate.

Why it matters: The party celebrated that Crestview elementary students have dramatically improved their attendance.

By the numbers: 22% of Crestview students were chronically absent two years ago. That improved to 5% this school year, according to a statement from Bryan Geelan, spokesperson for the West Des Moines school district.

• Chronic absenteeism occurs when a student misses 10% or more of their classes during an academic period.

How it started: Crestview launched a GOAT attendance initiative this year and awarded classrooms with a weekly traveling trophy if they had the highest attendance.

• The grand prize for the classroom with the highest attendance was a Greenbelt Goat party, but because the whole school improved, all students got to attend.
• Clive city staff brought out several goats, including a pregnant mama, for the students to pet and feed.

What they're saying: Some families have immigrated from countries where attendance isn't as important, Ashley Chase, a sixth grade teacher, tells Axios. So reaching out to parents has been a part of the initiative.

• "We also have the saying, 'be you, be here, belong,' so that really helps the students know that they're wanted at school," Chase says.

Iowa public schools received $293 in federal money per student in the 2023 fiscal year, according to new census data.

By the numbers: That puts Iowa 43rd out of the 50 states and the District of Columbia, and below the national average of about $360.

Threat level: Federal funding for local school districts is on shaky ground as the Trump administration seeks to cut spending and utilize its power of the purse to influence school curriculum and other policies.

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📄 Polk County deputy administrator Sarah Boese filed a lawsuit against Supervisors Matt McCoy, Jill Altringer and Mark Holm, alleging a hostile work environment after former Administrator John Norris was ousted. (Des Moines Register)

🗳️ Republican U.S. Rep. Randy Feenstra confirmed he is running for governor. (WHO-13)

💩 Reiman Gardens in Ames is on "high alert" for its 12-year-old corpse flower to bloom. (KCCI)

Axios Des Moines members hit the pavement on Ingersoll Avenue yesterday for a walking tour led by Lauren Kollauf, executive director of The Avenues.

Why it matters: Ingersoll is more than just a street — it's a growing destination for local shops, dining and neighborhood development in Des Moines.

What we saw: Tucked away public art, a bike footrest and unique edible garden.

• We wrapped up the walk with great conversations and cold drinks at The Station.

🙏 The bottom line: Thanks to all our members who joined us!

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