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Medicaid is the backbone of Iowa health care
Bob Ritz
May. 13, 2025 5:00 am
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In Iowa, nearly 700,000 people — including 300,000 children — rely on Medicaid for their health care, which is jointly funded by federal and state governments. These are our neighbors, co-workers, classmates, and loved ones, living in every corner of the state.
Medicaid helps them cover everything from routine checkups and maternity care to cancer treatment and emergency services. It’s not just a safety net — it’s a lifeline that keeps Iowa’s health care system strong and accessible for everyone.
Yet today, federal policymakers are considering cutting billions of dollars from Medicaid. If this occurs, access to care will be in jeopardy — not just for those enrolled in Medicaid, but for all Iowans. That’s the simple truth.
Fewer services, fewer doctors, and fewer clinics means everyone — even those with private insurance — could face longer wait times and reduced options. Providers already stretched thin may be forced to close rural clinics, cut staff or eliminate services, particularly when it comes to maternal care, behavioral health and pediatrics. It also means more people may access health care through higher cost, busy emergency rooms, instead of the primary care physician office.
A recent report underscores this reality, warning that Medicaid cuts would disproportionately harm rural and small-town areas more than metro centers. In Iowa alone, nearly 270,000 of those covered by Medicaid live in rural communities. This is especially concerning because these are the exact areas where medical care is already harder to access. For example, the challenges to maintain labor and delivery will only grow as smaller hospitals will be faced with questions about the long-term viability of these services.
And the consequences don’t stop there. Cuts to Medicaid could undermine nearly a decade of progress Iowa has made in restructuring and creating efficiency in the state’s Medicaid program. In 2016, leaders built Iowa Health Link shifting Iowa’s Medicaid program from a fee-for-service model to a managed care model. That effort created a proactive approach to identify health concerns early on before they became more serious and costly to treat.
While efforts to reduce our federal deficit should be commended, we ask Congress to review the Medicaid program to identify areas where smart changes can be made, while preserving its ability to ensure our neighbors can continue receiving high-quality, affordable care. We ask this because Medicaid is the backbone of Iowa’s health care infrastructure. Weakening it weakens care for everyone – families, newborns and seniors in every corner of Iowa, especially rural communities. I hope we can all agree that protecting Medicaid means protecting Iowans.
Bob Ritz is the president and CEO of MercyOne.
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