Posted by JT Santana | Davenport, Iowa | May 21, 2025*

Representative Miller-Meeks;

Let us not pretend there is any confusion here. You lied.

You looked the people of this district in the eyes—veterans, seniors, parents, students, farmers, small business owners, and those of us barely hanging on—and promised that you would not gut Medicaid. You said you were committed to protecting it. Strengthening it. You ran on it. You won votes with it. And then, once in office, you cast one of the deciding votes to cut more than $700 billion from the very program you vowed to protect.

That is not a broken promise. That is fraud. Legislative fraud wrapped in medical betrayal.

You are a physician. You know what happens when access to healthcare is removed from low-income, disabled, and rural communities. You know it means higher rates of death from preventable conditions. You know it means untreated maternal complications, children without primary care, diabetics without insulin, and seniors rationing heart medication. You know what happens to rural hospitals when Medicaid reimbursements disappear. And yet you voted to make it all worse.

Your constituents now face the closure of hospitals they rely on, the elimination of care they were told was protected, and the outright loss of life-sustaining services. Genesis Medical Center, Jefferson County Health, Henry County Health—these are not statistics. They are the lifelines of this district. Lifelines you chose to sever with the flick of a pen and the cold indifference of someone more concerned with Washington favor than Iowa survival.

Your actions will leave blood on the floor and silence in the wards. This is not hyperbole. This is consequence.

You cast this vote with full awareness of what it would do. You cannot claim ignorance. You cannot claim misinterpretation. And you certainly cannot claim to still represent the best interests of Iowa’s 1st District.

Let me be clear: I am one of your constituents. I live in this district. I have seen what happens when healthcare systems fail, when medications are unaffordable, and when hospital beds vanish overnight. I have also seen how politicians like you will say anything to get elected and then hide behind pre-packaged soundbites once the damage begins.

Your vote was not conservative. It was cruel.

Your rationale was not economic. It was cowardly.

You will not be forgiven for this betrayal. Not by the nurses who lose their jobs. Not by the mothers forced to give birth an hour from home. Not by the elders who will die waiting. And certainly not by those of us who believed—for a brief, foolish moment—that you meant what you said.

You owe this district more than an apology. You owe us the truth. Admit what you did. Admit that you campaigned on a lie. Admit that you prioritized political expediency over public health. And admit that the consequences of your vote are not theoretical—they are human.

People in your district will die because of what you did.

History will remember you not as a healer, but as someone who used her white coat and title to push policies that dismantled the very systems you swore to protect.

I will do everything in my power to make sure your constituents remember that, too.

With fury, disappointment, and righteous accountability,
JT Santana
Davenport, Iowa

*This is the first time I have posted a letter to an elected official of our Nation publicly. However, in this case the poem by Niemoller speaks. . .First they came for the socialists, and I did not speak out—

     Because I was not a socialist.

Then they came for the trade unionists, and I did not speak out—
     Because I was not a trade unionist. . .

I know how the rest of the poem goes – – – but now she adds a stanza as do I. . .

And now they come for the poor, disabled, and elderly.

So I am speaking out and speaking loudly!