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Happy Wednesday and welcome back to Cornhole Champions, where we throw bags at the state’s biggest stories. I’m Zachary Oren Smith. And this week, we’re talking about survival.
Back in May, the CEO of Washington County Hospitals and Clinics wrote a letter to the editor. It’s a letter I keep hearing about. One that I keep thinking about. CEO Todd Patterson wrote the GOP’s “Big, Beautiful Bill” promises “a crisis that threatens our very survival.”
“When Medicaid reimbursements fall short of the cost of care—as they routinely do—we absorb the loss. But we can only do so for so long. Cuts to Medicaid don’t just affect our ability to offer new programs or upgrade equipment; they force decisions about whether we can keep our maternity ward open, retain emergency services, or offer mental health care. These aren’t just services—they are lifelines,” Patterson wrote.
“This isn’t just a rural issue—it’s an American issue. When a town loses its hospital, the ripple effects touch everything from school enrollment to real estate values to business investment. A nation that allows its rural hospitals to wither is a nation that abandons its heartland.”
The fear about what this $344 billion proposed cut will have on our nation’s rural hospitals is visceral. While Senate Republicans have proposed a fund to dull the pain, these cuts could lead to a 19% decline in operating margins, on average, according to an analysis by The Commonwealth Fund. That’s a particularly harmful for rural, Medicaid expansion states—like Iowa—as these hospitals treat a higher share of Medicaid and low-income patients.
Structurally, the challenge of sweeping policy decisions is in understanding how it touches our lives. And maybe that’s the theme for this week.
In this letter, I took a trip to Ottumwa to try and understand why the administration is shuttering a program that even President Donald Trump’s stalwarts will tell you is a massive success.
But first…
Shrink to fit - Iowa's mental health system is getting its biggest overhaul in decades, combining 32 separate districts into just seven starting July 1st. The Quad-City Times reports the Iowa Primary Care Association will oversee all seven new districts, promising better coordination between mental health and substance abuse services. The goal makes sense—more than 25% of adults with serious mental health challenges also struggle with substance abuse. But some providers are sweating the transition, especially with funding questions still hanging in the air. The Eastern Iowa region is already facing a $4 million shortfall in its final year under the old system.
Funding flops - The Trump administration just announced a $10 million study of health effects from the 2023 East Palestine train derailment—an announcement that came from the state’s former US Senator and current Vice President JD Vance. Since the beginning, residents have been wondering if Norfolk Southern would be held accountable for the disaster which has left people with similar reported symptoms as 9/11 first responders. The $10 million sounds great, only the same administration is proposing to cut the National Institute of Health funding by 37% and have already terminated over 1,450 research grants worth $750 million.
Mobile home mayhem - Johnson County tenants are fighting back against their corporate landlord with demands that sound pretty basic: clean drinking water, a two-year rent freeze, and maybe some working streetlights. Havenpark Communities, a Utah-based company, bought up three mobile home parks in 2019 and promptly jacked up rents by more than 60% while letting infrastructure crumble. Residents say they are dealing with manganese-contaminated water. Households with babies have switched to bottled water. They say arsenic levels are 4-10 times EPA standards. And Havenpark raised the rent AGAIN from $375 to over $520. The kicker? Many of these residents own their homes. They just rent the land underneath, making it cost $15,000+ to move elsewhere, since their homes wouldn’t survive the move. The Johnson County supervisors sent Havenpark a formal letter demanding they knock it off, but with Iowa's minimal tenant protections, residents are mostly stuck fighting a company that sees affordable housing as just another investment opportunity to optimize.
And now, the baby and the bathwater…
(Ajai Long studied at the Ottumwa Job Corps. Photo courtesy Ajai Long.)
Ottumwa's Job Corps program, training 240 at-risk youth, faces Trump axe
Despite its success, Ottumwa Job Corps is among the 99 programs the Trump Administration is trying to shut down. The closure would eliminate over 100 jobs in small town Iowa, displacing the 240 at-risk youths served by the program.
When Ajai Long finished high school, she found herself spiraling. Instability at home led her to couch-hop. Couch-hopping left her feeling rootless.
“I knew I didn’t want to go the way I was,” Long said.
She spoke with a friend who told her about a program in Ottumwa. She’d have a place to stay. Food to eat. And in the end, the program promised she’d have the skills to build a career.
Ottumwa Job Corps is one of 99 sites across the country serving over 25,000 vulnerable young adults. The program was created in the ‘60s under President Lydon Johnson as part of the “War on Poverty.” For decades, it has offered free education and vocational training for ages 16 to 24.
Long studied medical office business support and even took college credit as part of the program. But it was also the first time she had access to regular dental checks and treatment for her depression.
“I liked being able to have a safe place to live,” Long said. “I didn’t have to worry about food, about bills. I could just focus on my mental health.”
Despite being funded by Congress into the next fiscal year, President Donald Trump’s Department of Labor announced in May that the program would be paused. Labor Secretary Lori Chavez-DeRemer announced a "phased pause" following release of a report showing troubling performance and financial data.
The program operated at a $140 million deficit in 2024 with projections reaching $213 million in 2025, while serving students at an average annual cost of $80,284 per person. According to the pause announcement, the department calculated that graduates cost taxpayers an average of $155,600 each, yet earn only $16,695 annually after leaving the program. Citing low graduation rates and high cost per student, they terminated the program’s contractors that run each facility. The order gave Job Corps sites less than a month to help students find a new placement. For Ottumwa that was 247 students.
The move was particularly surprising to staff and community members in Ottumwa who often bragged about the facility’s 94% job placement rate. And its $30 million facility that the federal government built in 2011 on land Indian Hills Community College donated.
Ottumwa Mayor Rick Johnson said he’s worried about homelessness among the students and how the 125 jobs lost will impact the community.
“It has a domino effect. It’s an economic driver for our community, but it will be an economic blow not just to the students but also to our community at large,” Johnson said.
Republican state Rep. Hans Wilz of Ottumwa said he was aware of the issues the DOL report revealed about other Job Corps sites. But he said the nation should have looked to Ottumwa for an example of how to do it right, not shut the program down in one fell swoop.
“They are really good kids that made a mistake or came from a tough situation,” Wilz said. “But they were deciding to break the chain of generational poverty. That’s long term savings for the state, for the federal government. That’s the return on investment we’re looking for. I fell in love with the program because it worked.”
US District Judge Andrew L. Carter, Jr. issued temporary restraining orders on June 4, 2025, blocking the closure after finding the administration likely exceeded its statutory authority. Two lawsuits have challenged the pause, with legal arguments centering on separation of powers and administrative law violations.
Governor Kim Reynolds has assembled a four-agency task force to explore alternatives for displaced students. However, no Iowa program replicates Job Corps' comprehensive residential model.
“Everyone comes from different walks of life,” Ajai Long said. “Some are born with the upper hand. Some walk through life and earn that upper hand. Some people just need a breakthrough and Job Corps provides that. It creates a breakthrough. I was an adult, and I needed a place to get to know myself again. To develop my independence, my life skills. Taking this away is taking away that start, that structure, that stability they need.”
Have more information on this story. Email news tips to zach@iowastartingline.com.
Question for you
We've talked a lot about small towns struggling to survive, but what about the people trying to serve them?
Have you ever worked in a profession where you felt like you were fighting the system just to do your job? Whether that's teaching in underfunded schools, policing with limited resources, or providing healthcare in communities that can barely afford it?
I'm curious about the human cost of these policy decisions – the burnout, the impossible choices, and the talented people we lean on until circumstance forces them to give up and move out.
Write me back with your thoughts on what it's like to serve communities that are systematically undervalued by our policies. I might feature your response in next week's edition.
Answer from you
Last week, I asked about things you've wanted to do but haven't because of fear of failure. Your responses hit deep:
Dan from Des Moines: "I've wanted to start a nonprofit helping ex-offenders find housing and jobs. Lost a brother to the cycle of jail, homelessness, repeat. But the thought of failing him again keeps me from trying. What if I can't raise the money? What if nobody cares?"
ZOS: Dan, anyone that knows will tell you that incarceration is only the first part of how we punish. So hearing that you want to do something about the cycle is so important. Maybe starting something new isn’t the move. Maybe there’s a way to put your talents to work with organizations like United Way of Central Iowa and their re-entry program. You’re doing thinking that would make your brother proud. I think your on the way to doing work that would make him proud too.
Tom from Burlington: "Running for city council. I see problems everywhere – crumbling infrastructure, businesses leaving, young people moving away. But I'm a single mom working two jobs. How do I find time to campaign? How do I compete with people who have money and connections?"
ZOS: Local politics asks too much of our time and money. It’s also in those local relationships that real people power can be built. I also believe that now more than ever we need electeds who understand what real life looks like for working families. So two things: 1) Start small. Go to a council meeting. Speak up during public comment or in your local newspaper. Money is important but so too is showing up where you can. 2) Talk to people who’ve done it before. I’m always amazed by how much expertise sits in our communities. Let me know when you announce!
To everyone who wrote in, thanks.
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Cornhole Champions is a weekly podcast powered by Iowa Starting Line with music by Avery Mossman and show art by Desirée Tapia. We are a proud member of the Iowa Writers Collaborative.
Your friendly neighborhood reporter,
Zachary Oren Smith
Political correspondent
Iowa Starting Line
P.S., Pray for the kids. I worry that egging houses is becoming a recessionary indicator.
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