Flip 5 to Take the House & IA-1:
Iowa sent one of its own to Congress — a physician, an Army Lieutenant Colonel with four deployments, the former director of the Iowa Department of Public Health. Mariannette Miller-Meeks had every credential to be a healthcare champion for eastern Iowa. In her years in office, she became a rubber stamp for Donald Trump. Here’s the story of IA-1, why it’s one of our top ranked flip races in the country, and how we’ll be targeting Miller-Meeks as part of our Flip 5 to Take the House campaign. We’ll be running ads in her district and reminding her constituents that when it came to prioritize them and their health or Donald Trump, she chose Trump every time. Help us flip this seat and take back power by supporting our Flip 5 to Take the House campaign now.
“Hospital near you closing? Thank your IA-1 representative, Dr. Miller-Meeks”
Flip the States is making cutting ads that break through. We’re launching ads targeting IA-1 Republican incumbent Mariannette Miller-Meeks so we can flip the House.
Help fund our campaign so we can define Miller-Meeks now.
The Iowa Miller Meeks Left Behind
Iowa’s 1st Congressional District stretches across eastern Iowa — Cedar Rapids, Iowa City, Dubuque, Waterloo, and Ottumwa — a region spanning university towns, manufacturing centers, and some of the nation’s most productive farmland. Miller-Meeks first won her seat in 2020 by just 6 votes out of nearly 400,000 cast — the closest congressional race in the country that year. The district is not a Republican stronghold. It is a place where every single vote matters, where constituent service and constituent trust are the price of admission. Miller-Meeks collected that trust and spent it on Donald Trump.
Healthcare runs through eastern Iowa differently than almost anywhere else. The University of Iowa’s hospitals anchor Iowa City, drawing patients from rural counties that depend on them. Cedar Rapids is a healthcare employment hub. And Medicaid — the program Miller-Meeks spent years publicly pledging to protect — is the lifeline for hundreds of thousands of Iowans across the 1st District. When Miller-Meeks voted for Trump’s One Big Beautiful Bill, she cast a vote that will cut Medicaid from 13,000 of her own constituents and blow a $713 million hole in Iowa’s health budget. Rural hospitals in her district — already operating on razor-thin margins — are looking at what that gap means for their survival.
In fact, $713 million is being cut from Iowa’s Medicaid budget — funding that keeps rural hospitals open and families covered in Miller-Meeks’ own backyard. That is a record that ignores her own constituents. That is a rubber stamp for Trump.
A Doctor Who Votes to Close Hospitals
Miller-Meeks built her entire political identity on her medical credentials. Ophthalmologist. Army Lieutenant Colonel. Four combat deployments. Former Director of the Iowa Department of Public Health. She told her constituents, repeatedly, that as a physician she understood how critical Medicaid was to Iowa’s health system. But if you thought that meant she’d show up for her constituents when it counted, you’d be wrong. She has not. And given this Republican Party, it should not be a surprise.
When constituents in Keosauqua showed up demanding answers — about her Medicaid vote, her tariff votes, her 100% Trump voting record — they did not get a town hall. They followed her to her car. She has held no in-person town halls for the people she represents. When asked, she told reporters she’ll hold town halls “when hell freezes over.” Her constituents know the pattern: Miller-Meeks votes with Trump. The public erupts. Miller-Meeks issues a statement.
Then there’s the farm economy. The Strait of Hormuz is the passage point for a third of the world’s fertilizer supply. The Iran war closed it. Seventy percent of American farmers say they can’t afford what they need to plant for 2026. Iowa is one of the most agriculturally productive states in the nation — and Miller-Meeks has voted with Trump 100% of the time, on the tariffs that inflated input costs and on the Iran policy that closed the strait. The farmers of eastern Iowa are paying for her votes right now, this planting season.
IA-1 is prime to flip, but we’re not taking anything for granted. A district decided by 6 votes is a district that can be won and, importantly, flipped. Medicaid cuts, rural hospital closures, and a farm economy under strain from Trump’s tariffs and foreign policy are exactly the issues that move voters in Cedar Rapids, Iowa City, Dubuque, and Waterloo. We need to be there with the right message at the right time.
Our Flip 5 to Take the House campaign is focused on reminding Miller-Meeks’ constituents that when it came to showing up for them or doing Trump’s bidding, she chose Trump every time — resulting in lost healthcare, rural hospitals under threat, sky-rocketing farm input costs, and a crisis driven by an incoherent tariff and foreign policy. This is why our campaign plans to target her frustrated voters now. Join us in making sure Miller-Meeks’ constituents don’t forget how she betrayed them.
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