The Big Budget Bill’s Impact on Iowa’s Health System: More Iowa Residents Uninsured, Higher Health Care Costs, and More Consequences of the Many Cuts to Care - Families USA Skip to Main Content
06.25.2025 / Press Release

The Big Budget Bill’s Impact on Iowa’s Health System: More Iowa Residents Uninsured, Higher Health Care Costs, and More Consequences of the Many Cuts to Care

New Families USA Analysis Details How Steep Cuts Will Hurt Iowa Residents

DES MOINES, IA – A new fact sheet from Families USA details how the pending budget bill, set to be voted on by the Senate in the next week or so, will harm Iowa’s health system, including cutting off coverage for at least 96,000 Iowans, making it harder for people to get and maintain coverage, and taking away crucial patient protections for children. The bill also drives up costs for those buying insurance through the Marketplace, skyrocketing premiums and increasing out-of-pocket costs while taking away crucial premium tax credits.

“The cuts to Medicaid and the ACA will have devastating and dramatic impacts on health coverage, care, and costs for American families, and in many ways especially in Iowa. The cuts will not just mean that tens of thousands of Iowa residents lose coverage, but federal cuts will force state budgets into crisis, forcing states to drastically scale back services, leading to closures of rural hospitals and community clinics,” said Anthony Wright, executive director of Families USA. “Senator Ernst must stand up to the party bosses and the billionaires who want more tax cuts and side with patients and health providers and plans who oppose this bill that harms access and affordability of health care for so many Iowa working families.”

“This budget belies traditional Iowa values and undercuts the very health care infrastructure that supports healthy families,” said Anne Discher, executive director of Common Good Iowa. “At the exact moment we need bold solutions to meet Iowan’s very real needs, this bill does the opposite. Senator Ernst is asking Iowans in every corner of the state to settle for less when they deserve so much more.”

“Senator Ernst’s support for this budget is a disservice to Iowans. In a time that demands bold investment in health care, social, economic and environmental systems, this bill instead threatens to topple community support,” said Sue Dinsdale, executive director of Iowa Citizen Action Network. “Iowans deserve policies shaped by community needs — not corporate interests. Policymakers should be focused on building a future for all, not just serving the powerful few.”

The proposed cuts are in opposition with the voters when 82% of adults nationwide — including 67% of Republicans want Congress to maintain or increase Medicaid spending.

The Iowa Medicaid program covers 702,000 children and adults, including:

  • 1 in 5 Iowa residents.
  • 319,000 children — 44% of all children in Iowa.
  • 104,000 seniors and people with disabilities.

Marketplace coverage, available for individuals and families who do not qualify for Iowa Medicaid but also do not have employer sponsored coverage, serves:

  • 136,000 Iowa residents.
  • 8,600 small business owners in Iowa and 16,000 self-employed Iowa residents.
  • About 90% of enrollees in Iowa who received an advanced premium tax credit to help them pay their premium.

Families USA, the longtime health consumer advocate, is organizing with groups in Iowa and across the nation to protect against care cuts that would force Americans to face increased costs and the loss of health coverage. The Families USA website has a plethora of materials on how its partners are working to defend Medicaid, and has facts sheets on the overall importance of Medicaid to people, the economy, and the health care system, how work reporting requirements would undermine access to Medicaid, and how cuts harm families and communities.