1. United States
2. Iowa
3. Letter

Across Iowa, families are skipping medications, delaying surgeries, and watching premiums double while the government remains shut down. This crisis is man-made, unnecessary, and entirely preventable. I urge you to act immediately to end the shutdown and extend the Affordable Care Act (ACA) subsidies before more people are hurt. Nearly 90,000 Iowans rely on ACA marketplace coverage, and four out of five receive subsidies. If the enhanced credits expire, average premiums could rise by $1,200–$2,000 per year, forcing thousands to drop coverage. Nationwide, more than 22 million Americans depend on these subsidies, and an estimated 4 million would lose insurance if they end. Meanwhile, each week of this shutdown drains billions of dollars from the U.S. economy—money that could instead fund clinics, hospitals, and vital services. This shutdown is wasteful and unsound. It inflicts pain and uncertainty only to advance attacks on a health-care program that saves lives and reduces medical bankruptcies. There is no credible replacement plan. Denying care doesn’t fix the system; it only drives up costs later through emergency care and public health crises. Extending ACA subsidies is not partisan—it’s responsible governance. Health care should never be used as a bargaining chip. The wise and humane choice is to protect coverage now and then engage in a genuine effort to reform and strengthen our health-care system. Please confirm whether you will vote to reopen the government and extend ACA subsidies. Your constituents deserve a clear answer.