Republican U.S. Rep. Mariannette Miller-Meeks faces Democrat Christina Bohannan for the third time in a race for eastern Iowa’s 1st Congressional District. Independent Michael Bridgford’s challenge has added a new wrinkle to the contest. It’s considered one of the tightest races in the nation by the nonpartisan Cook Political Report.
A concern for many Iowans that's forcing its way to the forefront of the 1st District race is cancer. Iowa's cancer rate is now second-highest in the nation, and younger Iowans are seeing more cancer diagnoses than before.
The American Cancer Society’s Cancer Action Network is hosting coffee chats with candidates across the state to find out what their plans are for improving prevention, research and treatment. They group is asking candidates to sign a “cancer promise” pledging support for prevention, affordable healthcare and research.
In August, both Miller-Meeks and Bohannan signed that cancer promise and chatted with cancer survivors. Each conversation began with the candidate sharing how she’s been personally touched by cancer: Miller-Meeks lost a brother to lung cancer and a sister to breast cancer, and Bohannan lost multiple family members to the disease. Bohannan said she recently got abnormal results back from a mammogram, but said her doctors think everything is ultimately OK.
The candidates then moved on to discuss the specifics about what each would do to fulfill their cancer promise in office.
Cancer prevention
Miller-Meeks said the causes of cancer are “not as simple as people are trying to make it out to be." She considers obesity, tobacco, genetic predisposition and water quality as various lifestyle and environmental factors that contribute to risk.
When it comes to water quality, she said she’s in favor of regenerative agriculture and cover crops, but it’s not just rural runoff that’s at fault. She said urban areas with plenty of concrete can prevent proper groundwater filtration.
Miller-Meeks said she’s trying to create a biochar institute at Iowa State University to study how the charcoal-like material could improve soil quality and water purification across the state.
Bohannan said she's particularly concerned with the uptick in rural cancer rates and wants to pay specific attention to environmental factors in those areas. She supports incentivizing cover crops to reduce chemical use and runoff.
She also wants local public health departments to maintain funding and support in order to keep pushing radon testing.
Healthcare access
Bohannan said Iowa is in a “very scary place” as cancer rates climb and treatment becomes harder to afford. She said the entire healthcare system needs to be improved, and Medicaid funding needs to be restored for multiple reasons.
First, rural residents need rural healthcare to stay available, Bohannan said, and those hospitals and clinics rely heavily on Medicaid reimbursement.
Second, she worries about people losing healthcare coverage due to Medicaid cuts. She experienced firsthand the financial stress of serious illness when her father was diagnosed with emphysema — a preexisting condition that suddenly disqualified him from healthcare insurance.
“We lost everything when my dad lost healthcare coverage,” Bohannan said.
She said insurance companies should not be able to discriminate against people with preexisting conditions.
Bohannan also said she learned from the Johnson County Board of Health chairperson that roughly 70% of all intensive pediatric care at the University of Iowa’s pediatric center is paid for by Medicaid. When a child is diagnosed with a serious illness, she said they automatically go on Medicaid, so keeping Medicaid funded is critical for those children and their families.
Miller-Meeks touted her multi-cancer early detection bill signed into law in February. It establishes Medicare coverage starting in 2028 for a blood test that can help diagnose up to 50 cancers in early stages.
Miller-Meeks said early detection is a gap in rural areas, but a blood test that can be performed locally and sent to a specialist lab somewhere else can help “level that playing field” for anyone in the state.
She praised telehealth for its potential to bring advanced care into people’s homes. She also applauded the Rural Health Transformation Fund, which pledges $50 billion to improve rural health systems.
Half of that fund will be distributed equally among the states, while the other half will be granted to different states via applications. Miller-Meeks said Iowa was one of the first states to get applications in.
“If [other states] can't get their act together, we're more than happy to have more awards,” she said.
Cancer research
Miller-Meeks said good research isn’t just happening on the coasts, which is why she thinks it’s important to fund cancer research happening in the middle of the country.
She said it’s important to fund ideas that take risks instead of “repetitive, redundant” research, which she said she sees in her full-time job as an ophthalmologist.
“I see that in ophthalmology all the time,” she said. “If you go to their conferences, everybody's doing the same thing because that's what gets funded. So looking at what's taking a risk, even if that fails.”
She stressed that any dollar going to fraud or waste is a dollar not going to cancer research.
Miller-Meeks also said clinical trials should be reformatted so that people in rural areas can take part. For example, she pointed to scheduling follow-ups locally so participants don’t need to drive to urban healthcare centers as frequently.
Bohannan said supporting and increasing cancer research funding is a must. For her, that means continued research into tobacco-related cancer, plus better inclusion of rural communities in any statewide research.
“Rural residents are underrepresented in [clinical trials],” she said. “I would really want to make sure that our rural residents are included in those studies because there are some issues that affect rural areas sometimes more than other areas.”
She said it’s not a good sign that more private cancer centers are popping up in rural areas while other healthcare disappears.
Bohannan doesn’t want Iowa to keep its reputation for high cancer rates. She said fighting cancer shouldn’t be a divisive issue.
“Everyone is talking about this, regardless of party,” she said.
