It’s Thursday, July 31, 2025.

Amie here. Have you read Zachary Oren Smith‘s latest story on what Medicaid cuts are doing to Iowans who rely on rural hospitals?

Here’s a preview.👇

When Dr. Robin Plattenberger retired from her Washington County practice eight years ago, she left behind patients who depended on Medicaid for everything from nursing home care to emergency visits.

Now, as federal budget cuts threaten to strip Medicaid coverage from 86,000 Iowans, she’s watching her former employer, Washington County Hospital and Clinic, prepare for what could be devastating changes.

“There’s really no extra money in a hospital,” said Plattenberger, who recalls her clinic operating on just a 3% margin. “Now you cut back what you’ve had and you just have no choice but to cut service.”

The cuts come as Iowa already faces a health care crisis. The state leads the nation in growing cancer rates, while rural hospitals struggle with thin margins and staffing shortages.

The cuts stem from the recently passed “One Big Beautiful Bill Act,” federal legislation which Iowa’s entire congressional delegation supported.

“When Medicaid reimbursements fall short of the cost of care—as they routinely do—we absorb the loss. But we can only do it for so long,” said CEO Todd Patterson in May. “They force decisions about whether we can keep our maternity ward open, retain emergency services, or offer mental health care.”

Check out Zachary’s full story here.

Have thoughts? Email me.

Amie Rivers

Newsletter Editor, Iowa Starting Line

Member, COURIER United (WGA East)

Email me

Gutting Iowa’s workforce: Pascual Pedro Pedro was a construction worker brought here as a child. Haitian refugees and others who were granted temporary legal status came here to fill meatpacking jobs. US Rep. Zach Nunn says President Donald Trump’s decisions to deport these Iowa workers are “right sizing.” Others openly wonder if it’s time to fight back. Iowa is already shedding people left and right because our laws are driving them away—contributing to Iowa being the fourth-highest state in the nation for outmigration of 20-somethings. (Iowa Capital Dispatch, IPR, Reddit, Cornhole Champions, Common Sense Institute)
‘It’s Better in a Union’ bus tour stops in Des Moines: Iowa attorney general candidate Nate Willems joins union members and leaders at Cowles Commons on Saturday at 1:30 p.m. to “hold Sen. (Joni) Ernst and Reps. Nunn and (Mariannette) Miller-Meeks accountable for their vote to pass the so-called ‘Big Beautiful Bill.’”
Prices keep rising. There was a “sharp rise in core goods inflation” in June thanks to Trump’s tariffs, which Iowans probably already noticed at the grocery store. The price of steak alone is more than 12% higher than last year. (Yahoo Finance, The Budget Lab, IPR)
It’s tax-free weekend in Iowa: Here’s what’s exempt from state and local taxes this weekend. Some think the holiday is “ineffective and gimmicky.” (Iowa Department of Revenue)
Community colleges aren’t safe from cuts: The state education board voted to move millions in career and technical education (CTE) funding, giving it to K-12 schools instead. That could mean “rural community colleges may be forced to scale back or eliminate specialized CTE programs … threatening the long term viability and responsiveness of academic offerings to our community and industry needs,” said Iowa Valley Community College District President Anne Howsare Boyens. (Iowa Capital Dispatch)
Training, water, shade, rest breaks: That’s all that workers are asking for in a federal bill they hope will prevent heat deaths, which are increasing. Help the effort by adding your name here.
Petitioning for a union: Seventy-two full- and part-time health care workers with River Hills Community Health Center in Ottumwa filed on July 14 to join the River Hills United union, affiliated with Teamsters Local 90.
Voting on a union: Seventeen full- and part-time baristas and shift supervisors at a Starbucks in Des Moines vote Thursday on whether to unionize with Starbucks Workers United. Seventeen linemen, apprentice linemen, line foremen and member service technicians with Southwest Iowa Rural Electric Cooperative in Corning vote Aug. 12 on whether to unionize with the International Brotherhood of Electric Workers Local 55.

American Contract Systems in Grimes is closing and laying off 62 workers by today. Read more here.
Lennox Industries in Marshalltown is laying off 62 workers by Friday. The company previously laid off 114 workers in 2023.
US Cellular in Cedar Rapids is laying off 30 workers by Friday.
The Mutual Group in West Des Moines is laying off 34 workers by Aug. 8.
Wells Fargo in West Des Moines is laying off 35 workers by Aug. 10, 35 workers by Aug. 24, 11 workers by Sept. 8, and 44 workers by Sept. 22.
Southeast Service Corporation in Mount Vernon is laying off 31 workers by Aug. 11.
Advanced Drainage Systems in Waterloo is closing and laying off 71 employees by Aug. 17. Read more here.
FedEx is laying off 168 workers at three locations by Sept. 1: 57 workers in Cedar Rapids, 84 workers in Des Moines, and 27 workers in Dubuque. Read more here.

There’s not enough money to raise wages, they say.

“They,” of course, are the CEOs, and yet they seem to find enough money to give themselves millions more every year.

How much money are they making? The AFL-CIO has this year’s list here.

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