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The Issues


Every stand I take in Congress will be in pursuit of these goals and the needs of the people in Iowa’s 4th congressional district.


Expanding, Quality Affordable Health Care 

As I’m driving around Iowa’s 4th congressional district, I frequently see a donation box at a gas station begging for donations to pay off someone’s health care expenses. 1 out of 3 GoFundMe campaigns are to pay for medical bills. Charity is not a sustainable health care system.

Our health care system should:

1) cover as many as possible

2) put efficiency, sustainability, and results over profits

3) make it easy

Over the past decade,  we’ve made tremendous progress as a country, covering 20 million more Americans. But, 87 million Americans remain uninsured or underinsured. We must build upon the progress that we’ve already made, and expand quality, affordable health care to all Americans. My goal is a universal health care system, but it will take steps to get there. We can immediately provide a robust public option and offer a Medicare buy-in for those 55 and older, while protecting folks with pre-existing conditions and helping small businesses provide coverage to their employees.

Our government should also be able to negotiate the cost of prescription drugs and invest in innovative ways to control costs and incentivize more efficient care — all without ever getting between a patient and their doctor or their health care needs.

Expanding Medicaid is the best moral and economic choice. It keeps rural hospitals open, improves their financial performance, and employs local people. It also provides better coverage, more accessible and affordable care, and better financial security. Unfortunately, Iowa privatized Medicaid leading to higher costs and less choice, putting the lives of the most vulnerable among us at risk.

Rural Hospitals and Health Care Workforce

Nearly 18% of Iowa’s rural hospitals are at high risk of closing unless their financial situations improve, endangering the health and well-being of our rural families. We need proactive policies that end the threat of shuttered hospitals and rural doctor shortages and a real strategy for providing healthcare to rural citizens: employing job incentives, innovations like telemedicine, and smart mechanisms for subsidizing rural facilities where the market alone isn’t providing enough support. To start, we need increased funding for rural hospitals and community health centers, higher reimbursement rates, and expanded recruiting, training, and mentoring for rural doctors, nurses and healthcare workers.

Mental Health Care

Our rural communities sorely lack sufficient mental health care facilities and workers. Iowa ranks among the worst states in the nation for mental health treatment — 47th in psychiatrists, 44th in mental health workforce availability and 51st (including D.C.) in the ratio of state psychiatric beds to residents. This is an epidemic. Let’s expand federal funding for community health centers in underserved, rural communities and the National Health Service Corps, and expand access to public addiction recovery services.

Family Health Care

As a Catholic, I have my own personal views on the issue of choice. But it’s not my place nor the government’s place to make decisions about a woman’s health. Criminalizing women and their doctors for these highly personal decisions will only lead to dangerous and deadly situations that disproportionately hurt young women, rural women, and women of color — and it won’t reduce the number of unplanned pregnancies. We have a common goal: to reduce abortion and ensure that women and families are safe and healthy. To do that, there are proven solutions like ensuring women have access to contraception and affordable, quality, health care, teaching age-appropriate sex education in schools, paid family leave, and expanding adoption, foster care, and better child care policies to make it easier for new parents to care for newborns.

In the last 15 years, at least 31 OB/GYN units have closed in Iowa so moms have to drive further to deliver a baby, elevating the risk of complications and deaths. No doubt that has contributed to the increases in infant mortality by 21% in the last four years. We must support rural OB/GYN units, midwives, and family planning centers.


Building the New Rural Economy

Iowa’s 4th district has the potential to lead in agricultural technology, advanced manufacturing, and climate change innovation. We have the resources and the ingenuity to build a thriving rural economy. Iowa already leads the nation in corn, hogs, eggs, biodiesel, ethanol, wind energy and more. That’s why I support fair trade policies and reformed trade agreements designed to benefit this district and not just Wall Street so we can strengthen traditional industries and small businesses and invest in new ones.

Farming and Agriculture

One of the last things my Grandma Fern said to me before she passed away was to take care of the family farm. This ultimately led me to run for Congress — to not just protect our family farm, but all Iowa farmers and rural communities.

Iowa’s 4th district is the 2nd most agriculture producing district in the nation. Just like my ancestors, our farmers and ranchers work hard to make an honest living to feed, clothe, and power all of our communities. But despite living around some of the best land in the world, many farmers are struggling to get by.

For years, politicians on both sides of the aisle have prioritized corporate profits and efficiency over resiliency and fairness. The result has made our food system unfair, unsustainable, and unstable through policies like “get big or get off the farm,” corporate consolidation, and the rise of Dollar Generals undercutting our independent small grocers. Big mergers, market consolidation, and foreign influence and ownership of our Ag industries have also hindered the power and opportunities of family farmers and ranchers.

To level the playing field, we need to:

Workers’ Rights 

Strong unions helped create and strengthen our middle class. But today, our unions are under attack. We’re fighting to ensure that all working people have a living wage, decent benefits, safe working conditions, and are treated with dignity and respect. I stand for revitalizing unions, giving more bargaining power to all workers, extending labor rights and protections to all workers (including those in the gig economy), raising wages and protecting pensions, and holding corporations accountable for labor violations.

Tax Reform for Regular People

We need tax reform that benefits working families and small businesses instead of millionaires and multinational corporations. But in Iowa and federally, destructive corporate giveaways have been passed that hurt our working people. The 2017 federal tax bill has allowed 91 corporations like Amazon, GM, and FedEx to pay zero dollars in federal income taxes. We should not keep rewarding corporations after they’ve spent years buying back stocks, increasing CEO pay, and outsourcing jobs. In Iowa in 2018, legislation was signed into law that provided giveaways to millionaires, corporations, and people who don’t live in Iowa. The law raised property taxes on Iowa families, seniors, and small businesses and resulted in cuts to health care services, job creation, education, and public safety.

Investment in Infrastructure

Our farmers, families, and rural communities rely on safe roads, highways, and bridges, water pipes, school buildings, dams, and more, but crumbling infrastructure is hurting our ability to fully compete in the thriving global economy. That’s why I’m pushing for rapidly scaling up investment in our nation’s infrastructure, supporting broader economic opportunity, creating jobs and revenue for our communities, and improving our quality of life. In Iowa, this means:


We can’t cut corners when it comes to education. Yet, for too long, the federal and state education budgets have been systematically gutted. A good education gives our kids the building blocks needed to start a career, get a good job, strengthen the middle class, and contribute to our economy. We must ensure that everyone has quality schools and job-training, regardless of income level or zip code, and without being saddled with mountains of debt. We also need to value those with the most important job in our country — our teachers — by ensuring they have the respect and resources they need and deserve. We need to increase federal funding for schools, ensure teachers receive competitive wages and benefits, provide earlier student loan forgiveness to teachers and full debt cancellation after 10 years of service, and increase the number of psychologists, guidance counselors, nurses, social workers, and other health professionals in our schools. We also need to invest in universal pre-K, fully fund IDEA, increase funding for Pell Grants, make community colleges and technical schools free, and invest in student loan debt assistance.

Raising the Minimum Wage

CEO pay has risen 940% since 1978, while typical worker compensation has risen only 12% during that time. Meanwhile, the costs of housing, education, transportation, child care, food, and health care have all skyrocketed. Our workers need a higher minimum wage. Iowa’s economy may have a low unemployment rate, but wages have not risen and families are falling further behind. I believe that cost-of-living adjustments should be taken into account because what works for San Francisco may be different than Sioux City. No one should be working a back-breaking full-time job and still be unable to lift themselves up out of poverty or provide better lives for their children. There is zero evidence that it stifles economic growth, reduces competitiveness, or leads to mass layoffs; instead, it will improve livelihoods, strengthen communities, and lift folks out of poverty.


No Corporate PAC Money

We need to return to a government of, by, and for the people. That means I stand for rules that minimize the amount of corporate and special-interest money flooding our political system. It doesn’t matter what party you belong to: when the wealthy and the powerful can spend without restrictions or accountability, it drowns out the voices of everyday citizens and undercuts the basic tenets of a free democracy. I’m proud that my campaign refuses corporate PAC money.

Voting Rights

Voting should be easy. But unfortunately, in Iowa and across the country, there are coordinated efforts to make it harder to vote, especially for communities of color, folks with disabilities, students, and the elderly. We must ensure that our elections are secure, accessible, fair, and free. To do that, we need 21st century voting machines, federal standards for federal elections, including automatic voter registration and same-day registration, to end voter roll purges, make Election Day a national holiday, end gerrymandering, and end racist and discriminatory voter-ID laws.


Food and Nutrition

When a community loses its grocery store, it’s a loss of revenue, local jobs and choices, and leaves folks in food deserts without access to affordable, quality, and healthy food so they have to drive further to get groceries. Ultimately, this harms our economy, our community culture, and our health and well-being. We need to expand benefits and the rate of eligibility for SNAP and WIC so that pregnant women and their children and poor families have healthy meals. We also need to support community food efforts from co-ops and mobile groceries to food hubs, grocery lockers, and independent local grocery stores through tax credits, grants, and technical assistance. Every community has different needs, challenges, and ongoing efforts to aid nutrition and combat food deserts. What works in Manning, Iowa may not work for Gowrie — and that’s why we need comprehensive federal data about food deserts so we can start to create real solutions. Our goal shouldn’t be to hamper local efforts or create excessive red tape, especially if their solutions are working, but to provide a helping hand to our local communities. We need all the information we can get to tackle this crisis head on, and give our rural communities the resources needed to raise healthy families.


We can never fully repay the great debt of gratitude to our nation’s servicemembers and veterans. What we can and must do is fulfill our promises and ensure they have the services and benefits they’ve earned and deserve. First and foremost, we should end our endless wars. We need to protect their pay and benefits and expand quality, affordable education, child care, and housing. We need to increase funding and the modernization of the Veteran’s Administration and their rules and regulations. We also need to work to eliminate military sexual assault and veteran and military suicide.


Millions of folks have had to sacrifice what they’ve managed to save for retirement in order to pay for education, health care, housing, and other daily and emergency expenses. Meanwhile, fewer people have the kind of pensions used to save for retirement. That’s why Social Security and Medicare are so critical. I will fight to protect and expand Social Security and Medicare to ensure that all seniors can enjoy the retirement that they have earned.

2nd Amendment

I support the 2nd Amendment and the rights and lifestyles of law-abiding, responsible Iowans to own a firearm. Yet, every murder and suicide using a gun that is bought and used by an unauthorized person should rattle each of us because it endangers our public safety, takes an innocent life out of our community, and disparages many responsible gun owners. The honest truth is that there is much common-sense, widely-supported, bipartisan solutions to reduce gun violence — like background checks and red flag laws — but special interests and dark money groups get in the way. We’re often presented with a false choice when it comes to guns between the 2nd Amendment and gun safety. That’s simply not true. My objective is to keep our communities safe while respecting responsible gun owners.

Americans with Disabilities

Senator Tom Harkin is one of my political heroes. I’m incredibly proud of his leadership in advocating for folks with disabilities and passing the Americans with Disabilities Act. We should honor his legacy and the needs of our most vulnerable citizens by ensuring equal opportunities and care for all. We should fully fund Individuals with Disabilities Education Act (IDEA) so students with disabilities have access to high-quality public education, schools can hire and retain more highly qualified special education teachers, and provide more services to students with disabilities. We also need to ensure that our economy and society values people with disabilities by paying them a living wage, ending workplace discrimintion and exploitation, and passing paid family and medical leave. It’s also our responsibility to ensure their full civil rights and liberties, promote affordable housing, and transition to universal healthcare.


Protecting and preserving our planet should be a national and global priority. Iowa ranks second in the nation in installed wind capacity, an opportunity for us to create more jobs, power more communities, and protect our planet. We must invest in green technologies and infrastructure, like wind and solar energy and the renewable fuels industry. We must also support communities that are hardest hit by climate change and push for innovation in sustainable farming and agriculture. Farmers and rural communities must be at the table to create these solutions, and ensure this transition brings new investment, jobs, innovation, and prosperity not only to our state but to our entire country.

Immigration Reform

The last comprehensive immigration reform package was passed in 1986. Since then, our economy and our world has drastically changed. 21st century immigration reform must reflect our values and our country’s founding and match our economic needs. Of course, we must protect our borders, but we must also remain true to our founding as a nation that welcomes immigrants and refugees. We should provide a pathway to citizenship for Dreamers, as well as those with Temporary Protected Status (TPS) and Deferred Enforced Departure (DED). Iowa and rural America have seen years of population loss. Without immigrants taking these jobs and contributing to our local economies, it would be even harder to live in our rural communities. That’s why we need to modernize our visa system to reduce the backlog, fix the problems like wage theft and abuse in the H2A visa program, ensure a year-round work visa for places like Iowa, and set up a mandatory e-verify system for farm employers nationwide. We also need to create a path to residency and citizenship for people who want to earn those rights. It’s long overdue for modern, humane immigration reform that enhances and grows our economy.

LGBTQ+ Rights

No matter who you are or who you love, you should be treated equally and fairly under the law. In Congress, I would support the Equality Act to extend non-discrimination protections for the LGBTQ+ community across areas of public life, including housing, education, employment, federally funded services, juries, and more.