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The problems with the insurance exchange in Iowa are fixable — and not a good excuse to fund tax cuts to the wealthy by forcing tens of thousands of Iowans off health insurance.

Not only would changes proposed in AHCA reverse gains in coverage, but they would end Medicaid as we know it.

“As President Trump prepares to visit our state next week, he should be aware of the severe impact that his proposals would have on many tens of thousands of Iowa families.”

For Iowa to pick up lost Medicaid coverage for vulnerable residents if the House health proposal becomes law, it would cost the state three times what it would spend under current rules. Millions across the country would lose coverage as states would not be able to absorb the cost.

Iowa’s expansion of Medicaid has increased access to health care for thousands. These latest census findings set a baseline for an evaluation of the impact of privatization of Medicaid that Governor Branstad imposed this year.

When the 2016 session began, Iowa faced a host of critical challenges. This session has done little to ease any of the major concerns, and nothing to meet them for the long term.

Aside from fiscal impacts, sales-tax proposals and actions in Iowa ignore existing law or voters’ directives, and long traditions in the way we govern ourselves.

“Is it a better use of taxpayers’ money to send millions in checks to profitable companies to do research they would do anyway, or to make sure schools can hire enough teachers next fall?”

“Too often, we see public officials relying on these rankings and the policy prescriptions they promote, when in fact the rankings have no predictive value for economic growth,” said Fisher.

The path to advancements in education, economic stability and environmental stewardship — as well as other critical areas where strong public policy and institutions are necessary — rests on strong, strategic investments.