The Iowa Senate Democrat is making healthcare the centerpiece of his Senate campaign, pinning rising premiums and rural hospital closures directly on Republican Ashley Hinson.
State Sen. Zach Wahls on Monday released a sweeping healthcare agenda—the fourth installment of his “Iowans Over Insiders” platform—that targets prescription drug costs, rural hospital closures, and Iowa’s worsening cancer crisis, while going after Rep. Ashley Hinson’s voting record.
Wahls’ plan is organized around four legs: lowering costs, expanding access to care, fighting Iowa’s heightened cancer rates, and addressing mental health and substance use disorder. Its most immediate target: the Medicaid cuts Congressional Republicans passed. The combined effects of the budget reconciliation law and the expiration of the enhanced premium tax credits will knock an estimated 110,000 Iowans off their healthcare, according to a report from nonprofit healthcare advocacy organization KFF.
In rural Iowa, the impacts of Medicaid cuts are expected to be even starker. Over the next decade, 37,700 rural Iowans will lose Medicaid coverage and rural hospitals will lose almost $2.7 billion in federal Medicaid funding, according to a report from the American Hospital Association.
Wahls told Iowa Starting Line he heard about these concerns firsthand. Shortly after launching his campaign, Wahls visited Montgomery County Memorial Hospital in Red Oak—where incumbent US Sen. Joni Ernst is from—and asked what the cuts would mean for the facility.
“They described Medicaid as a program that has been ‘our salvation,’ ” Wahls said. “Before Medicaid’s directed payments program came online, 60% of Iowa’s rural hospitals were operating in the red every year. Because of this new program that has dropped down to 10%—but with these cuts that Ashley Hinson voted for, every hospital leader in the state thinks that we are going to go back to where we were before.”
To reverse course, Wahls is calling for restoring the $800 billion in Medicaid funding Republican frontrunner Ashley Hinson and the rest of House Republicans voted to cut and for establishing a federal rural health infrastructure fund. This fund would help communities that have lost providers to help establish medical facilities with long-term leases for physicians.
“No Iowan should go bankrupt because they got sick,” Wahls said in the plan. “No Iowan should drive two hours because the rural clinic in their county closed.”
On costs, Wahls calls for a Medicare buy-in option at any age, expanded Medicare drug price negotiation, a $35 insulin copay cap for all Americans, and a permanent restoration of ACA premium tax credits that Hinson allowed to expire—causing Iowa premiums to nearly double.
Wahls accused Hinson of voting for “the largest cut to Medicaid in American history” and then refusing to restore the subsidies that kept working families covered.
He also calls for cracking down on pharmacy benefit managers, banning medical debt from credit reports, and ending surprise billing loopholes that Congress has failed to close since passing the No Surprises Act in 2020.
On access, Wahls wants to lower the Medicare eligibility age to 55, expand Medicare to cover dental, vision, and hearing, and defend the VA from privatization.
The plan also addresses Iowa’s cancer crisis. Iowa Starting Line’s multi-part series The Hot Spot tracked the weave of environmental, social and political forces causing Iowa to have the second-highest and fastest-rising cancer rate in the nation, according to the Iowa Cancer Registry. To solve it, Wahls is calling for tougher EPA review of exposure to herbicides like paraquat dichloride, which is increasingly tied to Parkinson’s disease and is banned in more than 60 countries.
The plan also takes on a more novel target: the use of artificial intelligence by health insurance companies to deny claims. Wahls wants to ban the practice outright.
“When a health insurance company is making a decision to deny medically prescribed healthcare, that is an individual decision—that is not a statistic, that is not a trend,” Wahls said. “That is a person’s physician trying to get them the care that they need, and having an artificial intelligence machine deny that claim, to me, is unacceptable.”
“Ashley Hinson made her choice,” Wahls said. “She works for the corporate special interests that bankroll her campaign. She doesn’t work for you.”
Read Wahls’ full plan here.
