Campaign Almanac: National Democrats target Iowa Republicans over rural health care cuts

DES MOINES — The campaign arm of U.S. House Democrats has launched a new rural-focused advertising campaign targeting Iowa Republican U.S. Reps. Mariannette Miller-Meeks and Zach Nunn over their votes on Medicaid and rural hospital funding, as health care access continues to erode in those communities.

The multiplatform campaign — running from Friday through early next week — includes half-page print ads in the Ottumwa Courier and the Quad-City Times, along with digital banner ads in the Des Moines Register and The Gazette.

The effort marks the first targeted outreach campaign aimed specifically at rural Iowa voters affected by clinic and hospital closures in Iowa’s 1st and 3rd congressional districts, according to the Democratic Congressional Campaign Committee.

Jacob Burg, the committee’s rural engagement manager, said the campaign is intended to hold Miller-Meeks and Nunn accountable for supporting what Democrats describe as the largest Medicaid cuts in U.S. history.

“Mariannette Miller-Meeks and Zach Nunn voted to rip funding from Iowa’s rural hospitals, abandoning rural communities from Wapello County to Henry County and everywhere in between,” Burg said in a statement. “Iowans deserve the truth: Miller-Meeks and Nunn are making the rural health care crisis even worse, and voters will hold them accountable this November.”

The ad campaign comes as rural health care systems in Iowa face mounting strain, highlighted by recent clinic closures and service reductions in southeast Iowa.

In Ottumwa, MercyOne said it will close its Family and Internal Medicine Clinic on Feb. 27 following an operational review, marking its second clinic closure in recent months after shutting down a facility in Traer, a city of 1,600 residents in Tama County. Patients are being redirected to other providers, while affected staff are being assisted with job placement.

The closures add to a growing list of service reductions in the region.

Earlier this year, Pella Regional Medical Clinic in Ottumwa scaled back its family practice services, citing ongoing workforce shortages and recruitment challenges. Several providers have left the facility, and it is no longer offering a full range of family practice care.

Additionally, the Southeast Iowa Regional Medical Center in Fort Madison announced plans to end inpatient labor and delivery services by late 2026.

According to reporting by the Ottumwa Courier, local providers and officials say these changes reflect broader systemic pressures on rural health systems, including staffing shortages and financial constraints.

Democrats have tied the wave of closures to federal policy decisions, particularly recent Republican-backed legislation that reduced Medicaid spending.

All four of Iowa’s Republican U.S. House members voted for the federal budget package known as the “Big Beautiful Bill.” The budget reconciliation package enacted in July is projected to reduce future Medicaid spending by $941 billion over 10 years and increase the number of uninsured Americans by 10 million, according to the nonpartisan Congressional Budget Office.

Republicans, however, maintain the legislation will not harm access to care and point to investments in rural health systems.

In a statement to the Ottumwa Courier, Nunn defended his record, saying he has supported funding for rural providers and workforce development.

“I’m fighting for Iowa’s rural hospitals, passing $50 billion for rural health care, leading bipartisan bills to train more nurses and doctors, and delivering over $200 million directly to rural providers in Iowa,” Nunn said. “My commitment to Ottumwa is simple: Every Iowan should have access to affordable, quality care — and I’ll keep working across the aisle to deliver.”

Nunn’s office said he is spearheading initiatives to grow training pathways for nurses, primary care doctors and physician assistants, while also securing funding to expand telehealth services and boost provider recruitment in rural communities. The office added that Ottumwa still has access to emergency and primary care, and that Nunn is working to ensure patients impacted by the closure experience a smooth transition.

In December, Miller-Meeks introduced legislation to expand association health plans, allowing small businesses and self-employed workers to pool together to negotiate coverage.

That same month, the federal government announced Iowa will receive $209 million from a federal program designed to bolster rural hospitals and clinics. The funding — part of a broader $50 billion grant initiative over 10 years — comes from Republicans’ tax policy and federal budget legislation that also slashed hundreds of billions from Medicaid and other federal health programs.

“This is a transformational moment for rural Iowa. Access to high-quality health care should never depend on your ZIP code, and today, we’re delivering on that promise,” Miller-Meeks said in a statement about the funding. “This $209 million investment will bring top-tier care closer to home for families, seniors, and veterans in every corner of our state. I fought hard to ensure Iowa received its fair share, and I’m proud to see that fight pay off for the people I serve.”

Miller-Meeks also highlighted $825,000 in funding secured for the Keokuk Area Hospital. The funding aims to restore critical health services in Lee County, which has been without an operational hospital since October 2022. The funding will support facility improvements to allow the rural emergency hospital to expand outpatient specialty services alongside emergency care, according to her office.

The Democratic campaign committee’s ad buy signals that rural health care access is likely to be a central issue in Iowa’s 2026 congressional races, particularly in districts where hospital closures and provider shortages are becoming more visible to voters.

Elevator union backs Zach Wahls in Senate race

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The International Union of Elevator Constructors Local 28 has endorsed Democratic state Sen. Zach Wahls, of Coralville, in Iowa’s open U.S. Senate race, adding to a growing list of labor support for his campaign.

Local 28, based in Omaha and representing elevator constructors in Council Bluffs and across southwest Iowa, cited Wahls’ support for union jobs, apprenticeship training and retirement security in announcing the endorsement.

“In the U.S. Senate, I’ll fight for an economy that rewards work, not wealth — protecting the right to organize, defending strong apprenticeship pipelines, and securing the retirement working Iowans have earned,” Wahls said in a statement.

Wahls faces a competitive Democratic primary against state Rep. Josh Turek of Council Bluffs as both vie for their party’s nomination in the race to succeed retiring U.S. Sen. Joni Ernst.

On the Republican side, Eastern Iowa U.S. Rep. Ashley Hinson is widely expected to secure her party’s nomination, though she faces a primary challenge from Sioux City attorney and former state lawmaker Jim Carlin.

Iowa House leader backs Adam Steen in GOP governor’s race

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State Rep. Henry Stone, the Iowa House Majority Whip, has endorsed Adam Steen in Iowa’s gubernatorial race.

Stone, a Republican from Forest City, cited Steen’s commitment to conservative leadership and fiscal responsibility in announcing the endorsement.

“Adam understands the challenges facing Iowa families and small businesses because he’s lived them,” Stone said in a statement. “He is not afraid to stand up for our values, defend our freedoms, and make the tough decisions necessary to keep Iowa strong. We need bold, principled leadership, and Adam is the right person for the job.”

Steen is one of five Republicans seeking the party’s nomination in Iowa’s open-seat gubernatorial election this year. The other Republicans running are U.S. Rep. Randy Feenstra of Hull; state Rep. Eddie Andrews of Johnston; business owner Zach Lahn of Belle Plaine; and former state Rep. Brad Sherman of Williamsburg.

Former state lawmaker endorses Brad Sherman for governor

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Luana Stoltenberg, a former Republican state lawmaker from Davenport, has endorsed Brad Sherman for governor in Iowa’s Republican primary, Sherman’s campaign announced.

“Brad Sherman would make a wonderful governor. He is a man of integrity and impeccable character,” Stoltenberg said in a news release from the Sherman campaign. “I have known Brad for over 30 years. He loves the Lord and represents Him well. Brad is pro-life and has worked tirelessly for mothers and the pre-born. He is a man of his word, never backs down, and stands for what is right. He will never be bought and will always work for the people.”

Sherman, a former state lawmaker from Williamsburg, is one of five Republicans seeking the party’s nomination in Iowa’s open-seat gubernatorial election. The others are U.S. Rep. Randy Feenstra of Hull, former state agency director Adam Steen of Runnells, state legislator Eddie Andrews of Johnston, and business owner Zach Lahn of Belle Plaine.

Gazette-Lee Des Moines Bureau

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