Dear Senators Grassley and Ernst,

I am writing to you not only as a constituent of Iowa but as a survivor of decades of struggle—struggles that many in our state quietly endure every day. I am also sharing this letter publicly because too many voices like mine go unheard in the legislative halls where our lives are debated and often dismissed.

I moved to Iowa when I was 19. At the time, access to health insurance without employment was nearly impossible unless you were a parent or pregnant. I had none of those qualifications—just a mounting storm of mental health conditions, including PTSD, PMDD, manic depression, and EID. Diagnoses I would only come to understand much later, because there was no path to care.

For years, I was adrift. I lived in shelters, cars, warehouses, and on couches. Not by choice, but because I couldn’t hold a job long enough to qualify for stability. I spent 20 years without a place to call home, punished over and over by a system that made no room for people like me.

It wasn’t until the Affordable Care Act (Obamacare) passed that I was finally able to access the healthcare I desperately needed. With Medicaid coverage, I was properly diagnosed, treated, and able to apply for SSI—support I should have had since I was 19, but wasn’t able to reach until I was 40. I am 50 now. That means I spent over half my life suffering without help.

Today, I live in a tiny tiny home on a patch of land, still battling stigma, housing insecurity, and a system that too often devalues women and the mentally ill. And now I live in fear again—because this administration’s policies threaten to take away my Medicaid.

If I lose Medicaid, I lose my SSI. I lose access to my medication. And I lose the safety net that keeps me alive.

And I am not alone.

According to the Kaiser Family Foundation, over 149,000 Iowans have already been disenrolled from Medicaid as of May 2024 due to the unwinding of pandemic-era protections. Many are being kicked off for paperwork issues—not because they’re ineligible. These are people—children, the elderly, the disabled, the working poor—who now face a terrifying choice between suffering or survival.

This is not an abstract policy issue. Research shows that Medicaid expansion under the ACA prevented approximately 1,818 suicides from 2014 to 2017. Suicide rates dropped significantly in states that expanded access to care. The data is clear: people die when they lose health coverage. Suicide, mental health crises, untreated trauma, and violence are not theoretical—they are the predictable outcomes of denying people care.

You may not see the direct consequences today. But they are coming. Suicides will rise. People with mental illness who lose care will be pushed into crisis. They will break down in public. And when someone in the crowd doesn’t understand what’s happening, they might react with violence. Innocent people will be harmed. Blood will be on someone’s hands. Please don’t let it be yours.

This is not partisan. This is about life and death. Healthcare access is not a handout—it is a human right. You have the power to help ensure that people like me do not fall through the cracks again.

Please do not support cuts to Medicaid. Please stand up for the Iowans whose lives depend on it.

Show us we are not invisible to you. We exist. We matter. We vote.

Sincerely,
Judy T.
Head Guerilla
judy@rescueourdemocracy.com

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Sources and Supporting Research:

1. Medicaid Expansion Associated with Reduced Suicide Rates (Health Affairs, 2020)
   https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00413
2. Global Economic Crisis and Suicide Trends (The Lancet Psychiatry, 2015)
   https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(14)00118-7/fulltext
3. Mental Health Care Matters (National Alliance on Mental Illness)
   https://www.nami.org/About-Mental-Illness/Treatment/Mental-Health-Care-Matters
4. Medicaid Enrollment and Unwinding Tracker – Iowa (Kaiser Family Foundation)
   https://www.kff.org/medicaid/issue-brief/medicaid-enrollment-and-unwinding-tracker/