The Truer Better Agenda: A Healthier Iowa for All

I hear it everywhere I go: cancer.

Everyone knows someone – a parent, a spouse, a friend – who has been affected by this crisis, even those without family histories or genetic exposure.

Cancer doesn’t care who you vote for, what your politics are, or where you live. It’s the top issue on everyone’s mind no matter what part of the state I’m in, and rightfully so. Yet over the last several years, Iowa has become one of only two states in the country with a growing cancer rate – and with the fastest rising cancer growth rate in the nation – while our current elected officials stick their heads in the sand and pretend there is no problem.

Or even worse: we hit a new low with legislators trying to tell Iowans we don’t have a nitrates problem because spinach and lettuce have high nitrates. I’m pretty sure leafy greens are not what is making Iowans sick – first, because, of course; but also, because, as an Iowan, I can tell you, we aren’t eating a ton of them.

We can have debates about a lot of things as it relates to Iowa’s sky-high cancer rate, but here are a few things we know: Iowa has a water quality problem. Nitrates, at a certain level, do cause cancer, and our waters are often above high levels. Iowa has some of the highest rates of radon in the country, contributing to our sky-high lung cancer rates – we have six times the average amount of radon. Alcohol consumption is related to cancer – we’re not Wisconsin, but we’re right behind them at number two in the country. And, we smoke more than most states.

However, according to the Iowa Cancer Registry, we screen for cancer at about the same rate as the rest of the country, so we know we’re not just looking for cancer more than the average state – we really do have more of it. And according to the American Association for Cancer Research, “roughly 40 percent of cancers in the US are attributable to modifiable risk factors” – things we can control to decrease our cancer risks – smoking, drinking, weight gain and diet, UV exposure, and more.

This is a multi-faceted problem that will take a multi-faceted approach to addressing. But one thing is certain: for the health of Iowans and the future of our state, we cannot continue to do nothing, or worse, make it harder to learn about the size of our problem.

As it stands, we’re prepared to close another legislative session with no meaningful action being taken by our elected officials. The timeline to tackle Iowa’s cancer crisis is currently multiple generations away, a finish line far too distant for a state staring down a cancer rate that demands immediate action.

This should be a top priority for every elected official in the state of Iowa – regardless of party. I spent last summer traveling the state as part of my 100 Town Hall Tour and participating in policy briefings with experts across industries and fields to learn more about the issue and what meaningful action we can take to address it. I’m releasing the following commonsense, bipartisan proposals that I think make meaningful progress to addressing Iowa’s water quality issues, reducing the cancer rates, and improving overall health for Iowa families.

No immunity for chemical companies sickening Iowans: Insiders have been pushing a bill that would give immunity to companies that are sickening Iowans. Chemical companies have spent decades buying influence with government insiders, while a foundational study upon which the claim of safety was recently retracted for being influenced by the same company that makes the chemicals. We need to protect Iowans’ health by letting the courts and juries, not politicians, decide whether chemical companies need to pay for the pesticides that pollute our air and water.

Invest in – not defund – water quality monitors: While our current elected officials deny a water quality issue, Iowans are facing the very real consequences of the defunding of water quality monitors across the state. They would rather keep Iowans’ heads in the sand than address water quality issues. It’s mind-boggling. Iowans should know what’s in their water. We need to increase funding for aggressive water quality monitoring and farmer-led water quality programs.

Invest in radon testing: Iowa is the number one state for radon levels, and we have the highest rate for lung cancer in the country. Radon testing is cheap, and we can’t afford to continue to do nothing. Home sale contracts should require a radon warning and information about how to test for radon, and home inspectors should be required to mention Iowa’s high radon levels and ask the potential buyer if they want to have a test done. The state can facilitate the training of more individuals to become radon mitigation professionals since the good ones we do have will be overbooked if they aren’t already. This is all a heck of a lot cheaper than treating cancer.

Implement transparent manure management plans: We need to trust, but verify, that manure is being handled appropriately according to the plans that producers already submit to the state. Right now, these documents are treated as non-public information, and are not easily accessible. We should change that. Manure management plans and their implementation should be available to every Iowan to allow us to not only see how, when, and where the manure is spread on Iowa farmland. A single, free, online form will replace handwritten records. It isn’t any more work for growers and producers – it just means we all can see what the plans are, to help steer in the right direction anyone tempted to forget them.

Invest in digester technology: Right now, any manure decomposing freely releases methane, a potent greenhouse gas, and nitrates from a form that is hard to predict due to weather, and hard to haul. Digesters control that breakdown in a controlled environment, capturing methane to be sold to renewable natural gas companies and turning nitrate into a different form, still for use as fertilizer but less likely to wash into rivers and streams. If you’ve heard of a closed-loop system that reuses materials, this is a pretty good one. Funding these efforts could help improve water quality, create jobs, including in the trucking industry, and bring more money to farmers. This is particularly timely with ongoing disruptions to the foreign fertilizer market, leaving our farmers in limbo ahead of planting. Digesters gives us a domestic source for fertilizer, lowering costs for farmers while tackling the water quality crisis head-on.

Expand and improve current conservation programs by offering tax credits for farmers: Very important to note: there are farmers who have been on waitlists for years to get into conservation programs. These programs run out of support from politicians long before they run out of farmers who want to participate. Farmers know we can do better, and want to do better. They are an ally in getting clean water – it’s the politicians who are blocking progress. We need to build on current conservation efforts and ensure farmers who want to participate have the resources they need to do so. Ninety percent of farm income goes to the biggest 10% of farms. A way we can do that is by expanding and improving Iowa’s current conservation programs, and also creating tax credits for farmers to help offset the costs of conservation programs they already want to participate in. That includes an income tax credit to help cover the costs of conservation practices, and a property tax credit per acre for farms using approved nutrient plans.

Establish a dirty water notification system: We need cleaner water in Iowa, but we also need quicker awareness of dirty water issues. Parents – myself included – never want to pick between a fun summer afternoon or risking our children’s health and safety. I grew up fishing in Decorah with my dad, and I’ve loved passing down that tradition to my own two boys, but I don’t want to second guess every body of water we enter every summer. To help mitigate that, I propose implementing a notification system to alert residents when drinking nitrate levels approach, hit, or exceed 10 mg/l. Same for swimming waters with E. Coli. The system would alert Iowans across multiple platforms through SMS, robocalls, and public press releases to ensure Iowans are equipped with the most up to date information on the safety of our drinking water, and our beaches and recreational waterways.

Establish a Cabinet-level Cancer Task Force: Managed under the Department of Health and Human Services, this task force would lead the charge on implementing policies at the state and local level to combat the cancer crisis. The task force can work with experts to identify best practices and help tailor solutions to specific regions or communities across the state.

Increase wetlands for health and habitat: One thing cleans our water very effectively and gives us opportunities to enjoy the outdoors by hunting, fishing, and floating: wetlands. They are the single most effective thing for filtering pollutants out of our water. And with Iowa ranked 49th in the country for public lands, we could use a few more spots for fun and recreation across the state. Iowa can work with Water Management Associations and Soil Conservation Districts to determine where and develop plans to finance projects. We should do a reverse-auction, inviting Iowa landowners who have a wet spot to offer it to the state; the state can then prioritize where to buy first to have the biggest immediate impacts on water quality. We also need to expand the Cattle and Conservation Working Lands Project, which helps farmers turn less desirable crop lands into pastures for cattle grazing to keep the land productive and help with water quality by preventing pollutants from reaching our waterways from the start.

These proposals aren’t a promise to solve Iowa’s water quality issues and cancer crisis overnight. There aren’t any realistic ways to do that overnight. But they are a promise to move our state in the right direction and the first steps towards seeing improved water quality and cancer rates in the coming years – not the coming centuries.

Besides raging cancer rates, Iowans’ health outcomes overall have been on the decline over the last decade of one-party rule. Health care in Iowa has become harder to reach, more expensive, and less reliable. We’ve seen a steady loss of health care workers – many leaving for other states with better pay and where they can better provide care for their patients. We’re already seeing the consequences: rural hospitals stretched thin, maternity care units shutting their doors, and mental health services nearly non-existent. It’s unacceptable and not sustainable.

As governor, I would propose the following to help Iowans live better, healthier lives:

  • Reverse the privatization of Medicaid: Privatizing Medicaid has been one of the most disastrous decisions in Iowa over the last decade. It prioritized profits over the health of Iowa families, reduced access to care for tens of thousands of Iowans, and has been an administrative nightmare. And illegal denial of coverage claims has increased 900% since the program was removed from public accountability. As governor, I’ll get started reversing the privatization of Medicaid on day one of my administration.

  • Crack down on PBMs: We need to ensure Iowans can use the pharmacy of their choice by cracking down on Pharmacy Benefit Managers (PBMs) that force patients to use only certain pharmacies through backroom deals.

  • Expand tele-health services: Iowans in our rural communities often live several miles away from the nearest hospital or clinic, putting care out of reach. We should increase access to tele-health services by expanding insurance coverage for health care offered via telehealth at the same rate as in-person care for all care, and require audio services be covered as well. We also need to improve high-speed internet access – not through the decades-old failures to lay more fiber, but with assistance in paying for satellite internet.

  • Reject culture wars, improve maternal health, and protect Iowa jobs: Communities across Iowa are being left without access to essential care, including labor and delivery units, putting the lives of expecting mothers and their unborn children at risk and forcing health care workers out of our state. As government insiders and my opponents promise further culture wars and restrictions on fundamental freedoms, I would veto any culture war bills that cross my desk that further attacks on providers, make Iowa a less welcoming place to live, and threaten access to surrogacy, contraception, and IVF.