Ed Tibbetts, a longtime reporter and editor in the Quad-Cities, is the publisher of the Along the Mississippi newsletter, where this post first appeared. Find more of his work at edtibbetts.substack.com.

Lately, you haven’t been able to turn on the TV without hearing how great Representative Mariannette Miller-Meeks is.

The American Action Network, a special interest group with ties to the U.S. House Republican leadership, has been blanketing area TV stations and online outlets with ads that claim Miller-Meeks, the member of Congress for Iowa’s first district, “led the charge for high-quality, less expensive health care, especially for rural Iowans.” Then they say that we should “thank her for delivering for all of us.”

Less expensive health care?

In what world?

Bruce Lear lives in Sioux City and has been connected to Iowa’s public schools for 38 years. He taught for eleven years and represented educators as an Iowa State Education Association regional director for 27 years until retiring. He can be reached at BruceLear2419@gmail.com 

A few years ago, we visited Northern Ireland. During our trip, we repeatedly heard the Biblical phrase “The time of trouble,” describing the Protestants/Catholic war. This descriptor needed little elaboration, because those who said it lived it.

While our last couple snowbird months in Florida this year don’t compare to 30 years of brutal violence, they did introduce us to the seventh circle of Hell: health care and insurance coverage in the U.S.

It was “Our time of trouble.”

Jack Hatch is a former state senator and was an author of every health care reform bill in Iowa from 2003 through 2014.

Health care is not a privilege. It is not a reward for good luck, good jobs, or good timing. It is a basic right. And in Iowa, health care, as an issue, has always been understood best when we remember that simple truth. There is another truth: health care is too expensive, in Iowa and across the U.S. 

For decades, our state has shown that when we lead with fairness, openness, and shared responsibility, we can build systems that work. Iowa passed meaningful health care reforms prior to the Affordable Care Act. We created bipartisan commissions to make policy. We listened to consumers, providers and other stakeholders. We debated publicly. And we acted with courage.

That tradition expanded children’s coverage to become the state with the highest percentage per capita for children covered by insurance in the nation as listed by the Kaiser Family Foundation (now known as KFF) in 2013. We led when we modernized health records. We led when we built patient-centered care. We led when we believed that health care reform required public conversation, not private contracts.

“I am not interested in pretending this is just a private medical matter. It is a public policy failure playing out in my body,” State Senator Catelin Drey said in an extraordinary Senate floor speech on January 26.

The Democrat from Sioux City revealed that she has been diagnosed with stage 1 uterine cancer, and explained why she plans to be transparent about her cancer journey.

The Iowa Senate Democrats made their recording of Drey’s remarks available to Bleeding Heartland.

A poll in the field this week previews attack lines Republicans may use against State Senator Sarah Trone Garriott, if she becomes the Democratic nominee in Iowa’s third Congressional district. The same poll tests positive messages about the incumbent, U.S. Representative Zach Nunn.

It’s not clear who commissioned the survey, but the question wording points to either Nunn’s campaign or some GOP-aligned group that plans to support Nunn’s re-election through independent expenditures.

The questions enclosed below are taken verbatim from a text version of the poll. I don’t know whether some voters in the third district are being surveyed by phone; some political polls are conducted entirely by text, while others use multiple methods to reach respondents. UPDATE: A source confirms there is a telephone version of this poll.

I fact-checked the claims about each candidate. According to the respondent who provided copies of the questions to me, this poll did not test any messages about two other Democrats seeking the nomination in IA-03: State Representative Jennifer Konfrst and Xavier Carrigan. That suggests whoever commissioned the poll expects Trone Garriott, who has led the Democratic field in fundraising, to win the June primary. UPDATE: Konfrst ended her campaign and endorsed Trone Garriott on January 26.

A quick reminder: although you may feel angry when you see or hear inaccurate or biased claims about Democratic candidates, it’s better not to click away or hang up. Take screenshots or detailed notes, or record the phone call, and share the questionnaire with me. (I won’t publish your name.)

Iowa’s all-Republican Congressional delegation votes in unison on almost every resolution or bill. But last week, U.S. Representatives Zach Nunn (IA-03) and Mariannette Miller-Meeks (IA-01) each parted ways with most of their GOP colleagues on high-profile measures.

Nunn and Miller-Meeks are among the country’s most vulnerable U.S. House incumbents. They have largely supported President Donald Trump’s agenda and remained loyal to House GOP leaders. But in recent weeks, they have taken different paths on an issue likely to be at the center of their 2026 re-election campaigns.

And while Nunn publicly explained why he supported a Democratic bill on health insurance subsidies, Miller-Meeks drew no attention to her votes to override Trump’s vetoes of two uncontroversial bills.

Nunn’s political strategy is easier to understand than Miller-Meeks’. But it may be just as risky.

Jenny Turner is a speech language pathologist who lives in West Des Moines. She is the board president of Iowa Citizens for Community Improvement and a member of the Fighting Oligarchy leadership team. This column first appeared in the Marshalltown Times-Republican.

I became a widow at age 38 when my son was 7. Solo parenting is hard, but thanks to the Affordable Care Act I’ve been able to work part-time from home in a way that makes our lives work pretty well.

In January, my health insurance premiums will jump 79 percent, from $191 to $342 per month.

For a lot of single mothers, that difference is their grocery budget for the month. This price hike is because of Republican inaction. Our representatives in Congress—Zach Nunn (IA-03), Ashley Hinson (IA-02), Mariannette Miller-Meeks (IA-01), and Randy Feenstra (IA-04)—have known these increases were coming for months, but chose to do nothing to prevent them.

Douglas Burns is a fourth-generation Iowa journalist. He is the co-founder of the Western Iowa Journalism Foundation and a member of the Iowa Writers’ Collaborative, where this article first appeared on The Iowa Mercury newsletter. His family operated the Carroll Times Herald for 93 years in Carroll, Iowa where Burns resides.

Fox News host Greg Gutfeld and his orbiting panelists relentlessly mocked the weight of a rural middle- and high school band teacher and Democratic candidate for the Iowa legislature in a viral three-minute national broadcast last week.

The barbs aimed at Dunlap City Council member Benjamin Schauer were incessant and cruel, and the piece has generated comments in a range of online forums, including The Daily Caller.

Sue Dinsdale is the Executive Director of Iowa Citizen Action Network and the State Lead for Health Care for America NOW.

Millions of Americans are struggling with the high cost of services and goods this holiday season, as politicians in Congress seem stuck in the past rather than looking out for our future. The Affordable Care Act was passed fifteen years ago and has been fully in effect for more than a decade. Despite its proven track record and majority support for the law, here we are again.

There’s no better example than the current health care affordability crisis. It’s not new, but the fight is coming to a head as Republicans in Congress continue to refuse to extend the premium tax credits that millions of people depend on for Affordable Care Act marketplace coverage. Failure to extend the credits could cause 4 million people to drop their health insurance, while millions more would pay double, triple, or more to keep their coverage. 

Jason Benell lives in Des Moines with his wife and two children. He is a combat veteran, former city council candidate, and president of Iowa Atheists and Freethinkers.

I find myself extremely frustrated with the media coverage and Democratic response to the government shutdown and the attitudes surrounding health care costs. With the ongoing health care crisis—and yes, it’s a crisis—it seems ridiculous to me that Democrats would focus their efforts on bringing down premiums and backing subsidies for health care costs.

Every year around this time, I get angry because our system makes me sign up for health insurance benefits through my employer. That is absolute garbage and one of the primary drivers of unhappiness and economic security for so many Americans.

I will lead with this hot take: Democrats shouldn’t be advocating for lower health care costs through subsidies and making access to the Affordable Care Act marketplace more affordable. That should not be their stated goal, nor their party position when it comes to negotiating on this point.

Xavier Carrigan is a Democratic candidate in Iowa’s third Congressional district.

Picture a hostage tied to the tracks. The train is coming. The kidnappers demand a ransom, and the so-called heroes in Washington hand them the keys to the vault.

That’s what happened this fall. After 43 days of a federal government shutdown, Congress reopened the government but left millions of working Americans still bound to the rails. The funding bill keeps programs like SNAP food assistance running, restores federal pay, and prevents layoffs. Those things matter. But what didn’t make it into the deal will hurt far longer than any shutdown: the failure to extend the enhanced premium tax credits under the Affordable Care Act.

Dr. Emily Boevers is a Readlyn farm kid, now an OB-GYN practicing in Iowa and living in Waverly with her family.

On October 1, the federal government “shut down” when the prior funding resolution, which Congress approved in March with bipartisan support in the Senate, expired. This time around, the same Congress was unable to work together for a bipartisan majority to authorize ongoing funding. A central sticking point is what to do about over tax credits for health insurance, which are set to expire at the end of 2025.

A month into the shutdown, a widening chasm exists between our political leaders in Congress, with little to no progress reported. While many Americans have gone about their lives, and the government has diverted funds to cover wages for some federal employees, the stakes are getting higher as we speak.

There is nothing positive about the shutdown, and yet, as a physician, I am glad to see our representatives fighting to maintain health care coverage options for patients through the Affordable Care Act tax credits. It presents an opportunity to share insights from the history of the health care reform law and discuss the challenges of taking care of patients in our current system. Perhaps most urgently, it presents an opportunity to leverage the ongoing chaos of both our political and health care systems into what could be meaningful policy reform.

Abbey Paxton is the owner of Storyhouse Bookpub in Des Moines.

In 2021, I opened an independent bookstore in downtown Des Moines. My husband, also a small business owner, and I have had two children since moving back to Iowa in 2020, and we work full time running our businesses. 

Like many other small business owners and self-employed Iowans, our family resides in the gap between barely affordable, mediocre, private individual health insurance and Medicaid—a gap that will only widen after the most painful provisions of the Republican budget reconciliation bill (the so-called “One Big Beautiful Bill Act”) are fully implemented.

Every Iowa member of Congress voted in favor of the bill, which makes historic cuts to Medicaid while providing big tax breaks for the wealthy and new tax loopholes for big corporations like health insurance and prescription drug companies. 

Bruce Lear lives in Sioux City and has been connected to Iowa’s public schools for 38 years. He taught for eleven years and represented educators as an Iowa State Education Association regional director for 27 years until retiring. He can be reached at BruceLear2419@gmail.com 

The federal government is shuttered. Are there round-the-clock intense negotiations to find a way to reopen? Are leaders proposing new innovative ways to turn the lights back on?  Is there a sense of urgency? Is the president tirelessly practicing “his art of the deal”? 

No, none of that’s happening.

The Senate convenes to vote on both Republican and Democratic funding proposals, knowing neither will pass. There’s no urgency and little concern. After the gavel, they flee to sympathetic shout-shows to point fingers, hoping Americans will blame the other side. 

Sue Dinsdale is the Executive Director of Iowa Citizen Action Network and the State Lead for Health Care for America NOW.

Politicians in Washington, D.C. are getting ready to shut down the federal government once again, despite single-party Republican control of the House, Senate, and the presidency. 

This time, disagreements in Congress over health care costs and access are preventing an agreement that would keep critical services going without interruption. 

Earlier this year, Republicans in Congress passed and President Donald Trump signed a massive budget reconciliation bill, the so-called “One Big Beautiful Bill Act,” which extended trillions of dollars in tax breaks that would otherwise have expired this year. The lion’s share of those tax breaks will go to wealthy households making over $400,000 a year and to large corporations through extra loopholes that were reinstated in the law. 

“You understand what too many of our fellow Americans have forgotten: that democracy is not on automatic pilot,” U.S. Senator Chris Van Hollen told hundreds of Democrats in Des Moines on September 13. “Its survival, its very survival, depends on us.”

In his keynote address at the Polk County Democrats’ annual Steak Fry fundraiser, the senior senator from Maryland repeatedly urged Democrats to fight back against President Donald Trump’s lawless regime. He also faulted members of his own party, who don’t always stand up for core principles.

Xavier Carrigan is a Democratic candidate in Iowa’s third Congressional district. He delivered these remarks at the Iowa Insurance Division’s August 19 public hearing on proposed increases in health insurance premiums for policies sold on Iowa’s Affordable Care Act exchange. Although he is not directly impacted by these potential price increases, he felt that sharing his own experience from recent years was important to add to the context of the unaffordability of health care in the U.S., as part of his fight for Medicare for All.

My name is Xavier Carrigan, and while I am running for the U.S. House, I am here today as a citizen who has been forced to navigate the ACA marketplace when I had no other insurance options.

I know what it’s like to lose your insurance and be thrown into a system where every choice is a bad choice. When you’re uninsured and dealing with a chronic condition, the marketplace becomes a cruel joke disguised as help.

Kay Pence is vice president of the Iowa Alliance for Retired Americans.

I’m a retired union representative for the Communications Workers of America living in rural Eldridge with my husband of 50 years. As a union rep I bargained contracts, and health care was always the biggest issue, especially before the Affordable Care Act became law in 2010.

I’m currently the executive vice president for the Iowa Alliance for Retired Americans, which has 4.4 million members nationwide. I’m extremely concerned about how Donald Trump’s so-called “Big Beautiful Bill” (the budget reconciliation package) will force people off their insurance and cause problems for providers. I’m especially concerned about insurance rates for everyone who thinks these cuts to Medicare, Medicaid, and the Affordable Care Act premium subsidies won’t impact them, since their coverage comes through their employer or private insurance plan.

Jon Muller is a semi-retired policy analyst and entrepreneur.

The Inflation Reduction Act (IRA), which Democrats in Congress approved and President Joe Biden signed in 2022, eliminated the subsidy cliff for health insurance purchased through the Affordable Care Act exchanges through 2025. It used to be the case that your ACA health insurance subsidy disappeared with the first dollar earned over 400 percent of the Federal Poverty Level (FPL).

Unless Congress acts to continue this provision of the IRA, the subsidy cliff will return in January. Thus far, Republicans in Congress show no interest in extending the enhanced subsidies for ACA health insurance plans.

The FPL in 2025 is $15,650 for a single person and $21,150 for a married couple. Thus, 400 percent of FPL is $62,600 and $84,600, respectively. A single person earning $62,600 currently pays $434/month on the Exchange for a Silver Plan. The married couple at 400 percent of FPL pays $599. The FPL increases with each dependent.

Under current law, a 60-year-old single person making just one extra dollar, or $62,601, experiences a rate increase of less than 1 penny/month. When the subsidy cliff returns in January, those premiums will go to $870/month, or an additional $5,119/year. For a 60-year-old married couple earning $1 more, the monthly premium will increase to $1,512, an annual hit of $10,953. These estimates are based on average rates for non-smoker 60-year-olds in Iowa. The increases could be more or less depending on other factors, including geography, age, and smoking status.

All four Iowans in the U.S. House voted on May 22 to pass a federal budget reconciliation package combining massive tax cuts with deep spending cuts on health care and food assistance.

The early morning vote on the “One Big Beautiful Act” (adopting President Donald Trump’s preferred phrase) followed an all-night debate. House leaders rushed the vote before the nonpartisan Congressional Budget Office (CBO) could analyze a manager’s amendment released on the evening of May 21, which made many substantive changes to tax provisions and deepened the planned Medicaid cuts.

House members approved the measure by 215 votes to 214, with two Republicans joining all Democrats to vote no, and one Republican voting “present.” The one-vote margin means U.S. Representatives Mariannette Miller-Meeks (IA-01), Ashley Hinson (IA-02), Zach Nunn (IA-03), and Randy Feenstra (IA-04) each can claim to have cast the deciding vote to cut taxes. They did it without waiting for a nonpartisan analysis of the costs and impacts for their constituents.

This vote will likely become a central theme for Democratic candidates in Iowa’s 2026 Congressional campaigns—and the governor’s race, if Feenstra becomes the GOP nominee. Within hours, Congressional challengers Travis Terrell (IA-01), Sarah Trone Garriott (IA-03), and Jennifer Konfrst (IA-03) blasted the vote in social media posts and fundraising emails. A video of Miller-Meeks running away from Social Security Works executive director Alex Lawson as he presses her about Medicaid cuts has gone viral on several social media platforms and will surely be seen in television commercials.

Tens of thousands of Iowans will lose their health insurance, food assistance, or both if the “big, beautiful bill” becomes law. Meanwhile, the package would raise the debt ceiling by $4 trillion and add at least $2.3 trillion to the deficit (or perhaps $3.2 trillion) over the next ten years.

Charles Gaba is a health care policy wonk, advocate, and blogger who mixes data analysis with snark at ACASignups.net, where this article first appeared. You can follow him on Threads, Bluesky, Mastodon, Spoutible, or X/Twitter.

Over the past couple of months I’ve compiled a master spreadsheet breaking out enrollment in Affordable Care Act plans (Qualified Health Plans and Basic Health Plans), Medicaid/Children’s Health Insurance Program coverage (both traditional and via ACA expansion) and Medicare (both Fee-for-Services and Advantage) at the Congressional district levels.

With the pending dire threat to several of these programs (primarily Medicaid and the ACA) from the federal budget proposal House Republicans approved in late February, I’m going a step further and am generating pie charts which visualize just how much of every Congressional district’s total population is at risk of losing health care coverage.

All four Republicans who represent Iowa in the U.S. House voted for the budget blueprint.

Alexandra Nickolas-Dermody is Vice Chair of the Iowa Democratic Party’s Progressive Caucus, a longtime election strategist and organizer, and a lifelong Iowan. On December 31 she emailed this message to members of the Iowa Democratic Party’s State Central Committee, who will elect a state party chair for the next two years on January 4. Bleeding Heartland has not edited her text in any way.

Dear Central Committee Members and Iowa Democrats,

I hope this email finds you well. As a lifelong Democrat, Central Committee Member, and Vice Chair of the Progressive Caucus, I have had the privilege of working alongside many of you to build a stronger, more inclusive party. Today, I am reaching out to ask for your support in my candidacy for Chair of the Iowa Democratic Party.

Who I Am

For those I haven’t had the opportunity to meet personally, I’m Alexandra Nickolas-Dermody — a caregiver, election strategist and organizer, former non profit director, and working class Iowan. I’m a proud lifelong Iowan who has dedicated my life to empowering working-class folks, young voters, and marginalized communities. My work advocating for affordable housing, workers’ rights, LGBTQ+ equality, and reproductive freedom has prepared me to take on the challenges we face as a party.

Henry Jay Karp is the Rabbi Emeritus of Temple Emanuel in Davenport, Iowa, which he served from 1985 to 2017. He is the co-founder and co-convener of One Human Family QCA, a social justice organization. This essay first appeared on his Substack column.

Shortly after the recent election, Democratic State Representative Ken Croken, one of the members of the Quad Cities delegation to the Iowa legislature, hosted a meeting at a local library. The theme was, “Where Do We Go From Here?”

The room was packed. It was booked for an hour, but for the first half hour those in attendance were obsessed with the question of “Where did the Democrats go so wrong?” Every speaker had his or her view on why Democratic candidates failed so miserably, both nationally and in Iowa.

It was interesting, to a point. It allowed people to grieve and vent their anger, but it wasn’t very useful and it definitely was off topic. Finally, I raised my hand in frustration and said, “We’re talking about the wrong thing! It will be two years before we can effect change through the voting booth! But it will only be two months before January 20 and day one of the Trump presidency! Right now we have bigger fish to fry and not a lot of time to get cooking!”

Charles Gaba is a health care policy wonk, advocate, and blogger who mixes data analysis with snark at ACASignups.net, where this article first appeared. You can follow him on Threads, Bluesky, Mastodon, Spoutible, or X/Twitter.

In early 2021, Democrats in Congress passed and President Joe Biden signed the American Rescue Plan Act (ARPA), which among other things dramatically expanded and enhanced the original premium subsidy formula of the Affordable Care Act (ACA). The changes brought the financial aid sliding income scale up to the level it should have been in the first place more than a decade earlier.

In addition to beefing up the subsidies along the entire 100 percent to 400 percent of Federal Poverty Level income scale, the ARPA also eliminated the much-maligned “Subsidy Cliff” at 400 percent of the Federal Poverty Level. Before 2021, a household earning even $1 more than that amount had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

COMPARING THE ORIGINAL ACA SUBSIDIES WITH ENHANCED SUBSIDIES

Here’s what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

Sharon Mayer is a Pella resident and health care advocate.

Rising health care costs are top of mind for many seniors, who often live on fixed incomes and struggle to afford our care. That’s why millions of people forgo critical vaccinations, including for shingles.

Luckily, I was able to get the shot covered by Medicaid. But many aren’t able to afford this important, preventative measure. Thankfully, starting in January, seniors could save hundreds of dollars when getting vaccinated against this painful illness.

Herb Strentz examines Chuck Grassley’s recent political messaging and low points from his record in the Senate.

The home stretch of this midterm election campaign is unfolding in in 3-D format — Dire, Divisive, and Despairing. That’s particularly true of the U.S. Senate race between Republican incumbent Chuck Grassley, seeking his eighth term at age 89, and Democrat Michael Franken, a retired U.S. Navy admiral, who will be 65 on election day, November 8.

That 3-D nature of our Iowa politics was illustrated well in one of the Grassley campaign’s recent television commercials.

In a backhanded way, Grassley acknowledged why it is time for Iowans to vote him out of office.

Julie Russell-Steuart is a printmaker and activist who chairs the Iowa Democratic Party’s Disability Caucus.

Glenn Hurst is a rural doctor in the small southwestern Iowa town of Minden and a founding member of Indivisble Iowa, whose activism helped elect U.S. Representative Cindy Axne. He faces Abby Finkenauer and Mike Franken in the June 7 Democratic primary for U.S. Senate.

Dr. Hurst has earned our endorsement for his strong experience advocating for people with disabilities and because he is laser focused on improving the lives of the American people in crucial ways.

Bleeding Heartland welcomes guest posts advocating for Democratic candidates in competitive primaries for local, state, or federal offices. Please read these guidelines and contact Laura Belin if you are interested in writing.

I want to introduce myself to the readers of Bleeding Heartland. I am Michael Andreski, a Democratic candidate in district 31 of the Iowa House of Representatives.

Why am I running for this office? The short answer is because the opportunity was there, and I was encouraged by several people, including Democratic State Representative John Forbes of Urbandale.

But the long answer is that as a fifth-generation Iowan, I could no long sit on the sidelines and see the state where I was born, raised, educated, started a career, and raised a family continue to become a place I no longer recognize as the Iowa I know and love.

Chris Peterson is a family farmer who lives near Clear Lake (Cerro Gordo County).

When most people think of small businesses, they imagine a brick and mortar store on Main Street that offers retail or restaurant services. Most would not think of the work worn hands of a person caring for Berkshire hogs on a small farm. But that’s exactly what family farms are: a small business. 

Farming is the only thing I’ve ever known – it’s the only thing I’ve ever wanted to do. I’m a third generation American farmer and I had my first pigs when I was a sophomore in high school.

John and Terri Hale own The Hale Group, an Ankeny-based advocacy firm focused on making Iowa a better place for all. Contact terriandjohnhale@gmail.com.

Two months ago, Bleeding Heartland published a column recounting our first-time escape to Arizona for a brief respite from Iowa cold and snow, and our encounter with someone who surprised us when he said “I used to be proud to be an Iowan.”

The column outlined the reasons he, and we, were frustrated about the Iowa that we now see vs. the Iowa that used to exist. They included:

RJ Miller: I chose to run to take the voices of my community and make their voices louder.

I am a community activist who’s been organizing in Des Moines since 2019 around the issues of racial discrimination, civil and human rights, and urban violence.  Originally a victim of gun violence in Minneapolis, I overcome the obstacles of gang activity and incarceration in order to inspire and support my community in a collective effort to defeat the issues that plague the inner city. 

My mission is to uplift, empower, and transform the Des Moines community through restorative justice, empowering the youth, and investing in solutions that will combat the forces of colonization and oppression at large.

The Hurst for Iowa campaign just received an overwhelming endorsement from Iowa’s leading progressive organization, Iowa Citizens for Community Improvement Action Fund. In the announcement, they stated, “We’re endorsing Glenn because he’s with us on the issues and on challenging business-as-usual politics and the status quo. He shares our belief that real change comes from the ground up, and he has a plan to win and can excite a grassroots base to turn out to the polls on June 7.”

Glenn Hurst is a family physician in southwest Iowa and a Democratic candidate for U.S. Senate.

Several years ago, my wife and I had a friend our family called Grandma Ruth. Ruth was special to us. She was one of the first people we brought my newborn daughter to meet. She had taken a special interest in our kids and was always present for their big events. Often, we would pick her up and bring her to our house for football parties and holidays. She included us in the celebration of her life events as well. She was estranged from her own family and just became part of ours.

I learned a lot from observing how Ruth navigated her world. She had learned how to use senior transportation services to get to doctor appointments as well as to the grocery store or other activities. She knew how to arrange Meals on Wheels and how to keep current with her disability to remain eligible for services she absolutely needed.

Glenn Hurst is a family physician in southwest Iowa and a Democratic candidate for U.S. Senate.

Several years ago, a man called my clinic seeking an appointment. He did not have insurance, and in fact had not seen a physician since childhood. But on this day, he was desperate. He had felt a popping sensation in his abdomen and thought he might have a hernia. If that was true, he needed surgery, and we were the gateway to that service. We agreed to see him and to work out a payment plan later.

When I entered the exam room, it was clear something was wrong. Here was a man in his late 50s who did not look well. His skin had a bronze-yellow tint, his cheeks were sunken in, and his belly protruded. He was weak and disheveled. He repeated his story about the popping sensation and told me he could feel something protruding.

Glenn Hurst is a family physician in southwest Iowa and a Democratic candidate for U.S. Senate.

In my very first days of private practice, I met a patient with an aggressive form of breast cancer. She was young, in her 30s. She and her husband had two children under the age of 5 and were doing the same struggling most young middle-class Americans do at that point in life. They worried about bills, insurance, saving for big purchases. They were not likely thinking about retirement, and they had no plans for a medical emergency. Now their family was faced with a medical crisis that no one could have predicted.

I could tell her hands were full as her husband tried to wrangle the kids who were up and down the walls of the exam room as she explained her situation to me.

Glenn Hurst is a family physician in southwest Iowa and a Democratic candidate for U.S. Senate.

The United Auto Workers strike at John Deere is about fair wages and the value of work, but also about the corruption of our corporate welfare system and the devaluing of American lives. Sadly, the corporate value of workers mirrors the values of our own government.

The shift of the distribution of wealth in this country from the time of Ronald Reagan’s “trickle-down” economics clearly demonstrates how that policy failed Americans. Wealth consolidated at the top, and a minuscule portion barely trickled down to just the highest 10 percent of earners.

A third Democrat joined the race for Iowa’s U.S. Senate seat on July 29. Dr. Glenn Hurst made clear that one issue in particular is driving his campaign.

“I went back to school and became a doctor because I saw a need in the rural communities I love and call home,” Hurst said in a news release. “I’ve had a front-row seat to the tricks insurance companies use to avoid paying for care, drowning providers in paperwork when we should be with our patients. I’m running for the U.S. Senate because Iowans deserve better. We deserve Medicare for All.”

Charles Bruner is a longtime advocate for policies that support children and strengthen families. -promoted by Laura Belin

About this essay

I studied political science at the beginning of the 1970s at one of the elitist of universities, Stanford University. My graduate school class, if not all radicals, shared a serious critique of American government and the military-industrial complex, the Vietnam war, the academic privilege and not freedom that embodied the Stanford administration, and the failure for society to listen to youth and follow-through on the vision expressed in the decidedly liberal document, The Port Huron Statement.

I returned to Iowa in 1975 feeling alienated and full of angst at my better understanding of the darker side of American politics. But I had no clue how to contribute to changing it. Fortunately, I found a group of 20-somethings in Iowa – largely through the Community Action Research Group (Iowa’s Public Interest Research Group) – doing that work in the policy field on the environment. They connected me to a job at the Iowa Welfare Association funded by the Compensatory Education and Training Act, the federal jobs program that provided nonprofits with funding to create jobs. It gave me space to learn and grow, as it did for others in my group.

Khadidja Elkeurti was field director for Kimberly Graham’s 2020 U.S. Senate campaign. -promoted by Laura Belin

Growing up in Cedar Rapids as a child of Algerian immigrants, many people ask why my parents chose to move to Iowa of all places. When my parents received their green card in 1995, they chose the small town of Elkader because of its historical relevance in being named after the Algerian revolutionary who fought for independence from colonial France. Despite their thick accents and unfamiliarity with American culture, my parents were welcomed to the town with open arms.

Many years later, they decided to stay in Iowa because of its renowned K-12 public school system, and the strong and diverse Muslim community found in Cedar Rapids.

In recent years however, our current leadership has threatened the future of a prosperous Iowa. Public education in our state is being undermined, and the current rhetoric around immigrants and people of color is becoming increasingly dangerous.

The U.S. House and Senate on December 21 approved a $2.3 trillion package to fund the federal government through September 30, 2021 and provide approximately $900 billion in economic stimulus or relief connected to the coronavirus pandemic.

No one in either chamber had time to read the legislation, which was nearly 5,600 pages long, before voting on it. Statements released by Iowans in Congress, which I’ve enclosed below, highlight many of its key provisions. The unemployment and direct payments to families are clearly insufficient to meet the needs of millions of struggling Americans. Senate Republicans blocked aid to state and local governments, many of which are facing budget shortfalls. President-elect Joe Biden has vowed to push for a much larger economic stimulus package early next year.

The legislation headed to President Donald Trump’s desk includes some long overdue changes, such as new limits on “surprise billing” by health care providers for emergency care and some out-of-network care.