Iowa families are already facing rising costs in our day-to-day expenses, and broken healthcare policies are making things worse. Prices keep climbing, while access and quality lag behind.

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If you’ve ever faced a surprise medical bill or watched your premiums rise year after year, you might question how our health system is working for you. The average single-coverage premium in Iowa now tops $5,500, and out-of-pocket expenses average $9,269, which is above the national rate. Consolidation among hospitals and clinics is limiting competition and driving costs even higher.

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Nearly 240,000 Iowans have medical debt, the fifth most common form of debt after mortgages, student loans, and personal loans. Rural communities not only have limited access to care but higher rates of unpaid medical bills, with many residents skipping treatments or appointments to avoid taking on more debt. Worse, 60% of hospitals aren’t complying with federal price transparency laws, leaving patients in the dark about what care really costs.

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It’s no surprise Iowa fell 10 spots in the 2025 State Health System Performance Rankings—the steepest drop in the country.

Iowans for Affordable Healthcare (IAAHC) works at the Capitol to stop harmful policies that drive up costs and to advance real reforms that increase transparency, competition, and affordability.