(Radio Iowa) – Health care providers who met with Rob Sand, a Democrat who’s running for governor, are raising concerns about the private companies that manage Iowa’s Medicaid system and the shortage of rural doctors. Dr. Abby Flannagan, a 33-year-old O-B-G-Y-N at UnityPoint Health in Grinnell, says without incentives to practice in rural Iowa, it won’t just be a shortage — there won’t be physicians delivering babies outside of urban areas. “And sadly, I think, in my lifetime,” Flannagan said, “which is terrifying ’cause it’s always something you think is never going to happen while you’re around, but I do think unfortunately in the next couple of decades we’re going to see that.”

Flannagan says UnityPoint in Grinnel is already the only hospital delivering babies between Waterloo and Pella and Des Moines and Iowa City. During a forum in Newton yesterday (Wednesday), Flannagan told Sand there need to be dramatically more residencies in Iowa for med school graduates and the state’s current student loan forgiveness programs are too limited. Sand held the listening session in Newton, where the city’s hospital closed its labor and deliver unit in 2024. “I think at the end of the day, the vast majority of Iowans want someone there to deliver their babies,” Sand said. “…I think it’s important we not just talk about being a welcoming Iowa, but just quit with the culture war and just be focused on solving real problems for people.”

Others who participated in the round table raised concerns about regulations they fear may penalize hospitals and doctors that deliver higher percentages of cesarean deliveries. The former president of Mercy Clinics in Des Moines told Sand hospitals, doctors and clinics are still waiting too long to get reimbursed for providing care to Iowa Medicaid patients — and have to consider whether it would cost more to sue or pay the interest on a line of credit from a bank while they wait to get paid by the managed care companies the state hired to handle transactions.