Today is the 61st birthday of the federal Medicare and Medicaid programs.
While a free forum Wednesday celebrated the occasion with cupcakes and ice cream, several speakers not only highlighted their benefits and importance, but lashed out against the government’s slashing of key parts of the health insurance programs.
The July 29 event at the Eastern Avenue Branch of the Davenport Public Library featured representatives of progressive organizations, older adults, health care experts, and local residents impacted by Medicaid.
“As we commemorate the 61st birthday of Medicare and Medicaid, we have this opportunity to remind Iowans of the tremendous contributions both programs have made to countless generations of Americans,” said Sue Dinsdale, director of the Iowa Citizen Action Network. “Medicaid and Medicare together provide insurance coverage to over 120 million people, or 2 in 5 Americans.
"The vast majority are seniors, people with disabilities, children, and low-income workers who have no other source of coverage. Over the years, policymakers have turned to Medicaid and Medicare again and again to address the shifting population trends, growing demand for coverage and services among vulnerable groups, and rising numbers of uninsured people.
“And despite the critical role of Medicaid and Medicare, current Republican leaders, including every single one of Iowa's Congressional district representatives, voted to make historical cuts to funding that puts both health programs at risk and threatens coverage for 10 million people over the next decade,” she said.
“These attacks on healthcare take our nation in the wrong direction. Instead of slashing popular health programs, what lawmakers should be doing is leveraging them to address both healthcare affordability — which is a crisis that many voters cite as top issue in the upcoming election. So this year we're using the Medicaid/Medicare birthday to remind everyday Iowans about the recent changes that will strip millions of people of health coverage.”
“We must demand long overdue action to make healthcare work for all for all of us by passing price reforms, stop healthcare corporations from using their monopoly power to gouge prices and inflate profits,” Dinsdale said. “The Medicaid and Medicare birthday is the opportunity to demand that lawmakers in Congress take action to stop corporations from using their power to hike prices and inflate profits. Not only must the Congress restore coverage and rescind these dangerous cuts, but healthcare champions must learn from the lessons of Medicaid and Medicare for healthcare reform that meets basic principles that it's our government's duty to make the American health system work for all of us.”
“We need it to cover all healthcare needs -- dental, vision, hearing,” she said. “Those are so important and they are so often not covered or not affordable. Doctors and hospitals and other providers close to home without long waits to get care.”
This past June was the last time scheduled deliveries took place at MercyOne Clinton Medical Center. Hospital officials said patients still have access to prenatal and women’s health services at the Clinton center. The change – forcing many women to travel to Davenport or Dubuque to deliver their baby – was due to increasing costs, staffing shortages and reimbursements that do not cover the full cost of care, hospital officials said.
Medicare and Medicaid were signed into law by President Lyndon B. Johnson on July 30, 1965, and have provided health care coverage to millions of Americans for 61 years. Organizers in Davenport discussed the programs' legacy, current issues affecting Medicare and Medicaid, and ways community members can advocate for their future.
Passed last year, President Trump’s One Big Beautiful Bill Act (H.R. 1) made significant changes to Medicaid—the primary insurance provider for health and long-term care for people with low incomes. These changes are expected to lead to coverage loss for many current enrollees and will reduce federal funding for Medicaid, placing new financial pressures on states and health care providers, according to Kaiser Family Foundation.
The impacts of the changes will vary across states and will be especially significant for states that have expanded Medicaid under the Affordable Care Act and will be required to implement new Medicaid work requirements starting next year.
The 2025 law cuts Medicaid by more than $1 trillion over 10 years – the largest reduction in the program’s history. The biggest change requires most adults under 65 who receive Medicaid through ACA expansion to work, train, or volunteer for at least 80 hours per month. Those who don’t meet the requirement lose health coverage.
In all 50 states and the District of Columbia, Medicaid pays all nursing home costs for persons who require that level of care and meet the financial eligibility requirements. Eligibility criteria, however, varies based on the state, according to American Council on Aging.
The 2025 law places a moratorium on a federal rule designed to help more low-income seniors get assistance with Medicare costs. Medicare Savings Programs use Medicaid funds to help pay for Medicare premiums, deductibles, and other out-of-pocket costs.
The blocked rule would have simplified applications and automatically enrolled more eligible people. By preventing these improvements, the law means that 1.3 million people who qualify for help won’t get it, according to GovFacts.
Coping with rising health costs
“Health care is becoming less affordable for Iowa families, not more,” Dr. James Kettelkamp, retired physician from Iowa City, who practiced in Bettendorf, said Wednesday. “Families are paying more for health insurance, more for prescription drugs, and more out of pocket than when they do seek care,” he said.
In 2025, the average premium for employer-sponsored family coverage climbed to nearly $27,000 a year, with workers contributing almost $7,000 to that coverage, Kettelkamp said, noting those costs will rise with H.R. 1 bill passed last year, as will Medicare Part B premiums.
He said in light of those rising costs, Iowa’s U.S. Rep. Mariannette Miller-Meeks voted against extending Affordable Care Act tax credits, “credits that had previously helped lower costs, lower costs for working families, even though experts warned her that premiums could dramatically increase if those credits expired, she voted to end them.”
“She told constituents that high deductibles were a good thing because patients needed skin in the game,” Kettelkamp said. “As physicians, we know that when patients face higher costs, they don't suddenly get healthier. Quite the opposite, they get sicker. They delay care, they skip appointments, they cut bills in half, they wait until what were once manageable conditions become medical emergencies. As a physician herself, Congresswoman Miller-Meeks should know this. Did she forget it? Or does she just not care?
“But beyond dissolving the Obamacare subsidies, H.R. 1 also slashed funding for Medicaid,” he said. “For patients, Medicaid means cancer screenings, prenatal care, treatment for chronic diseases, mental health services, and long-term care. Losing that coverage means people will go without the care they need until they are sicker and more expensive to treat.”
When Medicaid is cut, “hospitals lose revenue, services are reduced, and communities face the very real possibility of losing their local hospital altogether,” the doctor said. “This is already happening in Iowa. Often, these hospitals are the largest employer in town. And when these rural hospitals close, there are a cascade of bad events like falling dominoes. When people lose their jobs, the local restaurant and hardware store suffer as well.”
“If we want stronger rural healthcare, we should be expanding access to coverage, not cutting it,” Kettelkamp said. “The truth is simple. Iowa families are paying more, facing greater barriers to care, and now confronting devastating state and Medicaid cuts that threaten patients and rural hospitals alike. Iowans deserve leaders who will lower costs and protect access to care, not politicians who celebrate taking healthcare away.
"Miller-Meeks has demonstrated time and again that she cares more about Donald Trump and her wealthy donors than she does about Iowans. Call or write Miller-Meeks. Let her know that you think she's let us down and demand her resignation.”
“Do not let Republicans tell you that we don't have money for healthcare,” he said. “We have enough money to spend $1 billion per day on an illegal war in Iran. We have the money to build a ballroom and bomb shelter for the Epstein class for $600 million and sent $40 billion to a friendly dictator in Argentina. Now (Defense Secretary Pete) Hegseth wants another $1.5 trillion for his military. We are headed towards a collision with our national debt, and the Republicans couldn't care less.”
“We need to demand healthcare for all like every other civilized country in the world,” Kettelkamp said. “We have plenty of undertaxed billionaires and corporations to finance it.”
Obligation to protect people
“Birthdays invite us to remember why something came into being in the first place. 61 years ago, our country made a remarkable decision,” said Jay Williams of Bettendorf. “We decided that growing old should not mean losing access to healthcare. We decided that disability should not mean abandonment. We decided that poverty should not determine whether someone receives essential medical treatment. We also recognized that a civilized society has responsibilities attached to its freedom.
“That decision was imperfect then, and it still is imperfect today,” he said. “Medicare and Medicaid have never been flawless institutions. They require oversight reform, accountability, and continual improvement. But their existence expresses something far more important than administrative policy. They express compassion made public. That idea has become central to my own work, and I've spent years exploring simple questions: What does it mean for love to be more than a private feeling?
“What happens when love becomes an organizing principle for families, organizations, and even governments? My conclusion is simple: love is not merely an emotion. Love is what belongs at the helm,” Williams said. “Every institution is steered by something. Fear steers some, profit steers others, ideology steers others, and power more often steers more often than we'd like to admit. The question is never whether something is steering, the question is what is steering. What's steering us? And that includes government.”
Government should represent public promises, he said.
“They represent older adults who spent decades building our communities. They represent people living with disabilities whose dignity does not depend on productivity,” Williams said. “They represent children born with profound medical needs. They represent families who discover that one illness can erase a lifetime of financial security. These are not abstract populations. They are our parents, our neighbors, our friends. Sometimes they're our family. My grandson Hayden has survived challenges that few people can imagine.”
“Our family has witnessed witness firsthand what compassionate public policy looks like when it reaches a real child instead of remaining an abstract line in a political debate,” he said. “For us, these programs have never been merely government spending. They have been hope made practical.”
“Budgets are moral documents. They reveal what a society chooses to represent and protect,” Williams said. “Compassionate representation does not mean refusing to reform programs. Quite the opposite. If something truly serves people, we should make it better. If it's inefficient, we should improve it. If it's unfair, we should correct it.
"If it becomes unnecessarily complicated, we should simplify it. Reform should begin with the people the programs exist to serve, not with the convenience of institutions or the comfort of those already well protected. The measure of society is not how effectively it serves people with power.
“The measure of society is how faithfully it represents people without it. That's why we celebrate these birthdays,” Williams said. “Not because Medicare and Medicaid are perfect, and certainly not because government is perfect, but because they remind us of an aspiration worthy of a great nation. That compassion is worthy of expression in public life and public policy. My hope is that whatever our political affiliation, we will continue to ask one simple question of every policy, every proposal, every budget, and every candidate: Who is being represented and protected?
“And perhaps we could ask an even deeper question: What is at the helm?” he asked. “May we always choose leaders who see clearly enough to recognize every person's dignity, courageous enough to protect those with the least power, and wise enough to understand that a nation is ultimately judged not only by its prosperity, but by the compassion it is willing into organized public life.
"So happy birthday, Medicare, and happy birthday, Medicaid. May we never stop becoming the kind of people who believe that every life is worthy of care, protection, and compassion.”
Living with chronic disease
Doug Sample, 62, of Davenport, has lived with multiple sclerosis for 42 years, and has been confined to a wheelchair for several years. On Wednesday, he spoke of many times he has argued with the state over denials of service or inadequate pay for in-home care he requires from his Medicaid managed care organization.
Sample noted in 2021, state auditor Rob Sand (a Democrat now running for governor) released a report that showed the privatization of Medicaid in Iowa has resulted in a 500 to 890% increase in members being illegally denied services or care.
In 2016, Iowa transitioned Medicaid members from a fee-for-service system the Department of Human Services administered to a managed care system called IA Health Link, which Managed Care Organizations (MCOs) administer in exchange for a fee.
“It’s got even worse since then,” Sample said of the state report. “I’ve had months of living in filth and eating a box of cereal. I have a live-in caregiver, but she wasn’t going to work for $9 an hour.”
“I am one of the only ones who has received an exception to policy,” Sample said of winning his appeals, noting he lived alone without any care from May to October 2025. “There are thousands of others across the state that are living without, or have friends or family doing charity work.”
“No one teaches someone how to fight this,” he said. “Disability Rights Iowa used to help people with these waiver programs, fighting for in-home care. Their funding got cut; they can’t do it anymore. Iowa Legal Aid, same story. There’s no longer a Scott County office.”
Making systems better
“On a day like today where we're celebrating the 61st anniversary of Medicaid and Medicare, it's important to understand that while we have very deep deficiencies within these programs, we have seen how it is possible to reform and make these systems better,” said Krystle Able, executive director of Illinois Alliance for Retired Americans.
“We know Americans continue to pay the highest prices for prescription drugs in the world, and older and retired Americans who rely on multiple medications to who stay healthy and often live on fixed incomes bear the brunt of the crisis. One in four people over age 65 report skipping or rationing at least one medication because of cost.
“Meanwhile, pharmaceutical corporations continue to post record profits, rewarding executives and shareholders while patients struggle to afford the treatments they need,” Able said.
“To help rein in the pharmaceutical industry's grip on the healthcare system, President Biden signed the Inflation Reduction Act into law on August 16, 2022. So that anniversary is also coming up. The law has already lowered prescription drug costs for tens of millions of Medicare beneficiaries, including caps on insulin, free vaccines, and reduced out-of-pocket spending.”
Under that law, drug companies that raise their product prices faster than inflation must repay Medicare for the portion of the increase that exceeds inflation, she said. “This provision addresses brand-name drug corporations longstanding practice of yearly price increases, often which were more than twice the rate of inflation, and helps reduce the amount seniors pay for their prescription.
“It also strengthens the Medicare program's finances. The Inflation Reduction Act also makes it so that out-of-pocket prescription drug expenditures are capped for Medicare Part D and MAPD beneficiaries at $2,100 per year in 2026,” Able said.
“This still has helped millions of Medicare beneficiaries with high prescription drug costs be able to afford, uh, their medication. It also required Medicare to negotiate lower prescription drug prices. The Inflation Reduction Act ended the long-standing prohibition established under the Medicare Prescription Drug Improvement and Modernization Act of 2003 against the federal government negotiating prescription drug prices for Medicare beneficiaries.”
Just on Tuesday, the Trump administration said it wants to end the Medicare premium subsidy program for Medicare Part D, she noted.
“While Part D is optional, 25 million people will opt into this program to help with their medication coverage. The program has that $2,100 cap for out-of-pocket costs on medication thanks to the Inflation Reduction Act,” Able said. “Nearly all the enrollees are seniors and people with disabilities. The subsidies for what Medicare Part D costs saves consumers hundreds and sometimes thousands of dollars per year, and ending them is going to make healthcare even more expensive for people who are already on fixed incomes.
"So we just found out yesterday we have that to look forward to in 2027. Anyone who's receiving subsidy for their Part D, that is going to be ended. We also see the federal government pushing AI in care on us.”
“The Alliance believes that your healthcare decisions should be between you and your doctor, not a computer,” Able said of this AI preauthorization pilot program. “Under this active pilot, 17 medical procedures now require an artificial intelligence prior authorization process managed by for-profit corporations, of course. Effectively replacing the medical decisions of patients and doctors with automated algorithms.
"Compounding this issue is a deeply concerning payment structure. The Centers for Medicare and Medicaid Services pays these corporations fees based on the number of medical procedures they deny.”
“This creates a direct financial incentive for corporations to maximize procedures averted to increase their own profits at the expense of your care,” she said. “The Alliance for Retired Americans strongly opposes this model, and there is significant concern that the Wiser program is already leading to lower benefits, delayed or denied care, and it could result in widespread benefit cuts and delays for all Medicare beneficiaries.
"Despite these severe risks to seniors and people with disabilities, the Senate recently failed to vote down the program, allowing this corporate-driven erosion of Medicare to continue, and we expect to see it piloted out to even more states, probably Iowa, because unfortunately your congressional representatives are supportive of this kind of thing.”
Able urged people to stay involved, vote in the midterms, and hold elected officials (of both parties) accountable for their actions.
“It's very important that all of you who are in this room today continue to be in rooms everywhere, continue to pull up a chair and have a seat at the table, to organize with the different coalitions that you're a part of,” she said. “We see hospitals closing, home care agencies being chronically understaffed because they do not pay enough.
"In Illinois, our home care workers get paid $18.75 an hour. We had to fight for that for a long time. Is much better than Iowa, but it's still not enough.
“Where I live in Normal, Illinois, it costs, for a 2-bedroom apartment, you need to make at least $25 an hour to afford that. And most people are not making that kind of money where I live, and surely not here either,” Able said. “We know that something has to give. We're running our country into bankruptcy by funding never-ending wars and giving tax breaks to millionaires and billionaires. And it's so important that we start sharing our stories like Doug did today. We have to become vulnerable.
“We have to become brave and make sure that our legislators know that we are not just numbers on a piece of paper,” she added. “We are not just data on spreadsheets. We are real people who are being deeply impacted by the decisions that they are making, and they really need to understand that if they're not going to represent us and see us as real humans and not just a pocketbook that can continue to pay out taxes to a federal government that wants to wage a war on Iran, they are not going to take us seriously…We can't just sustain what we've already built. We have to continue organizing and growing power, and not just electing Democrats but also holding Democrats accountable.”
“The power that they have ultimately comes from us, and we need to make sure that we are exercising that power that we have by getting out to vote, holding our elected officials accountable, and making them understand that there are consequences for their actions no matter what side of the aisle they may be on.”
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