October Perspectives from Both Sides of the Aisle: Healthcare

The fire, the vote, the triumph — when it happens, Decorah News shows up. Support us being there. DecorahNews.com's monthly feature aimed at providing balanced political perspectives continues into the month of October. Each edition highlights a timely issue through two guest columns—one from a Democrat and one from a Republican—offering readers a fuller understanding of the policy debates shaping Iowa. This initiative isn't just about sharing opinions. It's a collaborative effort among Iowa newspapers to reinforce the value of thoughtful, civil discourse and to highlight the vital role local journalism plays in our democracy. This month's theme is Healthcare. Stop Making Things Worse By: Sen. Janice Weiner A cardinal rule as elected officials is not to break things – as in, if it isn't broken, don't "fix" it – not unlike the medical profession's Hippocratic oath: first, do no harm. Our state faces multiple self-inflicted healthcare crises that result from ignoring that rule. We have the second highest cancer rate in the nation and are one of just two states with a rising rate of new cancers. We have the lowest ratio of OB-GYNs in the country, paired with one of the steepest declines in access to maternal healthcare. We have high rates of mental illness, with deficient access to mental health care. We have an aging population, and serious problems with nursing homes and other options for care. And then there are all the unknowns coming from Washington with respect to Medicaid and Medicare. Decisions, whether made in Des Moines or in Washington – both controlled by Republican trifectas – are actively making caring for Iowans more difficult. Take our state's cancer crisis – we all know a friend or family member impacted by cancer. A rational person would conclude that Iowa needs increased funding for research and treatment, and an influx of medical professionals to tackle the problem. Instead, the federal government slashed National Institute of Health (NIH) grant funding to our universities (including ongoing patient trials), and the governor asked the legislature to allocate just $1 million for new cancer research, a relative drop in the bucket. Meanwhile, some of our state legislative colleagues have been so focused on attacking higher education that it is increasingly difficult to attract and retain the medical professionals and researchers we so desperately need. We only need to look across the Missouri River to neighboring Nebraska for a different model. They have purposefully built a robust, well-funded, and well-staffed research and development program. We can, too. Iowa struggles to provide adequate access to maternal healthcare, especially in our rural areas (fully one-third of our counties are considered maternity care deserts). After abandoning the federal Medicaid family planning network in favor of an anemic state-run program, the legislature passed one of the country's strictest abortion bans. Now, even more hospitals are closing labor and delivery units, in part because legislative policy has created an environment where medical professionals must walk a legal and medical tightrope while trying to make split-second, complex decisions. We must again become a welcoming state for medical professionals. We've lost out on a dozen CDC grants aimed at providing funding for state and local health departments because Republican officials fell in line, rather than challenging President Trump's draconian cuts in court. States that did, won their legal challenges and kept their grants. We work for Iowans – we should have, too. We still can. Carefully researched legislation aimed at addressing Iowa's nursing home issues can't even get subcommittee hearings because they were introduced by a Democrat. Good ideas aren't red or blue – they're Iowan. Let's pass them. On top of it all, every member of our Republican federal delegation signed onto a disastrous budget bill that has our rural hospitals, which already run on thin margins, worried that upcoming cuts to Medicaid may force them to shutter. And when a hospital closes, it doesn't just close for Medicaid patients, it closes for everyone, with enormous economic knock on impacts for that community as well. That's bad policy – let's reverse it. Improving healthcare access, affordability, and quality for ALL Iowans, regardless of zip code, starts by examining what actually works, not "fixing" things that aren't broken. The next step is showing a spine and working for Iowa solutions. Real leadership means getting it done. We're ready. Iowa Republicans Are Focusing on Practical Solutions to Rural Healthcare, Not Partisan Fearmongering By: Linda Upmeyer, Republican Party of Iowa Co-Chairwoman & Former Speaker of the Iowa House of Representatives I have spent decades in healthcare, both in clinical settings and in policymaking, and one thing has become crystal clear to me: the best solutions for rural Iowa's healthcare challenges come from Des Moines – not Washington, DC. Under Gov. Kim Reynolds' leadership, a conservative Iowa legislature, and a strong federal partner in President Trump, Iowa is taking bold, results-driven steps to solve the rural healthcare challenges Iowa families face. While Democrats resort to fearmongering and deception, Republicans here at home are focused on delivering real solutions. Like every state, Iowa faces a shortage of doctors and healthcare workers. Rural hospitals are stretched thin, and the cost of care continues to rise. But instead of relying on top-down federal mandates, Iowa is building on a strong foundation to solve problems the right way: by empowering local communities, cutting red tape, and investing in people. That starts with keeping more Iowa-trained doctors in our state. New laws passed by Republicans ensure that medical and dental school slots prioritize Iowans and give preference to residency candidates with Iowa roots. Primary care residencies are now required to offer rural rotations, introducing them to communities that need them most. These smart, targeted reforms directly address the shortage and retention problem. We're also expanding access to maternal healthcare by removing outdated barriers that made it harder to open birthing centers. At the same time, Iowa is adding hundreds of new residency slots, investing in maternal health through enhanced Medicaid reimbursement, and streamlining approvals so providers can deliver care more efficiently. These are real investments with real impact for rural families, not just empty rhetoric. And it's paying off. WalletHub recently ranked Iowa as the 4th best state in America to practice medicine and 2nd for opportunity and competition. Those rankings aren't just numbers on a page, they reflect Iowa's growing strength in training, recruiting, and retaining top medical talent. Caring for veterans and disabled Iowans remains a top priority. The new state budget increases funding for home and community-based services, boosts rates for prosthetic and orthotic providers, and invests millions more into the Department of Veterans Affairs and the Iowa Veterans Home. These resources are making a real difference for the Iowans who deserve our deepest respect. Rural hospitals are also receiving critical support to expand access to specialty care. Recent state grants helped Cass Health, Mahaska Health, and Van Buren County Hospital bring new services closer to home for rural Iowans. And by combining mental health and substance use care into a single Behavioral Health Service System, we're simplifying access and ensuring more coordinated, effective support. At the federal level, President Trump's One Big Beautiful Bill makes the largest investment in rural healthcare in American history, more than $50 billion to modernize hospitals, retain staff, and expand services. Importantly, the program trusts communities to decide how best to use those dollars, rather than forcing them into a one-size-fits-all federal mold. The bill also strengthens Medicaid for the vulnerable including pregnant women, children, seniors, people with disabilities, and low-income families, while rooting out waste, fraud, and abuse. It cracks down on improper payments, and ensures taxpayer dollars are going where they are truly needed. And it includes commonsense work requirements for able-bodied adults without dependents. Most Americans agree that if you are able to work, you should either have a job or contribute through community service in order to receive Medicaid benefits. Democrats oppose this, but Iowans know Medicaid must remain an honest program that protects those who truly need it. Whether you live in a big city or a small town, every Iowan deserves access to affordable, quality healthcare close to home. Thanks to Gov. Reynolds, Iowa Republicans, and a strong partnership with the Trump administration, rural healthcare is no longer an afterthought, it's a top priority. We're not done, and we should never be complacent. But the progress is real, and the future is bright. Iowa is proving that strong conservative leadership works. We need to keep going. Unlock a world of knowledge! Sign up for free DecorahNews.com newsletters and receive local news, local events and everything that is happening in and around Decorah.