Families and hospitals brace for Medicaid cuts

In April, I met Nancy, a parent of a disabled child enrolled in Medicaid.

With tears in her eyes, Nancy shared her story with me of her family being forced to deal with roadblocks and red tape to access the care her son is entitled to and eligible for, her son’s unexpected seizures, and driving over three hours to Franklin County for a town hall with her representatives and their staff, who wouldn’t even look at her or her son.

It was Nancy who reminded me that our state is currently without a director of Medicaid.

Liz Matney, one of Gov. Kim Reynolds’ top advisers, left the role on Nov. 1, meaning for over six months, there has been no one in charge of overseeing the program that provides care to over 700,000 Iowans — including Nancy’s 9-year-old.

Just last week, our representatives in Congress voted for the biggest cuts to Medicaid in history to give tax breaks to billionaires, and which experts estimate will increase the national debt by $3-5 trillion. With cuts to Medicaid on the table and no one overseeing the program, I can only imagine the administrative nightmares that await Iowans like Nancy and her son.

This is the sad reality of the current failed leadership in Iowa.

These cuts will hurt our communities in need the most — our children, our parents and grandparents, our veterans, and Iowans with disabilities, and threaten the very existence of our rural and critical access hospitals, which are already hurting.

Last year, Newton Medical Center was forced to close the doors to its labor unit, leaving an entire community without this critical service and forcing mothers to travel 35 miles to Des Moines to give birth. Over 19,600 Iowans in Jasper County rely on Medicaid.

MercyOne Medical Center in Primghar closed in September, leaving O’Brien County with one less facility for it's over 7,000 Medicaid enrollees.

Spencer Hospital in Clay County is one of the last hospitals in Iowa still offering inpatient mental health care, with 40% of the hospital’s psychiatric inpatients getting coverage through Medicaid. Just last week, the facility warned of the damage these cuts pose to access to mental health care in Iowa.

Between 2008-2023, Iowa has lost 600 health care facilities across the state.

These closures only worsen the growing health care worker shortage across Iowa, as workers are either being forced to leave their communities from these closures or are leaving on their own for better opportunities in places where they know they will be able to provide care.

With our rural hospitals already at risk of closing, a growing health care worker crisis, and families on Medicaid already struggling to get by, our current leaders voted to make it harder for our hospitals to keep their doors open, force health care professionals out of their communities or even out of state to work, and make it harder for Iowans to get the care they need.

They know the damage these cuts would cause, and gave it a rubber stamp in service to tax cuts for their billionaire donors anyway.

As Nancy said, Iowa is in desperate need of new leadership — the kind that puts public service — not politics — first.

Rob Stand is Iowa’s state auditor and a Democratic candidate for governor.