For many Iowa families, cancer is no longer an abstract concern. It is personal. Iowa faces one of the fastest-growing cancer incidence rates in the nation. Families are stuck making impossible choices about their healthcare. With that reality in mind, the 2026 legislative session should have been an opportunity for swift action to improve public health, address water quality concerns, and make healthcare more affordable and accessible. Instead, the Legislature failed to deliver.
One of the clearest examples was Senate File 2480. The bill imposed a 5-cent tax per unit on nicotine pouches and a 5-cent per-milliliter tax on vape products. These rates are far below what experts recommend to meaningfully reduce youth usage and addiction. Research consistently shows that stronger tobacco taxes reduce youth use and improve long-term public health outcomes. Yet instead of following the guidance of experts, lawmakers settled for a token measure that appears designed more to protect the predatory tobacco industry over the health of Iowans. As Sen. Bill Dotzler bluntly said during Senate debate: “Quite frankly, the industry is the one that wrote this.”
He’s right.
I’ve spent the last eight years in the Iowa Legislature fighting against special interests, big corporations who see people only as lines on a spreadsheet. Big Tobacco’s fingerprints were all over it. Rather than aggressively addressing nicotine addiction, the bill created the appearance of action while preserving a favorable environment for the companies profiting from these products. Even more troubling was the decision to tie pediatric cancer research funding to the new nicotine tax revenue stream. Pediatric cancer research deserves strong, stable funding immediately.
Unfortunately, the Legislature’s failure on healthcare extended beyond tobacco policy. We see the same mission when it comes to predatory big agricultural corporations. We know we have high nitrate rates in our water. We know that high nitrates lead to cancer. Now, these companies are asking elected leaders to eliminate their financial liability should someone develop cancer from using their product. It’s wrong and I won’t let it happen on my watch.
House File 2739 temporarily raises taxes on Health Maintenance Organizations, increasing the rate to 3.5% from January through September of this year. Republicans framed the change as a budget maneuver, but the real-world impacts on Iowans are difficult to ignore. Taxes on insurers do not disappear. They are often passed along to consumers and employers through higher health insurance premiums and increased costs. It also comes on the heels of legislation aimed at weakening Iowa’s Medicaid program, a trend that should deeply concern anyone who cares about cancer detection and treatment. We know cancer is most treatable when we catch it early. Preventive screenings, regular doctor visits, and affordable access to care save lives. When healthcare becomes more expensive or less accessible, Iowans delay care. They skip screenings and wait until illnesses become more advanced and more difficult to treat.
If lawmakers are serious about addressing Iowa’s cancer crisis, then Republicans should be focused on expanding healthcare access, strengthening Medicaid, supporting rural healthcare providers, cleaning up our water, investing in prevention, and pursuing meaningful policies grounded in science rather than industry talking points. Instead this session reflected misplaced priorities. Iowans deserve leaders willing to confront difficult challenges directly.
Lindsay James is an ordained Presbyterian minister and state representative for House District 71 in Dubuque. She is running for Iowa’s 2nd Congressional District.
This article originally appeared on Des Moines Register: Iowa Legislature fell short of the mark on combating cancer | Opinion
Reporting by Lindsay James, Guest columnist / Des Moines Register
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By Lindsay James, Guest columnist | USA TODAY Network
