At a noisy coffee shop in Ottumwa near closing time, a group of local residents and healthcare workers gathered around several pushed together tables. At the head of the table was Josh Turek, the Democrat running for the U.S. Senate against Republican Ashley Hinson and Libertarian Thomas Laehn. He was hosting a campaign event on healthcare.
Turek, a state representative from Council Bluffs, told the table that healthcare access is personal to him because he was born with spina bifida and endured nearly two dozen surgeries by the time he was 12.
"What drove me into politics initially, four years ago, was because of what I was seeing with the privatization of Medicaid in the state. It was leading to huge increases in denial rates, delay rates," he said.
MercyOne closed a clinic in Ottumwa in February, citing changing demographics and community needs. It has left some residents traveling up to an hour away for care.
Turek was quick to tie clinic closures like Ottumwa’s to recent Republican-backed legislation, like President Donald Trump’s One Big Beautiful Bill Act, which significantly reduces Medicaid spending.
"When you're going to cut the funding to the level that they're doing, just to give tax breaks to billionaires, this is the real-world implications is more closures," he said.
Healthcare has been a major issue for many candidates during this highly competitive midterm election.
Democrats, like Turek, have been highlighting healthcare to try to win over some of the state's Republican and uncommitted voters. They've been speaking extensively about issues like Medicaid cuts and clinic closures, but it's unclear what kind of impact the issue could have on this year's close races.
Healthcare as a campaign issue
Iowa’s high cancer rates and the state’s privatized Medicaid system have been main talking points for gubernatorial candidates Democrat Rob Sand and Republican Zach Lahn.
Turek has criticized Hinson, a current U.S. representative, for supporting Medicaid spending reductions and voting against extending Affordable Care Act Marketplace subsidies.
But Hinson has pushed back on Turek’s comments and has hosted her own events spotlighting healthcare.
In September, she toured the Crescent Community Health Center, a federally qualified health center in Dubuque.
At a roundtable event, she unveiled legislation to expand birth control and telehealth options at these community clinics while asking clinic leaders about their concerns.
"I see the value in what you do every day, and being able to tour today and hear about all the good work you're doing to expand patient care, I just appreciate what you are all doing," she said. "So thank you for including me in this conversation today."
But some polling data suggests healthcare might not be at the top of voters' minds this election.
Economy, inflation top voter concerns
A New York Times/Siena poll released in early October found just 3% of Iowa voters ranked healthcare as their top issue. It fell behind seven other choices, including the economy, inflation, character and competence of the candidate, and immigration.
The polling data also indicates Democrats are more concerned about healthcare than Republicans and independents, and in order to win, Iowa Democrats need some independent and Republican votes.
According to the poll, 7% of Democrats said healthcare was their top issue, as compared to just 2% of independents and less than 1% of Republicans.
At a recent rally for Republican gubernatorial candidate Zach Lahn, Urbandale resident Joanie Riehl said reforming the healthcare system is her top concern. She supports Hinson and doesn’t trust Democrats to fix the issue.
"We can't let big corporations like big pharma take away our rights," Riehl said. "And the Democrats, as far as I'm concerned, just take payoffs."
Back in Ottumwa at the Turek event, Desi McDonough, a registered nurse, said she doesn’t always vote for Democrats, but she has in the past few elections. She doesn’t believe Hinson will help improve healthcare options in smaller communities like hers and thinks Turek better understands the issues facing her community.
"In healthcare right now, we’re in the dark ages. We have clinics closings, hospitals closings. Physicians are few and far between. We have nurse practitioners that are leaving communities because there's not opportunities," she said.
