Zach Nunn and Medicaid cuts: Iowa clinics close in the 3rd District

Last year, U.S. Rep. Zach Nunn told Iowans that hospitals wouldn’t close as a result of President Donald Trump’s “One Big Beautiful Bill Act.” While hospitals have yet to close, the rural healthcare concerns he dismissed are showing up in other forms.

“Let’s dispel myth from reality here,” Nunn told WHO13 in 2025. “I think that the myth here is that rural hospitals are going to close down. That’s not the case.”

Although the Medicaid cuts in the bill have not yet gone into effect, clinics are already closing and scaling back services, citing future cuts. So far, at least three clinics have closed in Nunn’s district, leaving some of his constituents 40 miles – more than an hour drive away – from the nearest medical care facility.

In November, Nunn is running for a third term in Iowa’s 3rd Congressional District against current Iowa state Sen. Sarah Trone Garriott (D-West Des Moines), a pastor who has made funding health care a core aspect of her campaign. As a state senator, she’s introduced several bills aimed at increasing health care access for all Iowans, such as lowering costs for prescription drugs and insulin.

One in five Iowans depend on Medicaid benefits, in addition to nearly 40% of the state’s children as of 2024.

Although Nunn supported the largest Medicaid cuts in history last year, he has told voters that he is committed to reducing health care costs. So far, his solutions have prioritized funding studies instead of services. 

The One Big Beautiful Bill is estimated to eliminate $793 billion in Medicaid spending and leave 7.8 million people uninsured across the country. Nationwide, 67.1 million rely on the government-funded Medicaid program, including 675,000 Iowa residents. 

Cuts from the bill are set to go into effect in January 2027.

Health clinics are already closing, some in Nunn’s district

Over the last year, at least four clinics have closed in Nunn’s district, including one in Centerville and others in Ottumwa and South Des Moines. The two health systems, MercyOne and River Hills Community Health Center, both said that the federal cuts caused the financial strain.

MercyOne, part of one of the largest Catholic health care organizations in the country, has also eliminated 67 staff positions at its Des Moines and Mason City clinics. The layoffs come after a projected $1.5 billion revenue loss due to the recent government changes to Medicaid under Trump’s Big Beautiful Bill, according to a statement from MercyOne.

Across the state, other health care facilities have reported similar budget concerns, while some clinics have at least temporarily prevented closing by scaling back essential services. For example, Pella Regional Medical Clinic, also located in Ottumwa, has limited its family services and is not accepting new patients. The Southeast Iowa Regional Medical Center in Fort Madison has ceased its birthing services entirely, with more than 20 of additional closures expected in the future.

Heartland Signal reached out to both candidates for comment, including Nunn to clarify his original position that these closures were “a myth,” but did not receive a response from either in time for publication. 

Three months ago, Nunn had a physical altercation with a reporter who asked him if he still thinks rural hospital closures are a myth. The video shows Nunn using his phone to knock the reporter’s phone out of their hands. 

Despite voting to cut millions of people off from government-subsidized health care, Nunn has technically voted to expand it — once — to cover fertility treatments. 

Over the last 25 years, Iowa has lost half of its birthing centers, and currently 61% of its rural communities do not have a hospital within an hour drive that can deliver a baby. Medicaid also pays for more than half of nursing home care and 36% of births, according to a report from KFF, an independent health policy research organization.

Nunn’s other campaign priorities include preventing abortion and making it easier to adopt children. Nunn is an Air Force veteran who currently serves as a colonel in the U.S. Air Force Reserve. He was also a cybersecurity consultant.

Trone Garriott proposed multiple health care access bills, to no avail

By contrast, Trone Garriott’s campaign has outlined multiple health-related priorities that center on affordable health care, reproductive rights and specialized support for seniors.

As one of few Democrats currently in the state Senate, Trone Garriott’s efforts to roll back cuts to Medicaid have largely been unsuccessful. She’s sponsored several pieces of legislation, including bills that would have provided free annual lung cancer screenings and lowered prescription drug and insulin costs.

These bills all died in the Senate earlier this year.

“At the state level, I haven’t been able to see some of my priorities move over the finish line, and so, the possibilities at the federal level are so much bigger,” Trone Garriott told Iowa Capital Dispatch at an event in July.

If Trone Garriott beats Nunn in November, it will continue her success flipping red seats to blue, further solidifying Democrats’ chances of taking control of the House majority in Congress.

Early voting is already underway, and Iowans can vote early in person or by mail ahead of Election Day or head to the polls on Nov. 3.