Pam Mackey Taylor is the Director of the Iowa Chapter of the Sierra Club.

Every three years, the Iowa Department of Natural Resources (DNR) conducts a Triennial Review of its water quality standards. Part of the review is a determination of what changes need to be made to Iowa’s existing water quality standards.

The agenda for the Triennial Review was simple. The DNR intends to focus on the following topic areas related to water quality standards:

• Tribal reserved rights
• Antidegradation
• Human health criteria
• Chapter 61/Surface Water Classification document cleanup
• Use attainability analysis
• PFAS (per- and polyfluoroalkyl substances, sometimes called “forever chemicals”)
• Lake nutrients

After digging into these topics during the review meeting, what jumped out was the lack of investment the State of Iowa and the DNR have made in water quality and improved water quality standards over the last two decades. 

For years, Governor Kim Reynolds resisted COVID-19 vaccine mandates, saying she believed “in Iowans’ right to make health care decisions based on what’s best for themselves and their families.”

But as this year’s cold and flu season begins, many Iowans who want to protect themselves and their families from COVID-19 are unable to get a booster shot, because the U.S. Food and Drug Administration restricted access to updated vaccines.

Public health authorities in about two dozen states have issued guidance or standing orders designed to help adults choose to vaccinate themselves or their children against COVID-19. The Reynolds administration has not acted.

Staff for the governor’s office and Iowa Department of Health and Human Services did not respond to several requests for comment over the past ten days.

Edward Kelly, Jr. is a former Pentecostal Fundamentalist minister. He lives in Bellevue, Nebraska and works as a case manager at Heartland Family Service.

Imagine this scenario: Stephan had made the appointment with her primary care doctor as a last resort. She had recently developed a habit of delaying seeing a doctor until the symptoms became overwhelming, and the symptoms now were unbearable, so she called. But she knew they would say the same thing. “Stephan, we still do not have a legal change of name. We have you as Stephen.” They just would not recognize her gender nor her name.

It was one big hassle. And when they came out and called her to go in, it was always the same: “Stephen.” She would walk up, and they would announce to the doctor, “Stephen is here.”

Julie Stauch is a Democratic candidate for governor.

My team and I hit the ground running in June, and visited all fifteen Community College districts of Iowa. From the start, I made it clear: this campaign would be different. The old way of running campaigns isn’t working anymore, and I believe Iowans deserve a new approach. 

Over the last three months, I’ve spent my time understanding what people across this state most want from their next governor. The core message I heard was that Iowans want leaders who will focus on the real problems they face. The people of Iowa are fed up with candidates not deeply engaging in conversation with them. 

That’s why I’ve held 27 in-depth interview sessions across these districts, ensuring that every voice is heard and every concern is taken seriously. In fact, during the very first interview session, a woman wrote on her worksheet, “I feel like I’ve been heard for the first time.”

Randy Evans is executive director of the Iowa Freedom of Information Council, a nonpartisan, nonprofit organization that promotes openness and transparency in Iowa’s state and local governments. He can be reached at DMRevans2810@gmail.com. 

Government regulates business to protect the health, safety, and welfare of the public. That is the theory behind enacting and enforcing regulations, and it is a commendable mission.

But, too often the regulators seemingly do not want the people they are supposed to protect to know which businesses fall short of the minimum expectations spelled out by these regulations. The regulators seemingly do not want people to know when and how businesses fail to meet the baseline standards.

Each time that happens, the mission of government regulations fails the public.

Chris Jones is a fisherman who lives in Iowa City. He writes the Substack newsletter The Swine Republic, where this post first appeared. 

Secretary of Agriculture is one of seven executive offices Iowans see on their off-year voting ballot. The Iowa legislature created both the office and the Department of Agriculture (now IDALS) in 1923.

It may seem curious that we have a statewide election for the administrator of a department that employs less than 2 percent of the state government workforce and represents a private industry that is only Iowa’s third-biggest and one with a declining share of the state’s Gross Domestic Product. All sorts of economic sectors are bigger than agriculture; for example, health care now nearly doubles Ag’s GDP in Iowa.

But we have to remember that in 1923, almost 40 percent of Iowa’s population lived on farms. It’s well below 10 percent in the present day, when only 67,000 people in Iowa list farming as their primary source of income (2 percent of Iowa) and many farmers don’t even live on the farm. GMO has made crop farming so easy that some Iowa farmers also farm in Kansas and the Dakotas and probably other states as well.

A person could wonder why we all don’t vote for a Secretary of Teachers, or a Secretary of Bartenders or Hairdressers or Truck-drivers.

Diane Rosenberg is executive director of Jefferson County Farmers & Neighbors, where this commentary first appeared.

Recently, a friend asked how the Iowa state legislature or governor have impeded the work of the Iowa Department of Natural Resources (DNR) and other agencies in cleaning up air and water borne toxins that may be causing Iowa’s increasing cancer rate.

After eighteen years of working on confined animal feeding operation (CAFO) issues, a whole laundry list of impediments rolled off the tip of my tongue.

Numerous studies link high nitrate levels to a variety of cancers. And this major agricultural state has the second highest rate of cancer in the nation and is one of two states where the number of cases is rising.

Water quality is in the news this summer. High nitrate levels are affecting drinking water in Central Iowa, a new Polk County water quality report links 80 percent of nitrate pollution to agriculture, and too many beaches are unswimmable just when we need to cool off in this blistering heat.

Given all that, I thought this is a good time to spotlight some of the ways I see our state government failing us.

Emily Boevers is an OB-GYN practicing in Iowa. She lives in Waverly with her husband and children. This essay first appeared on the website of the Iowa Coalition for Reproductive Freedom.

On June 28 of last year, when the Iowa Supreme Court reversed and remanded the prior permanent injunction on a near-total ban on pregnancy termination, the majority utilized the rational basis test, which means the fact that this law inflicts harm on individual rights doesn’t matter. The court held the law is constitutional if it is rationally related to a legitimate government interest.

And so, when the law went into effect on July 29, 2024, women in Iowa were taken back in time, relegated to lesser citizens by the state, and placed squarely behind men and fetuses in their rights.

Now, only two of five clinics previously providing abortion in Iowa remain open for care. Of note, this is a barrier to women, particularly low-resourced women, receiving cancer screenings, contraception, treatment for infections, and a safe place to seek information, not only abortion care. Very pro-life, and especially poignant to reduce care for women that are already struggling to make ends meet.

Tom Walton is an attorney in Dallas County.

In March 2024, Dr. Peter S. Thorne, Department of Occupational and Environmental Health at the University of Iowa, with his colleague Dr. Angelico Mendy, an epidemiologist at the University of Cincinnati College of Medicine, published an important scientific paper on the association between drinking water nitrate levels with the risk of death from cancer. Thorne is the former Chairman of the U.S. Environmental Protection Agency’s Scientific Advisory Board.

The report has received little, if any, coverage by others, including in Iowa. It deserves more.

Randy Evans is executive director of the Iowa Freedom of Information Council, a nonpartisan, nonprofit organization that promotes openness and transparency in Iowa’s state and local governments. He can be reached at DMRevans2810@gmail.com. 

People living in central Iowa received a wake-up call last week that should drag water quality back in front of the state’s 3.2 million residents.

Iowa’s largest water supplier, which serves a fifth of the state’s homes and businesses, ordered its 600,000 customers to immediately reduce water demand by ending lawn-watering and cutting use in other ways.

Such orders typically come during persistent drought when water supplies are short. This time, water is plentiful. But Central Iowa Water Works is struggling to remove enough nitrates to make its water safe for human consumption.

This is not just a Des Moines area problem. This is an all-of-Iowa problem. 

Dr. Greg Cohen has practiced medicine in Chariton since 1994 and is president-elect of the American College of Osteopathic Family Physicians. He was named the Rural Health Champion by the Iowa Rural Health Association in 2014 and was awarded the Living Doc Hollywood Award for National Rural Health day in 2015. He was named a Distinguished Fellow by the American College of Osteopathic Family Physicians as well as Physician of the Year by the Iowa Osteopathic Medical Association in 2019.

I was hoping I would never have to write this, but measles has come back to Iowa. Although the last measles case in Iowa was was recorded in 2019, it has been more than a generation since the last significant outbreak. It has been 25 years since the United States was declared measles free—meaning there was no longer year-round spread.

We are now at a 30-year high in cases and still rising. Since the start of this year’s outbreak in Texas, there have now been more than 1,168 cases in at least 35 states, 137 hospitalizations, and three confirmed deaths. 95 percent of those diagnosed with measles this year have been unvaccinated, and all of the deaths have been unvaccinated. The Iowa Department of Health and Human Services announced on June 11 the third confirmed measles case in our state: an unvaccinated child “who was exposed during international travel.”

“People are excited, and I think so far what we’re seeing is hunger for something different,” State Auditor Rob Sand told me on the day he announced he’s running for governor in 2026.

“The real theme across my work is I’m a problem solver,” Julie Stauch told me shortly before her campaign launch.

I interviewed both candidates about their top priorities and the case they will make to Iowa voters over the coming year. Toward the end, I discuss the biggest challenge facing each contender at this early stage.

Bill Bumgarner is a retired former health care executive from northwest Iowa who worked
in hospital management for 41 years, mostly in the state of Iowa.

Prior to retiring at the end of 2023, I worked in hospital leadership for 41 years. For the last 24 years of that time, I served as president at two hospitals in rural Iowa.

I’ll be quick to my point and blunt. When President Donald Trump or any Republican member of the U.S. House or Senate tells you that their Medicaid budget plans are strictly focused on cutting waste, fraud and abuse, they’re lying.

Patrick Swanson has been restoring a Harrison County prairie.

About six months have passed since I wrote about my experience on a fall LoHi Trek through the southern Loess Hills. This spring, LoHi Trek number 5 was held April 23-28 in the middle reaches of the Loess Hills, centered in and around Hitchcock Nature Center (HNC) in Pottawattamie County. This was my fourth LoHi Trek, and was distinctive from my previous journeys for its inclusion of an urban hike through the neighborhoods and urban core of Council Bluffs. 

Like earlier LoHi adventures, Golden Hills Resource Conservation and Development spearheaded the planning and logistics of the trip, and posted an excellent summary of each day’s activities, highlighting the many partners and volunteers that made this event possible. 

Crescent Hill at Hitchcock served as our home base, where we set up camp near the Crescent Ridge Cabin. This area was formerly operated as Mt. Crescent Ski Area; Pottawattamie County acquired it in 2021 to expand Hitchcock Nature Center to the south and develop additional recreational opportunities beyond the snow-based activities for which Mt. Crescent was well-known.

UPDATE: The Iowa House and Senate adjourned for the year on May 15. The pesticide immunity bill did not advance in the House, nor was it attached to any late-moving legislation. Original post follows.

Diane Rosenberg is executive director of Jefferson County Farmers & Neighbors, where this commentary appeared on May 13 as an updated version of an article first published on March 25.

Even though 89 percent of Iowans oppose the pesticide immunity bill, also known as the “Cancer Gag Act,” the Iowa Senate voted to move it forward for the second year in a row sending it to the Iowa House where it remains stalled. Senate File 394 would protect pesticide companies from personal injury lawsuits if a product has an EPA-approved warning label. Companies would still be protected if the label is inaccurate, doesn’t fully disclose all risks, or harms are identified in the future.

The chemical giant Bayer is lobbying heavily for this bill, and the corporation has a lot to gain if the bill passes. In 2018, Bayer purchased Monsanto, the manufacturer of Roundup that misled regulators and the public about glyphosate’s associated cancer risks. Since then, Bayer/Monsanto has faced approximately 165,000 glyphosate lawsuits, paying out massive verdicts totaling over $13 billion so far. 54,000 active cases remain with more expected every year.

Robin Opsahl covers the state legislature and politics for Iowa Capital Dispatch, where this article first appeared. Brooklyn Draisley, Cami Koons, and Kathie Obradovich contributed to this article.

As the Iowa legislature advanced past the second major deadline of the 2025 session, conversations on pipelines, Medicaid work requirements and new higher education requirements are continuing through surviving bills—though agreements have not necessarily been reached between the two Republican-controlled chambers.

The session’s second “funnel” deadline is another checkpoint for lawmakers during the legislative session, culling the bills that remain eligible for consideration as the Legislature nears the end of session. During the first funnel, bills were required to gain approval by a committee in one chamber to survive. In the second funnel, bills must have passed in floor debate in one chamber and gained committee approval in the other chamber to remain eligible.

There are several exceptions to this deadline, such as bills involving taxes, spending and government oversight components, and they include the property tax legislation proposed by Iowa lawmakers. Legislative leaders can also sponsor a bill and bring it forward without abiding by the deadline.

In addition, the language of a bills considered “dead” because of the funnel can still be added, at any point, as an amendment to a surviving bill.

There are also several bills that remain eligible for consideration by being placed on the “unfinished business” calendar, allowing them to remain up for consideration during the remainder of the session.

Sue Dinsdale is the executive director of the Iowa Citizen Action Network, a grassroots public interest organization committed to creating social change in Iowa and across the nation. She is also the state lead for Health Care for America NOW. Brian Keyser is a health policy research associate at Center for American Progress, an independent, nonpartisan policy institute that is dedicated to improving the lives of all Americans through bold, progressive ideas, strong leadership, and concerted action.

Last year, 60-year-old Iowan Susan McKinney started a new job working from home for a travel agency. Susan suffers from diabetes, arthritis, and atrial fibrillation (AFib), and her insurance coverage hadn’t kicked in before her health deteriorated to the point where she couldn’t walk up or down her apartment steps. She couldn’t get to a doctor—which she had no way to pay for anyway—so her conditions went untreated. In November, her concerned siblings moved her back to her hometown of Cedar Rapids, where the local free clinic told her that she qualified for Medicaid. Susan’s sister says, “Medicaid saved her life.”

Medicaid provides comprehensive medical coverage and long-term care for approximately 21 percent of Iowans like Susan. In 2023, the federal government covered around 72 percent of Iowa’s $7 billion in Medicaid spending.

But on February 25, all four members of Iowa’s House delegation voted in lock step with the Republican majority to advance a budget that would necessitate slashing federal contributions to state Medicaid programs to fund tax cuts for the wealthy. If implemented, this legislation could mean a loss of more than $8 billion for Iowa’s economy over the next decade.

The Center for American Progress estimated how the $880 billion in proposed Medicaid cuts nationwide would cost each Congressional district in federal funding. Here are the Iowa numbers:

Peggy Huppert retired as the executive director of NAMI Iowa in 2023 after 43 years serving nonprofits as a communications, development, government relations and executive director. She has been active in Democratic politics since 1984.

It is the task of a good man to help those in misfortune. -Sophocles

Dave Heaton was the definition of a Good Man.

He lived his life with honor and in service. He was loyal, hard working and dedicated. He was compassionate and empathetic. He followed through with things to the end. He didn’t care about praise or recognition. He cared about helping others.

Dave left this world on February 12 at the age of 84. He will be remembered and missed by many, including some you might not expect.

Dr. Shawn Ellerbroek, Wartburg College Professor of Biochemistry and Direstor of Student Research, previously was a full-time cancer research scientist at the University of North Carolina and remains active in cancer research. He currently serves as a member of the Waverly-Shell Rock School Board. This essay first appeared in the Waverly Democrat on February 13.

Cancer sucks. And Iowa, once again, has the second highest cancer rate in the country. Our cancer rates are rising faster than any state, so unfortunately we could soon be number one in America. 

Sometimes I hear, “Oh, it is because Iowa has more old people.” Age does matter when it comes to cancer, but that is not the reason; Iowa’s median age (39.1) is near the national median (39.2) and the same as states whose cancer rates are dropping. 

As a cancer research scientist, I’ve read and heard many opinions about what might be causing Iowa’s cancer problem. Cancer is multifactorial, meaning many chemicals (and UV light) can cause and promote it, making it a big challenge to pinpoint primary causes. 

Iowa Attorney General Brenna Bird enjoyed suing the Biden administration. She filed or joined more than a dozen multi-state lawsuits against the federal government during her first year in office alone. At least a dozen more lawsuits followed in 2024.

Bird has often welcomed media coverage of her legal battles against Biden administration policies. Her office issued many press releases to announce new litigation or joint letters challenging the federal government.

But Bird’s office kept quiet about one case, which Iowa and sixteen other Republican-controlled states filed in the Northern District of Texas last September. Texas v. Becerra could prove catastrophic for Americans with disabilities. Not only are the plaintiffs seeking to vacate a federal rule prohibiting discrimination against disabled people in health care settings, they are also asking the court to declare a 1973 law known as Section 504 unconstitutional and unenforceable.

After reporters began asking questions about that lawsuit last week, Bird and her staff lied repeatedly about the scope of the case and the plaintiffs’ goals.

Mary Weaver writes a regular column for the Jefferson Herald and Greene County News online. She is a former registered nurse and former public health nurse administrator, who currently chairs the Iowa Democratic Party’s Women’s Caucus. Mary resides on a farm near Rippey.

To the editor:

As a former Public Health Nurse, I am very anxious and concerned that Robert Kennedy Jr. may be confirmed to the cabinet position of Health and Human Services secretary.

I will share a couple of stories to emphasize my concerns, particularly in the arena of vaccinations.

I have a good friend who loves to explore cemeteries. I cannot say it is my favorite diversion, but one very weather pleasant day she talked me into going with her. She likes to look at the headstones and I dutifully followed along. There were numerous markers with lambs. This was usually the grave of an infant who had died of diphtheria or whooping cough. It is painful to believe this type of marker may indeed be seen in future cemeteries.

As each new year begins, I enjoy looking back at the posts that resonated most strongly with readers in the year that ended. Some things never change: actions by the Republican-controlled state legislature and Governor Kim Reynolds—especially attacks on public education—inspired many of Bleeding Heartland’s most-viewed posts from 2024. That’s been true every year since the GOP trifecta began in 2017. U.S. Senator Chuck Grassley, who featured prominently in two of last year’s most popular posts, makes another appearance below.

I’ve learned there is no way to predict which pieces will take off. Some of the posts linked below required intensive research and days of writing, while others took only a few hours from start to finish. One was among the longest I wrote last year (more than 5,000 words), while another was among the shortest (fewer than 300 words).

Some authors whose work gained a large following in past years made the list again. But three authors featured below were contributing to Bleeding Heartland for the first time.

This list draws from Fathom Analytics data about total views for 561 posts published from January 1 through December 31, 2024. I wrote 145 of those articles and commentaries; other authors wrote 416. I left out the site’s front page and the “about” page, where many people landed following online searches.

A half-dozen posts barely missed the top 24, by a few hundred views or less:

Kurt Meyer writes a weekly column for the Nora Springs – Rockford Register and the Substack newsletter Showing Up, where this essay (originally published in two parts) first appeared. He served as chair of the executive committee (the equivalent of board chair) of Americans for Democratic Action, America’s most experienced liberal organization.

It seems I lucked out. I don’t know what the statute of limitations is on the illegal sale of raw milk, but I’m about to make a confession. If my violation is so heinous that I simply cannot “run out the clock” on this and enforcement is still possible after five-plus decades, then I’m in big trouble.

My confession: I was part of what, in retrospect, can only be called a raw-milk “syndicate” for maybe five years in my mid-to-late teens. Co-conspirators were my parents and at least one brother, my back-up milker, who always seemed somewhat less helpful than I wished. My customers, beneficiaries of my crime ring, were nearby farm families, plus a thirsty household in Mona, and two guys Dad worked with at the plant… Hormel’s in Austin, Minnesota.

Yeah, we smuggled contraband raw milk across state lines.

Rachel Bruns is a volunteer advocate for quality maternal health care in Iowa.

As the phrase “your body, my choice” has infiltrated social media in the days following the 2024 presidential election, Linda Crownover-Inch, the International Cesarean Awareness Network (ICAN) of Quad Cities chapter leader and a doula, posted the following on Facebook:

There is one place where this phrase has been accepted and normalized for decades and will not disappear until people rise up and face it head on. That place is in the medicalized maternity care setting.

In my experience as a seasoned doula, every one of the medical maternity care providers (OB’s and medicalized midwives) that provided labor and birth service for my client’s, have violated my clients right to bodily autonomy in ways that should be categorized as assault.

Sadly, US medicalized birth culture has normalized assault during labor and birth as “That’s just the way it happens” and “They need to do those things to me to make labor and birth safe”, or “I can’t tell them what to do”. Too often I’ve stood in circles of people retelling, All the while normalizing trauma and assault in their medicalized birth stories.

While I’m sure many will balk at applying this horrendous saying to standard maternity care in most of the United States, Linda’s post resonated with my experience as a maternal health advocate in Iowa. The current reality is that most women seeking prenatal, birth, and postpartum care in Iowa face inadequate care options and degrading experiences, all in the name of so-called health care. 

Dave Miglin is Chair of the Broadlawns Board of Trustees.

In January 2021, the people of Polk County made their voices heard and I was honored to be appointed as a Trustee for Broadlawns Medical Center to complete the term of retired Trustee, Mary Fuller. At that time, our county hospital was dealing with an extraordinary health care crisis (COVID-19) and internal transition brought by the retirement of longtime CEO Jody Jenner. Those months of transition and uncertainty could have easily derailed the positive momentum that was underway at Broadlawns – but it didn’t.

Together with my fellow Trustees, our hospital leadership, and community partners, Broadlawns not only survived these trying times, but it has flourished. Since I joined the Board, we have started or completed many projects that will help Polk County families for years to come, including:

“It’s been a great pleasure to come back and serve only ten miles from where I grew up,” Dr. Emily Boevers said during an August 22 panel discussion at the Democratic National Convention in Chicago. “And it’s my joy to take care of women every day, and women of all ages, and women of many different circumstances.”

But the Waverly-based obstetrician/gynecologist painted a troubling picture of how abortion restrictions harm rural health care access in many ways, putting lives at risk—and not only for those seeking to terminate a pregnancy.

Dr. Emily Boevers is a OB-GYN physician practicing primarily in Waverly, Iowa. When not taking care of patients she enjoys spending time with her husband and three children. This piece was first published in the Waverly newspapers.

This coming week, the seven justices of the Iowa Supreme Court will issue a ruling in the misnamed “Fetal Heartbeat” ban. This legislation is the third iteration forced through the Iowa legislature in six years. It seeks to ban abortion at the instance of embryonic cardiac impulse at six weeks, well before most women know they are pregnant. The Supreme Court may allow the state to enforce the ban or leave the law blocked while litigation proceeds. Either way, a large portion of the electorate will be anguished, disappointed, or even angry.

I cannot say which way the justices will decide. So instead, I will paint a picture of two possible futures for my patients and for myself as a woman’s health physician (an obstetrician gynecologist). I care for women before, during and after pregnancy.

Erin Farquhar is the mother of Abram Miller, who relies on consumable hemp products to control seizures.

This year, the Iowa legislature approved and Governor Kim Reynolds signed House File 2605, placing new regulations on Iowa’s CBD, or consumable hemp, industry. Proponents described the law as an effort to limit the amount of THC in the intoxicating products being sold in our state to protect kids, but that is not what the bill does.  

Unfortunately, HF 2605 was written in a way that has very far-reaching consequences. It does the opposite of what the bill proponents said by banning access to nonintoxicating consumable hemp products used for medical purposes and maintaining access to intoxicating products, like THC infused drinks, used largely recreationally.  

The bill even makes it illegal for me to provide my son the consumable hemp medication he has used for the past nine years to remain seizure-free.   

Kali White VanBaale is an Iowa-based novelist, creative writing professor, and mental health care advocate. Find more of her work at kwhitevanbaale.substack.com (where this essay first appeared) and www.kaliwhite.com.     

This month, Governor Kim Reynolds signed several critical pieces of mental health care legislation, including House File 626, “an Act relating to continuity of care and non-medical prescription switching by health carriers, health benefit plans, and utilization review organizations.” This legislation has a long, contentious history at the Iowa capitol.

Why was this bill important enough to lobby for it year after year with no success? What exactly is non-medical switching?

Keith Schneider, a former New York Times national correspondent, is senior editor for Circle of Blue. He has reported on the contest for energy, food, and water in the era of climate change from six continents. This report was first published by The New Lede and is part of an ongoing collaborative project between The New Lede and Circle of Blue that looks carefully at how agricultural policies are affecting human and environmental health.) 

EMMETSBURG, IOWA –Raised in rural Iowa, 71-year-old Maureen Reeves Horsley once considered her tiny hometown in the northwest part of the state to be a blessed space. She recalls a time when the streams here ran clean and the lake water was clear.

The family farm where Horsley grew up was one of more than 1,200 farms in Palo Alto County in 1970. In her memory, the county’s 13,000 residents enjoyed a thriving agricultural-based economy and close-knit neighbors. Cows grazed in verdant pastures. And seemingly endless acres of corn marched to the horizon.

“We had good crops, corn and soybeans,” Horsley said of her family’s farm along the West Fork of the Des Moines River. “You could make it on a small amount of farmland. You felt safe. It was a good life.”

Two generations later, Emmetsburg and Palo Alto County have been radically transformed into a place where many residents worry that the farms that have sustained their livelihoods are also the source of the health problems that have plagued so many families.

Two bills Governor Kim Reynolds signed on May 1 will make advanced testing for breast cancer and other diseases more accessible to Iowans with health insurance coverage.

House File 2489 requires certain types of private health insurance policies to cover supplemental or diagnostic breast examinations such as magnetic resonance imaging (MRI), ultrasound, or contrast-enhanced mammography. House File 2668 requires public and private health insurance to cover biomarker testing for some cancers and other diseases or conditions. Both bills take effect on January 1, 2025.

Governor Kim Reynolds had every reason to be confident about her legislative plans this year. Republican lawmakers approved most of her priorities in 2023, including some that had previously stalled in the Iowa House, such as a “school choice” plan and damage caps for medical malpractice awards.

Ten weeks into the 2024 legislative session, only two policies the governor requested have made it through both chambers. Nearly a dozen other bills still have a chance to reach her desk with few changes.

But Reynolds’ top priority—downgrading the Area Education Agencies (AEAs) and centralizing power over special education in her administration—will be dramatically scaled back, if it passes at all.

Three bills the governor introduced and promoted in public remarks or on social media are almost certainly dead for the year. Those include her effort to enshrine “separate but equal” treatment of LGBTQ Iowans.

Leaders moved several of Reynolds’ bills to the “unfinished business” calendar in one or both chambers on March 14, keeping them eligible for floor debate despite missing an important legislative deadline. The rest of the governor’s proposals involve taxes or spending, and are therefore “funnel-proof.”

Shutterstock image of an angiogram is by April stock

Rick Morain is the former publisher and owner of the Jefferson Herald, for which he writes a regular column.

I had a heart attack on the evening of February 27. All is well.

Tuesday about 7 p.m. I was sitting at the press table at the Jefferson City Council meeting, taking notes, when my chest started to hurt. I figured it was probably acid reflux, which I have from time to time, so I waited for it to go away.

It didn’t. It hung around after the meeting adjourned at 8 p.m., so when I got home I told Kathy that if it didn’t disappear by 9:30, I would go out to the emergency room at Greene County Medical Center to have it checked out.

Following two days of contentious debate in the Iowa Senate, the chamber’s calendar for Wednesday, February 21 appeared to be stacked with non-controversial bills.

Then State Senator Jeff Edler rose to offer Senate File 2369, an “act relating to autologous and directed blood donations.”

The blood donation bill may not be as impactful as other legislation Senate Republicans approved last week: proposals to undermine Iowa’s state auditor, reduce Medicaid eligibility for pregnant Iowans, make state funded crisis pregnancy centers less accountable, enable discrimination if grounded in religious beliefs, and repeal the gender balance requirement for state boards and commissions.

Yet Senate File 2369 is important—not only because of its potential impact on the blood supply, but for what it reveals about legislative culture in the eighth year of Iowa’s Republican trifecta.

“When I joined Environmental Protection, I never envisioned that I would be talking about a raccoon bounty, but here we are,” Democratic State Representative Josh Turek said on February 7, while the House Environmental Protection Committee considered the only bill on the agenda that day.

As they weighed in on the bill, Democrats voiced broader frustrations about the committee’s failure to engage with any of Iowa’s serious environmental challenges.

Rachel Bruns is a volunteer advocate for quality maternal health care in Iowa. This article originally appeared on the Des Moines Register’s website.

The Des Moines Register article “What Patients Should Know About Hospital Drug Testing” missed some key information that may help families disrupt the illegal maternal and newborn drug screening practices taking place at Iowa hospitals and clinics.

The U.S. Supreme Court made clear in 2001 (Ferguson v. Charleston) that prenatal drug testing without specific informed consent is unlawful. Nevertheless, some Iowa clinics and hospitals continue to conduct such tests, when urine is gathered for testing of urinary tract infections or to check urine glucose or protein levels. Such practices are not only unlawful, but also create mistrust of the medical system—putting the lives of moms and babies at risk. 

Photo provided by the author, showing maternal health advocates advocating for licensure of certified professional midwives during an Iowa House Ways and Means subcommittee meeting in February 2023.

Rachel Bruns is a volunteer advocate for quality maternal health care in Iowa.

This time last year I wrote about five policies that would improve maternal health in Iowa. I’m updating the piece for the 2024 legislative session with a focus on three core priorities. 

Although access to abortion care and contraceptives are critical to maternal and infant health, I do not discuss those topics here. I want to highlight lesser-known aspects of maternal health specific to prenatal, birth, and postpartum care, which receive much less media coverage.

For the 2024 legislative session, I am focusing on three issues I raised last year, which have a strong chance to be enacted. These policies would improve maternal health in Iowa by expanding access to midwives and expanding prenatal care options. I wrote at length in 2021 about how midwives save lives, and it seems like every week a different study or article underscores how the midwifery model of care leads to better outcomes. If you’re interested in diving deeper, one of my favorite resources released in 2023 is this Issue Brief on Maternity Medicaid Strategies from the Maternal Health Hub.

Ralph Rosenberg of Ames is a retired attorney, former state legislator, former director of the Iowa Civil Rights Commission, and former leader of statewide Iowa nonprofit organizations. He and Barbara Wheelock, also of Ames, signed this open letter on behalf of PRO Iowa 24, a group of concerned rural Iowans with progressive values from Greene, Guthrie, Boone, Story, and Dallas counties.

Now is a good time for the public to make their wishes known for 2024 state policies. Tell your legislators to act on behalf of all Iowans, create an economy that works for all Iowans, and use the government to protect the most vulnerable. Republicans can enact each and every one of these items on a bipartisan basis.

Doris J. Kelley is a former member of the Iowa House and former Iowa Board of Parole Chair, Vice-Chair and Executive Director.

After being re-elected to the Iowa House of Representatives, I met newly elected State Senator Kim Reynolds in 2009 at an event where a bipartisan group of “veteran” legislators were giving advice to newly elected ones. My next interaction with Reynolds was when she was lieutenant governor, and Governor Terry Branstad appointed me to serve as Vice-Chair of the Iowa Board of Parole. After I was promoted to chair that board, I met frequently with Branstad and Reynolds, apprising them of the progressive measures the board was undertaking.

Two recent surveys by Morning Consult, released in late October and late November, identified Reynolds as the country’s governor with the highest disapproval rating. A summary of the October poll noted, “her unpopularity increased partly because of a surge in negative sentiment among independent and Republican voters during a year in which she signed a strict anti-abortion law and took a lashing from former President Donald Trump …”

What has happened to Iowa since Reynolds assumed the office of governor on May 24, 2017?

Nancy Dugan lives in Altoona, Iowa and has worked as an online editor for the past 12 years.

Dr. Mark Z. Jacobson is a Professor of Civil and Environmental Engineering and also serves as Director of the Atmosphere/Energy program at Stanford University, where he has worked for 30 years. He’s spent decades studying ethanol and carbon capture and has published two books that extensively explore those subjects as part of his broader research work examining clean, renewable energy solutions: 100% Clean, Renewable Energy and Storage for Everything (2020), No Miracles Needed (2023).

Thus, Jacobson’s work places him in the eye of the storm surrounding Summit Carbon Solutions’ plan to capture and carry “9.5 million metric tonnes per annum (MMTPA) of CO2 collected from the 34 ethanol facilities, although the pipeline has the potential to carry more.”

Environmental Science & Technology, a biweekly peer-reviewed scientific journal of the American Chemical Society, published Jacobson’s most recent study on October 26. That study, called Should Transportation Be Transitioned to Ethanol with Carbon Capture and Pipelines or Electricity? A Case Study, was funded in part by the Sierra Club.