IOWA CITY — The nation’s top Medicaid official defended Republicans’ tax and spending law that slashes the public insurance program, arguing the overhaul would “right-size the system” as he joined Republican U.S. Rep. Mariannette Miller-Meeks to tout the measure’s rural health investment.
Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz joined Miller-Meeks for a tour of the University of Iowa Stead Family Children’s Hospital on Wednesday, May 27, where they cheered Republicans’ “One Big, Beautiful Bill” and said it will transform health care across rural Iowa.
Already, several Iowa clinics have shuttered or announced reductions in service lines, with hospital administrators pointing to the law’s Medicaid changes as the cherry on top of longstanding woes. The law will slash nearly $1 trillion in federal Medicaid spending over a decade, largely as a result of new work requirements and eligibility checks.
Pouring more money into the old system “would’ve bankrupted Medicaid,” Oz contended.
“I am concerned about hospitals,” Oz said. “It’s not that we don’t have a problem with hospitals. … what we did did not cause that problem. It was already there. What we’re trying to do is right size the system.”
Oz downplayed health care officials’ warnings about reduced services in response to the budget reconciliation law, saying it “will not have any impact on hospitals until next year. None. And in many states doesn’t really have much of an impact until ’28.”
He said rural health funds were awarded before those changes taking effect. And he defended the law’s Medicaid changes as necessary oversight, accusing states of engaging in “money laundering.”
His agency has audited and withheld billions in federal funds from blue states such as Minnesota over claims that funds were allegedly used to cover non-citizens or spent by fraudulent hospice agencies.
Oz later directed CMS to require all 50 states to submit plans revalidating Medicaid providers to stop abusers from siphoning federal tax dollars.
Miller-Meeks, an Ottumwa Republican seeking a fourth term in one of the nation’s top battleground seats in the midterm elections, said “we certainly know that hospitals and clinics are under stress,” but their challenges have “nothing to do (with) what we did to strengthen and preserve Medicaid.”
“We have been the last and almost 48 to 50th in every health care specialty,” Miller-Meeks said. “I was the first female president of the Iowa Medical Society in 2007. And I can tell you those numbers aren’t because of what we’ve done last year, those numbers have existed and has been a problem.”
Oz, Miller-Meeks tout federal rural health investment
To help offset some of the losses hospitals will see from the steep cuts, the law included a $50 billion Rural Health Transformation Fund managed by CMS.
The agency awarded Iowa a $209 million federal grant to expand and improve rural health care, the first award in what the state hopes will amount to $1 billion over five years.
Iowa’s Healthy Hometowns program seeks to expand rural health care access; improve cancer prevention, treatment and outcomes; and increase telehealth access, among other efforts.
Oz called it the “most ambitious investment ever in rural health care” that is awarded to states through a competitive process, rather than as the result of undue influence from lobbyists or lawmakers’ personal ties.
“The hope of innovative congressional leaders like Dr. Miller-Meeks was to go out there and say, ‘Forget it. We’re done with that. We’re not just going to pay the bills. We’re going to put enough money into rural health care,'” Oz said. “They were going to transform the system, completely revise and re-envision what it could be to get health care in rural America.”
He said Democratic-controlled states like California and New York “take a lot more money out of the kitty” than states such as Iowa, leaving the federal government on the hook for a higher share of Medicaid dollars.
“You’re not playing the game the same way,” Oz said. “And we needed to correct that.”
Miller-Meeks said Republicans’ sprawling domestic policy package would redirect money that historically went to health insurance companies toward care, education and training.
“No care was cut,” Miller-Meeks said. “That strengthens and preserves Medicaid for those who was intended.”
University of Iowa working with state on rural health care model
UI Health Care officials are working with the Iowa Department of Health and Human Services to use rural health funds to expand a “hub-and-spoke” care model. That establishes coordinated systems delivering primary care locally while offering “health hubs” that offer specialty medical services to neighboring counties.
After he and Miller-Meeks visited the children’s hospital’s neonatal intensive care unit and pediatric specialty clinic, met with physicians and learned about efforts to provide health care throughout the state, Oz complimented UIHC’s efforts to expand the “hub-and-spoke” model.
He said “it means you’ve got the big, the Mecca, which this is a world-class institution, is able to be a partner with other institutions which are also great trying their hardest, but they don’t have all the resources.”
UI Vice President for Medical Affairs Denise Jamieson, the dean of the Carver College of Medicine, said improving rural health outcomes is a “team effort” that needed strong support from public agencies.
“Like many states, Iowa is experiencing increased demand for care,” Jamieson said. “As we also face persistent workforce challenges, particularly in rural communities, that reality makes partnership essential. It’s why we work closely with rural hospitals across the state to provide outreach care, programmatic support, telehealth and more. “
Marissa Payne covers the Iowa Statehouse and politics for the Register. Reach her by email at mjpayne@registermedia.com. Follow her on X at @marissajpayne.
This article originally appeared on Des Moines Register: Mehmet Oz defends Medicaid cuts amid Iowa visit with Miller-Meeks
Reporting by Marissa Payne, Des Moines Register / Des Moines Register
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