"STRAIGHT TALK" Enough Is Enough

(SBA) – Alright, Sergeant Bluff, I’m going to say what everyone’s thinking. Our elected leaders in Washington need to stop kissing each other’s backsides, quit the self-congratulations, and start doing their jobs. Represent the people—period.

There’s a Backstreet Boys song called “Quit Playing Games (With My Heart).” Well, Washington, that’s exactly what you’re doing—playing games with my heart. My actual, physical heart. My health.

There comes a time when people get tired of being polite about the things that are slowly killing them. And in Northwest Iowa — where we work hard, pay our taxes, raise our families, and keep this country functioning whether Washington notices or not — that time has arrived. Should affordable healthcare be considered a human right? The fact we’re still asking this question in 2025 is, frankly, infuriating. Yes, it should be a human right. Yes, it should be something everyone can access without having to perform financial gymnastics or choose between groceries and survival. But apparently Americans are expected to smile, nod, and keep waiting while a government that claims to represent us plays chicken with our lives.

We live in a nation that has figured out how to cure diseases, reverse organ failure, repair hearts, fight cancers, and extend life in ways previous generations would have thought miraculous. But despite all that progress, we still treat basic healthcare as a luxury product. The system practically demands you be wealthy, lucky, or both. And the most infuriating part is that no matter how healthy you eat, how often you walk the Floyd River Trail, how many vitamins you take, or how disciplined you are about lifestyle — your body will eventually need medical care. That is not failure. That is human biology. You cannot fix degenerating spinal discs with a bowl of oatmeal. You cannot reverse Crohn’s disease with vitamin C. You cannot cure cancer with a multivitamin on sale at Walmart. At some point, every single one of us — born at St. Luke’s, MercyOne, or a small hospital in Lyon County — will need help.

But millions of Americans, including far too many right here in Northwest Iowa, are forced to delay or forgo life-saving care because they simply can’t afford it. Not because they’re irresponsible. Not because they’re lazy. Because the financial system surrounding healthcare is designed so that people who fund it can’t afford to use it. And that is outrageous.

Let’s talk about the research behind these so-called “miracle” drugs, procedures, and medical equipment. Pharmaceutical and medical companies love to lecture us about how expensive it is to develop them. They talk about the years of trials, mountains of paperwork, and the “unimaginable cost” of innovation. They guilt-trip the public into believing they have no choice but to charge sky-high prices. But they conveniently skip one critical truth, a lot of that research was funded by us. Federal grants. Federal subsidies. Government-funded labs. University research supported by taxpayer dollars. Those dollars came from teachers in Sergeant Bluff, from packing plant workers in Denison, from farmers near Salix, from retirees working part-time in Sioux City. Everyone pays in. Even minimum-wage workers. Even teenagers at their first job.

But when the breakthrough finally arrives — the drug, the treatment, the machine — the very people who funded it are shut out because they can’t afford the final product. Somehow, the companies that received our money still need to “protect their profits,” still need to hand out bonuses big enough to buy another luxury car or vacation home. Meanwhile, the people who made that research possible can’t afford the medication. They can barely afford the premiums.

That’s not just unfair — it’s infuriating.

And then there are the health insurance companies. The ones who comb through policies to decide what is and isn’t covered. The ones who tell you that tumor might not count as medically necessary. The ones who act like they’re doing you a favor by charging $1,200 a month for a plan with a $9,000 deductible. They claim they’re forced to charge so much because equipment and drugs are expensive. But of course, they also have to earn a profit. They also have CEOs and executives who expect new Mercedes and multimillion-dollar homes. They also have to satisfy shareholders.

But every day families in Northwest Iowa? They’re expected to decide whether they refill their blood pressure medication or buy an $8 pound of ground beef.

We pay into the research. We pay into the insurance system. We pay into the tax base. We pay and pay and pay. And they live well. They live long. They live healthy. And the rest of us — the people who funded the entire system — are left to fend for ourselves.

The Affordable Care Act, imperfect as it was, at least helped narrow the gap. It made healthcare accessible for millions who had previously been priced out or locked out. It helped families across Woodbury County get coverage they could actually use. But instead of improving the ACA, adjusting what didn’t work, and strengthening what did, Congress once again left working Americans hanging.

We limped through a 43-day government shutdown because politicians couldn’t agree on whether people deserve affordable healthcare. A shutdown — over whether Americans get to afford insulin. A shutdown — over whether seniors have to choose between apples and heart medication. A shutdown — because leaders would rather posture than govern.

Now the enhanced ACA premium tax credits — relied on by 90% of enrollees — are about to expire. That means 22 million Americans will see their insurance costs skyrocket. Not by a few dollars. Not by a manageable amount. But by 114%, on average. In Northwest Iowa, where wages are steady but prices keep climbing, that increase isn’t just painful — it’s devastating.

The average ACA participant will pay an extra $1,016 a year. But that’s just the average. A family of four making $75,000 — which is hardly wealthy in today’s economy — will pay an additional $3,368. That’s months of groceries. That’s heating bills through January and February. That’s school expenses. That’s the cost of getting the car repaired so you can even get to work.

People are furious — and rightfully so.

Some ACA participants have already told reporters they might go without insurance altogether because they simply can’t afford the new premiums. Others will choose cheaper plans with terrible coverage, leaving them one accident away from financial ruin. The Congressional Budget Office says four million people could drop coverage.

Four million. Think of what that means. That’s not four million reckless thrill-seekers. That’s four million parents, grandparents, workers, farmers, teachers, and young adults who are being priced out of health insurance by a political system that seems to think healthcare is a luxury item.

Small business owners and self-employed workers — a huge part of Northwest Iowa’s economy — will be among the hardest hit. Nearly half of ACA enrollees either own a small business, work for a small business, or are self-employed. These people don’t get employer-based insurance. They rely on the ACA because it was the only path to coverage.

That includes people like Iowa farmer Aaron Lehman, who testified before the Senate on December 10. He and his wife are staring at premiums that will more than double in 2026. Their story is the story of countless farm families in our region. Farming is already a high-risk, low-margin job. It breaks your back, breaks your sleep, and sometimes breaks your spirit. But now it might break you financially just because you need healthcare.

And what did Congress do? Nothing. They put two competing bills forward as part of their grand performance, and both failed. They promise bipartisan cooperation later — as if that’s going to help the families receiving cancelation notices in January.

Some lawmakers are optimistic. Great. They can be optimistic while people choose between insulin and heating bills. They can be optimistic while rural hospitals — already stretched thin — brace for a wave of uninsured patients. They can be optimistic while emergency rooms prepare for the financial hit that comes when millions of uninsured Americans have no choice but to show up at their doors.

Here in Northwest Iowa, we are tired. Tired of hearing the same excuses. Tired of watching the same power games. Tired of being told to be patient while politicians who will never face our struggles debate whether we deserve affordable care. Tired of being used as a political bargaining chip by people who have never had to choose between medicine and food.

We come from a culture where people take care of each other. Where neighbors show up when your house burns, when the blizzard hits, when a family loses everything. We don’t wait for permission or ask for praise. We step up. But even the strongest communities cannot fix a broken national healthcare system. They cannot foot six-figure medical bills. They cannot keep rural hospitals open. They cannot rewrite insurance rules.

And they shouldn’t have to.

Healthcare should not be a privilege reserved for the wealthy, the well-connected, or the lucky. It should not depend on your job, your zip code, or whether Congress is having a productive month. It should not require Americans to sacrifice their dignity or their financial future just to stay alive.

We have paid into this system in every way imaginable — through taxes, through premiums, through wages, through research funding, through decades of quiet endurance. And in return we get rising premiums, expiring subsidies, and politicians who can’t be bothered to do their jobs.

At some point, anger is the only honest response.

So yes, affordable healthcare is a human right. And the fact that millions of Americans are forced to choose between medication and food, between coverage and debt, between survival and bankruptcy, is a national disgrace.

People here in Northwest Iowa are done being quiet about it. And Washington had better start listening.