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How will the Iowa Legislature address cancer in 2026?
A year after Gov. Kim Reynolds referenced cancer in a major speech, a vape tax, radon mitigation bills and funding for cancer research could return for consideration
Jan. 9, 2026 5:30 am, Updated: Jan. 9, 2026 9:00 am
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A statistic on the tip of Iowans’ tongues: the state has the second-highest rate of new cancer cases in the nation. It’s a figure often cited in research reports, media coverage and statements by politicians. Gov. Kim Reynolds mentioned cancer in her 2025 Condition of the State address, and representatives in both the Senate and the House have introduced legislation to combat it.
“I can feel that lawmakers are interested in doing something about cancer,” said Jackie Cale, Iowa government relations director for the American Cancer Society. “They're not the easiest bills to pass, but there was a good amount of support for each [bill last session].”
The American Cancer Society supported five new bills aimed at cancer prevention and treatment in 2025, but only one passed. Lawmakers and advocates say they expect to see many of them resurface this year. But midterm politics and federal funding cuts could add to the challenges of getting one of hundreds of bills through the legislative process on time.
Reynolds declined to be interviewed for The Gazette’s legislative preview series.
Legislative Preview Series
The Iowa Legislature begins its 2026 session Jan. 12. The Gazette will examine these state issues in the days leading up to the session:
Sunday: Property taxes
Monday: State budget
Tuesday: Public safety
Wednesday: Eminent domain
Thursday: Agriculture/environment
Today: Health care
Saturday: Abortion
Jan. 11: Higher education
Jan. 12: K-12 education
Proposed vape tax could fund cancer projects
Lung cancer is one of the four cancers driving the state’s uniquely high rate of new cases. The majority of cases — 85 percent — are tied to smoking, according to the Iowa Cancer Registry. Cale said increasing Iowa’s cigarette tax, which hasn’t changed in almost 20 years, is an evidence-based way to decrease smoking in the state.
But, she said, vape products would need to be taxed too.
“We recommend increasing the taxes on both products at the same time, so that we are not accidentally making one product cheaper than the other, and then inadvertently incentivizing use of a product over another product,” Cale said.
While the connection between lung cancer and vaping is unclear, tobacco alternatives are still a public health concern. Nicotine is addictive, regardless of the delivery method, and vaping can damage users’ lungs and immune systems.
Currently, vapor products and nicotine pouches are only subject to sales tax. But Sen. Mike Klimesh, R-Spillville, introduced a bill last year that would implement a 10 percent wholesale tax on vapor products and nicotine pouches. The estimated $2 million generated by the tax would then be used for cancer research. Klimesh, who became the Senate Majority Leader in September, told The Gazette he anticipates the bill will return this year.
“I think it’s important, if we’re going to tax cigarettes and other traditional tobacco products, there’s a value to have a conversation to tax those as well,” he said.
Researchers at the University of Iowa say vaping is not a proven way to stop smoking. But proponents argue it’s a safer alternative, and smokers can gradually break the habit by decreasing the amount of nicotine in their vape juices over time.
Phil Jeneary, a lobbyist representing vape shops, said the bill would create a “double tax” on vapor products with sales tax and a tobacco alternatives tax combined, making products too expensive for customers.
“We are not opposed to the idea of having a tax on products, but in order to do that and fund the cancer research project that the bill had intended to is that we need products to sell in order to tax those to get that money,” Jeneary said.
When asked about the nicotine alternatives tax, Senate Minority Leader Janice Weiner, D-Iowa City, told The Gazette she thinks the midterms will influence Senate Democrats’ support for the bill.
“There’s always a tricky balance in an election year,” Weiner said. “But it seems to me that public health and figuring out how to lower if not our current, our future cancer rates really should take priority over some other political concerns.”
Reynolds declined to be interviewed for The Gazette’s legislative preview series.
Radon testing and the Rural Health Transformation Program
Smoking is the leading cause of lung cancer. Long-term radon exposure is the biggest driver of lung cancer in nonsmokers. Together, the two are even deadlier — the CDC estimates smokers are 10 times more likely to develop lung cancer from radon exposure than people who have never smoked.
Iowa is among the states with the highest levels of radon, a cancer-causing gas created when radioactive metals break down in rocks, soil or groundwater. An estimated 400 Iowans die each year from radon-related lung cancer.
Two bills were introduced last year to tackle radon’s effects: House File 377, which would require landlords to install mitigation systems in rental properties with high radon levels, and House File 211, which would create a tax credit for installing a radon mitigation system. Neither advanced beyond the House.
Cody Smith, director of climate initiatives at the Iowa Environmental Council, said he anticipates both bills will be reintroduced in the coming session.
"This is an opportunity for all lawmakers, regardless of their party affiliation, to do something that's going to make a difference in the lives of Iowans,“ Smith said.
In addition to the existing legislation, Smith suggested the state could provide radon training for professionals who frequently work in basements — like plumbers and HVAC repair people — to add radon testing to the services they offer. Another initiative could require people with tobacco licenses to provide radon testing materials or disclose that smoking and radon exposure increase the risk of lung cancer.
The revenue generated by the alternative nicotine products tax could make these efforts possible, Smith said.
“There also is always the refrain of, OK, how are we going to pay for it? Well, this year, there's an opportunity for legislators to answer both questions at the same time,” he said.
Rep. Hans Wilz, R-Ottumwa, who sponsored HF 377, said he’ll revisit the bill annually. However, Iowa’s Rural Health Transformation Program could change whether radon legislation is a priority.
Iowa will receive $209 million this year as part of the $5 billion the Centers for Medicare and Medicaid Services is distributing across the nation over the next five years as part of the Rural Health Transformation Program. The program was created as part of the One Big Beautiful Bill Act to counteract strains on rural health care from other provisions in the act.
In Iowa’s proposal, the Iowa Department of Health and Human Services said it would fund 30,000 radon tests each year, subsidize the cost of installing radon mitigation systems for 500 Iowa homes and “support the training of additional radon mitigation professionals to expand service availability in rural areas.”
Wilz said he will evaluate what the state needs in light of the radon appropriations provided in the federal program.
“I want to make sure that when we look at the bills we move forward with, that there's not something already in place,” Wilz said. “I think there's some things we need to look at, maybe restructure … so that we're kind of attacking it up at all levels.”
Federal changes cast a shadow over cancer research funding
Before Devyn Kaas was 1 year old, she had been through four rounds of chemotherapy. Diagnosed with leukemia at seven months, Kaas is currently in remission and toddling around like a champ. But her father worries about the quality of treatments that will be available if her cancer ever returns.
According to the Pediatric Cancer Research Foundation, only 4 percent of federal cancer research funding goes to pediatric cancers. Scott Kaas, Devyn’s dad, has been pushing the state to fill some of that gap since 2024 in the form of a bill that would allocate one dollar to pediatric cancer research for each person in Iowa.
“I’m much less optimistic this year,” Kaas said. “We’ve made progress but the reason I’m not optimistic is because they have to cover all these other programs that the federal government has taken away.”
Grant Witness, an independent project tracking federal funding cuts, estimates 1,186 cancer-related NIH grants were disrupted in some way in 2025. Some were terminated or had their funding frozen while others were reinstated after months of delay.
“Federal government support is absolutely vital, but the amount of money flowing to cancer researchers from the federal government has really been disrupted in the past year,” said George Weiner, a cancer researcher at the University of Iowa, speaking in a personal capacity.
Weiner said the way the government distributes research funds also has changed, reducing the total number of grants it can support at a given time. Instead of paying for a lot of four-year grants on an annual basis, now a smaller selection of grants receive all of the money up front. As a result, Weiner said one-fourth as many grants are getting funding.
Weiner said that, although private organizations provide funding for cancer research too, there are gaps in what those groups are willing to fund.
“The private sector doesn't invest in cancer prevention very much, and that's really important,” he said. “In Iowa, the private sector tends not to invest in smaller populations, rare cancers and pediatric cancers.”
In light of the federal funding cuts, Weiner said he wants state support for pilot research funds that would get studies off the ground and increase their chances of being grant funded later on.
Other cancer-related bills to watch for
- Jackie Cale, Iowa government relations director for the American Cancer Society, said she expects to see the return of a bill introduced by Rep. Shannon Lundgren, R-Peosta, that would ban smoking inside casinos, ending their exemption under the Iowa Smokefree Air Act.
- Rep. Austin Baeth, D-Des Moines, said he “would love” if a bill introduced by Rep. Hans Wilz, R-Ottumwa, restricting tanning bed use for minors came back for consideration, but expects opposition. Multiple studies have shown that early tanning bed use increases the chance of developing melanoma.
- Cale said she also anticipates a bill related to the cost of breast cancer imaging will resurface. The legislation, which passed the House unanimously, would get rid of cost sharing requirements for diagnostic breast cancer imaging, which advocates say patients delay or go without due to expense.
What happened to the $1M Reynolds requested in 2025?
In her 2025 Condition of the State address, Reynolds announced a new research partnership between the Iowa Department of Health and Human Services and the University of Iowa’s College of Public Health to identify key cancer drivers in the state.
The legislature approved the $1 million Reynolds requested for the yearlong project, which has four key initiatives:
- Investigate programs and policies in other states that could work in Iowa;
- Study prostate cancer screening to ensure procedures are consistent across the state;
- Map the four cancers thought to be driving Iowa’s high rates — as well as colorectal and HPV-related cancers, which also have high rates — and identify areas that still have high rates even when known risk factors are accounted for; and
- Identify gaps in current understanding of cancer prevention.
Edith Parker, dean of the University of Iowa’s College of Public Health, told The Gazette in an email that the project team is currently working on the mapping initiative, starting with breast and prostate cancers. The team’s final report is due in June, but Parker said they are preparing an interim draft report due to Iowa HHS this month.
Parker also said the project will lay the groundwork for identifying available genetic and environmental data that could be used in a more detailed analysis, if funding is granted for a second year.
“Identifying what is driving our cancer rates is very complex and it is very challenging to come up with a definitive answer in a year,” Parker said in the email. “The findings from this year may point to additional areas for exploration and we will look to the state for guidance on how to proceed if that is the case.”
“When you think about the number of Iowans with cancer, when you think about the progress we could be making, I’m of the opinion that [the $1 million] is a great start,” George Weiner said. “But we need to do much more.”
When is it time to act on cancer?
Interest in Iowa’s cancer rates has picked up over the last year, said Rep. Austin Baeth, D-Des Moines. He said Reynolds’ announcement of the cancer drivers project jump-started the creation of other legislation intended to tackle the state’s high rates.
Baeth, a practicing physician, said he is hopeful changes in leadership will lead to prioritization of cancer prevention bills. He also said he would like to see more bipartisan cooperation on non-controversial issues, which is why he and Wilz plan to focus on radon.
“People of all political stripes know that this is something that may be a danger to them and it only makes sense that the state that has the highest radon level in America put the power of its state government behind mitigating that risk,” Baeth said.
Speaker of the House Pat Grassley, R-New Hartford, said he wants to wait for the cancer drivers project’s report to make decisions.
“We can pass things just to pass things. But I think if we’re going to make a million-dollar investment in taxpayer money, let’s see how that study comes back before we just start throwing bills against the wall,” Grassley said.
“I hear a lot of concern from Iowans about our cancer rates,” said Republican Sen. Kara Warme, of Ames, who chairs the Senate Health and Human Services Committee. “I hear a lot of curiosity in what's driving it, and I think that most people understand that it's a puzzle, and we're not going to find one particular thing that explains it.”
However, Warme said she isn’t hearing Iowans ask for legislation to address it.
“I don't necessarily have people demanding that we pass certain laws or certain rules, even if they might reduce cancer,” she said. “It doesn't seem to be the way that Iowans pursue it.”
The drive to pass cancer-focused legislation also could be influenced by the influx of funding from the Rural Health Transformation Program. The state will receive more than $2 million this year for its Healthy Hometowns plan, which includes provisions for cancer care like upgrading screening equipment and paying for follow-up diagnostics for breast and colorectal cancers.
Regardless of how likely cancer legislation is to pass, George Weiner, the UI researcher, said he will continue to advocate for its passage.
“For this to get caught up in the political meat grinder is really very frustrating for those of us who see the impact of cancer every day,” he said. “It’s a marathon, but we have to prepare and we have to do everything we can to make progress.”
Comments: fern.alling@thegazette.com
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