Rep. Mariannette Miller-Meeks cast votes to gut healthcare and support tariffs

In her first 2026 re-election ad, Iowa Republican Rep. Mariannette Miller-Meeks presents herself as “the doctor in the House” who fights for constituents “against big insurance companies that are ripping us off.” But she voted with her party’s leadership on almost every issue, resulting in higher healthcare costs and increased prices for Iowans.

Miller-Meeks, an ophthalmologist, was first elected to Congress in 2020. In her first year in Washington, D.C., she voted with her party about 91% of the time, according to data collected by the legislative tracking site CQ. Now in her third term, her party loyalty score has increased to about 96%.

“I am Mariannette Miller-Meeks and I am running for re-election to Congress because the people of Iowa deserve someone who will never quit fighting for them, their future and the future of their American dream,” she says on her reelection campaign website. Visitors to the page are invited to join Miller-Meeks at campaign events “as she fights for lower healthcare costs, lower taxes, and common sense.”

In the current term, however, Miller-Meeks has cast votes on legislation that reduced Iowans’ access to healthcare and drove up the prices they pay for staples like groceries and gasoline.

She voted with House Republicans to pass the One Big Beautiful Bill Act, the 2025 budget bill that contained about $1 trillion in cuts to federal health spending over a decade. In addition to the cuts to healthcare, the bill provided huge tax breaks to millionaires and billionaires. The legislation passed without a single Democratic vote.

“This bill strengthens and preserves Medicaid for those it was intended to serve: children, pregnant women, seniors, veterans, and people with disabilities. It also delivers $50 billion in new relief for rural hospitals serving communities like ours,” she said in a July 3, 2025, press release. “This is a once-in-a-generation victory for the American people. I was proud to vote for it and look forward to President Trump signing it into law just in time for Independence Day.”

The cuts to Medicaid have already prompted some Iowa healthcare providers to close clinics or scale back services offered and have imperiled hospitals across the state. A March analysis by Public Citizen estimated that 446 hospitals could close due to Medicaid cuts, including three in Iowa. According to an estimate by the nonpartisan research organization KFF, 68,000 Iowans currently enrolled in Medicaid will be left without health insurance by 2034.

On December 31, after Congress failed to take action, federal subsidies that had helped 22 million Americans pay for health insurance on the Affordable Care Act marketplace expired, causing sharp increases in insurance premiums. With the subsidies no longer available, more than 120,000 Iowans saw their monthly insurance premiums go up by an average of 95%, according to a Daily Iowan analysis of KFF data.

On Jan. 8, Miller-Meeks voted against bipartisan legislation to extend that subsidy.

“The Democrat solution is to continue writing taxpayer-funded blank checks to large insurance companies,” she told reporters in December. “It hides the fact that premiums are going up by shifting who pays for those increase in premiums, rather than getting to the root cause of actually lowering healthcare costs.”  

KFF estimates that between the ACA subsidy expiration and the Medicaid cuts, about 110,000 more Iowans will become uninsured by 2034.

In addition to rising premiums, President Donald Trump’s administration has imposed tariffs that have raised the cost of goods, and gas prices have skyrocketed as Trump’s war in Iran continues.

Trump imposed tariffs without congressional approval, citing emergency powers included in the International Emergency Economic Powers Act shortly after his January 2025 inauguration. The tariffs applied to goods and services imported into the United States, including a 10% tariff on items imported from nearly every country and higher tariffs on goods from select countries. The Supreme Court ruled in February 2026 that the president did not have the power to unilaterally impose tariffs under the IEEPA and that the tariffs were illegal. The president responded with new tariffs, citing different legal authority; those now face a separate legal challenge. 

An analysis by the nonpartisan Tax Foundation published in May found that the tariffs amounted to a tax increase of about $1,000 for the average American household in 2025 and are estimated to cost families another $700 in 2026.

Miller-Meeks voted three separate times in favor of temporary rule changes to block the House of Representatives from considering any proposals to terminate the national emergencies that Trump had declared to justify his tariffs.

She then voted in February against a resolution that would have ended the national emergency Trump declared to impose tariffs on goods imported from Canada. The measure passed the U.S. House of Representatives 219-211 and awaits consideration in the U.S. Senate.

“I remain ready to work with anyone on either side of the aisle to deliver lasting trade wins for Iowa,” Miller-Meeks told Iowa Public Radio in a statement. “But I won’t play along with the Democrats political stunts, which seek to undermine our negotiating strength as a nation and our president.”

Following U.S. and Israeli military attacks on Iran, Iran blocked ships from traveling through the Strait of Hormuz, a major shipping passage for the United States’ oil and natural gas imports. The closure reduced and drove up prices for America’s supply of the natural gas and oil Iowans use to fuel cars and farm equipment, leading to soaring diesel and fertilizer prices for farmers.

Since the attacks against Iran were launched on Feb. 28, Iowans have seen their average gasoline prices jump from $2.635 for a gallon of regular unleaded gasoline to $4.077 on May 28, according to AAA data, a nearly 55% increase. 

Miller-Meeks voted in March and April against proposals to remove the U.S. military from hostilities with Iran. 

“Iran was perilously close to a nuclear weapon,” she told KWQC 6 in Davenport in April. “And the United States and every other country has said Iran cannot have a nuclear weapon. So we’re making sure that Iran does not have a nuclear weapon.”

Miller-Meeks’ campaign did not immediately respond to a request for comment for this story.