HEALTH CARE

It’s no surprise health care ranks among the public’s most important policy issues; it's a matter of life and death. It's also an economic anchor and major employer in many communities. The U.S. health care system rings up $4.5 trillion in annual spending.

From Senator Grassley's senior position on the Senate Finance Committee, he works to find policy solutions that will make health care services more accessible and affordable. Congress has responded to grassroots demands by enhancing health insurance portability, curbing practices that denied patients coverage for pre-existing health conditions, creating a Medicare prescription drug benefit and more.  

Rx Costs  

Grassley in 2003 steered through Congress the first-ever comprehensive Medicare prescription drug benefit: Part D. The voluntary public health insurance program for seniors and individuals with disabilities had 57 million enrollees as of October 2024. Grassley consistently seeks to ensure Part D is delivering for those patients.

When an Iowan wrote Grassley asking why the price of insulin was so high, Grassley set out to find the cause. What started with a single letter from a constituent became a bipartisan, multi-year investigation into insulin prices that continues to inform regulatory and legislative proposals. Specifically, Grassley’s findings exposed a link between powerful middlemen called pharmacy benefit managers (PBMs) and the sticker shock plaguing patients. PBMs exist to negotiate lower prices, but in reality, they’re engaging in opaque practices that pad their own pockets at the expense of patients and independent drug stores. Grassley has since made PBMs a household name in his efforts to bring more sunshine to their operations. He’s led the charge by commissioning subsequent inquiries into consolidation (only three PBMs control 80 percent of the market) and introducing several bills to increase accountability. 

Rural Hospitals 

Representing Iowa in the U.S. Senate allows Grassley to wear his advocacy for Rural America on his sleeve. He has long championed policy fixes to keep hometown hospitals and rural clinics open, with qualified professionals on the payroll to provide care for local residents. Grassley successfully established a new hospital designation as a lifeline for rural inpatient facilities facing closure.  

Grassley additionally overhauled the Medicare formula used to reimburse physicians and other health care professionals in rural areas. Throughout the legislative drafting process, he emphasized fairness to rural residents, as Medicare formulas are essential to keeping health care close to home. He cosponsored a bill, now law, to reverse the 21-percent payment cut that jeopardized physician service availability to Medicare beneficiaries.

Patient Safety

Our nation’s sprawling health care system needs oversight to keep tabs on care quality. Grassley in 2005 launched an investigation into the organ donation system: he uncovered story after story about patients who needlessly lost their lives due to negligence and abuse in the Organ Procurement and Transplantation Network (OPTN). Based on his years of inquiries, Grassley in 2023 proposed and successfully passed into law bipartisan reforms to the broken organ transplant system. Grassley’s Securing the U.S. OPTN Act brought the first-ever changes to the organ transplant system, after 40 years of the failing status quo.  

The same year, Grassley received reports multiple female patients had suffered sexual assault by a provider at an Iowa hospital. The facility in question, along with several others Grassley inspected nationwide, were operated by private equity-backed hospital companies and experiencing alarming downgrades in patient care. Grassley teamed up with Senator Sheldon Whitehouse (D-R.I.) to review whether these private equity ownership structures had enabled abuse, along with lapses in care and resource shortages. Grassley is pursuing this bipartisan investigation to ensure all patients receive the care they deserve. He previously pursued similar oversight of physician-owned hospitals and private equity ownership in nursing homes.

His decade-long, bipartisan quest to add medical device identifiers on Medicare claims forms is in the home stretch. This simple disclosure would save lives and lower costs – a goal consistent with Grassley’s work to root out Medicare and Medicaid fraud so patients get the most bang for their buck. The Right Rebate Act is one fraud-fighting law Grassley authored to close a Medicaid loophole he revealed EpiPen manufacturer Mylan had exploited to the tune of billions. After all, transparency brings accountability. In that very spirit, Grassley pressed the Food and Drug Administration to strengthen its drug safety surveillance system.?He also fought for labeling standards to better equip consumers with knowledge of risks associated with anti-depressant medications prescribed to youth and pushed for nursing home audits to monitor overuse of psychotropic drugs on residents in their care.

Youth Care

After a seven-year Grassley campaign, the bipartisan Family Opportunity Act made it to the president’s desk. The 2006 law encourages parents to get ahead without sacrificing health coverage for their children with special needs. Grassley is partnering with bipartisan colleagues to build upon his Advancing Care for Exceptional Kids Act, helping families secure life-saving care for their kids with complex conditions when the medical solution is out-of-state. Learn more about Grassley’s pro-family priorities.  

Looking Ahead 

Grassley’s policies aim to help Iowans afford coverage; expand access to care, especially in rural areas; promote wellness, preventive care and disease management; consider the financial impact on employers, small businesses and taxpayers; and empower Americans to be conscientious stakeholders in our health care system.