On Tuesday, Donald Trump is heading to Clive, Iowa to brag about his supposedly strong economy. The reality is, for farmers and working Iowans alike, costs are skyrocketing and the math isn’t adding up. These cost hikes are the direct result of Trump and Republicans ripping away Affordable Care Act tax credits from nearly 22 million Americans, causing premiums to more than double in Iowa. Health insurance premiums are spiking by hundreds of dollars, and Hawkeye State residents are being forced to make impossible choices between basic needs and losing health coverage.
BY THE NUMBERS: Trump’s War on Iowans’ Health Care
- Nearly 120,000 Iowans who buy insurance through the ACA are now forced to pay an average of $610 more annually for health coverage. A poll of Iowa ACA enrollees found that 86 percent would delay or skip care if Republicans ripped away tax credits.
- Thanks to GOP premium hikes, 24,000 Iowans will lose their health care coverage entirely this year, including small business owners, farmers, and older adults.
- Around 14,000 fewer Iowans have signed up for health insurance through the ACA this year compared to 2025 after Trump and Republicans ripped away tax credits.
- Premiums for Iowans receiving ACA tax credits are increasing by an average of 173 percent this year:
- A 45-year-old in Iowa making $64,000 will see their average annual premium costs rise by $1,353 to hit $6,793 this year.
- A 60-year-old couple in Iowa making $85,000 will see their average annual premium costs rise by $18,310 to hit $25,535 this year.
- A family of four in Iowa making $130,000 will see their average annual premium costs rise by $8,171 to hit $19,221 this year.
- Hospitals and clinics across Iowa are already folding under the weight of GOP cuts to Medicaid. Iowa hospitals alone are expected to lose nearly $300 million annually.
- Now, thanks to Republicans gutting the premium tax credits and hiking Iowans’ premiums, providers in Iowa will lose an additional $27 million in funding.
Iowa Farmers Are In Dire Straits Thanks to Trump and Republicans in Congress
Iowa Farmers Are Hard-Hit By Trump-GOP Health Care Cuts. Trump and Republicans’ decision to rip away ACA tax credits will hit Iowa farmers especially hard. More than a quarter of America’s agricultural workforce purchases health insurance through the ACA. Before the passage of the ACA, many farmers and agricultural laborers had to find off-farm jobs in order to get health insurance. The ACA has provided a critical health insurance marketplace for Iowa farmers to buy insurance on their own, and tax credits made that health care affordable, even during unprofitable years. Farmers are delaying care, downgrading coverage, taking off-farm jobs just to keep insurance, or going uninsured and hoping they don’t have a farm accident or medical emergency.
Iowa Farmers Are Already Facing An Existential Crisis. Iowa’s economy is heavily dependent on farming, and the local industry has struggled amid Trump’s trade wars, foreign bailouts, and deportations. By late last year, Iowa had the second-highest rate of farm bankruptcies in the country, recording the most since 2021. Farmers have faced unprofitable yields for three years in a row, and Iowa farmers’ income is only expected to decline in 2026, dropping by $3 billion – a 24 percent decrease.
Even With Trump’s Rural Health Fund, Iowa Hospitals and Clinics Are Folding Under the Weight of Health Care Cuts. Across Iowa, hospitals and clinics are folding under the weight of Trump and the GOP’s massive $1 trillion cut to Medicaid. Shortly after Republicans slashed Medicaid, state leaders in Iowa requested $1 billion from the Trump administration to shore up rural health care in anticipation of slashed budgets and closed clinics. The state was awarded just 20 percent of the requested funding, however, receiving $209 million from the Centers for Medicare & Medicaid Services (CMS). Given that Iowa hospitals alone are expected to lose nearly $300 million annually, providers will still face severe cuts that could force facility closures across Iowa even with the Trump administration’s rural health grant.