Playbook for America

As a doctor, a veteran, and the proud representative of Iowa's First Congressional District, I've spent three terms in Congress fighting to deliver conservative, common-sense solutions that put people over politics. Whether it's cutting taxes, securing the border, strengthening our military, or lowering health care costs, I've worked every single day to honor the trust Iowans placed in me. That's exactly what my five-pillar Playbook for America delivers: putting Iowa first, lowering costs for working families, expanding access to affordable health care, backing law enforcement while rooting out fraud, and restoring trust in government.

Here's what I believe: Iowa doesn't need Washington to tell it how to live. Iowa needs Washington to get out of the way, cut the waste, lower the costs, and let hardworking families keep more of what they earn. Iowans feed and fuel this country. They raise their families on faith and hard work. They don't ask for handouts. They ask for a fair shot and a government that respects their sacrifice. But this isn't a victory lap. For every promise kept, there's more work to be done. That's why each pillar lays out not only what we've delivered for Iowa, but the fights still ahead, because the day we stop fighting is the day Washington stops working for the people. Iowa first, and the best is yet to come.

Pillar 1: Iowa First. Always. 

Everything I do in Washington starts with a single question: is it good for Iowa? Our state is the backbone of this country, and Iowans deserve a representative who fights for them first, last, and always. From securing our border to backing our farmers to taking on the cancer epidemic striking too many Iowa families, this pillar is about putting the people of Iowa ahead of the politics of Washington.

Putting Iowa First

Delivered for Iowa

• Secured the border and deported criminal illegal aliens. I voted to fully fund border security, detain and deport criminal illegal aliens, and end the magnet of taxpayer-funded benefits, because Iowa jobs and Iowa paychecks belong to Americans. I championed Sarah's Law, named for Iowan Sarah Root, killed by an illegal immigrant the day after her college graduation, so no Iowa family suffers a preventable tragedy like hers again.
• Brought federal dollars home to southeast Iowa. $27 million this year alone, and $87.1 million since I took office, for the things our towns actually need: fixing roads and bridges, modernizing water systems, reopening the Keokuk hospital, and backing local law enforcement. Counting the Army Corps Upper Mississippi project, that number climbs past $132 million, Iowa's own tax dollars coming back home to the communities that need them.
• Backed Iowa farmers against a broken fertilizer market. A handful of corporations control up to 90% of fertilizer production, and Iowa farmers have been paying the price. I led the fight to cut the taxes on imported fertilizer that were driving up input costs, helping deliver a 22% cut in phosphate prices for more than 100,000 American farms, and I'm forcing transparency into a market rigged against the family farm.
• Kept boys out of girls' sports and stopped taxpayer-funded sex change surgeries. Iowa's daughters deserve a fair shot and their own private spaces, and hardworking taxpayers shouldn't be forced to bankroll radical gender ideology. I voted to keep men out of women's sports and locker rooms and to end taxpayer-funded sex change surgeries, protecting both our girls and the paychecks of the Iowans footing the bill.
• Showed up for Iowans who needed help. My office has answered more than 100,000 emails, letters, and calls, and gone to bat for over 2,700 Iowans stuck fighting a federal agency, returning more than $6 million to the people it belonged to. I'll keep traveling all 20 counties and meeting Iowans face to face, because this job is about serving people, not Washington.

Still Fighting For

• Protecting Social Security and Medicare for Iowa seniors. Seniors live on fixed incomes, and every dollar matters for groceries, prescriptions, and staying in their own homes. I will never stop fighting to preserve the benefits they paid into over a lifetime of hard work, and to root out the waste and fraud that threaten those programs' future.
• Defeating the cancer epidemic hitting Iowa families. Iowa has one of the highest and fastest-rising cancer rates in the nation. I'm leading the charge on early detection and building a statewide cancer network so Iowans can get world-class cancer care without leaving home.
• Keeping jobs in Iowa. I'm fighting for the pro-growth policies that keep good-paying jobs here at home, standing up for Iowa workers, and supporting the American manufacturing our communities depend on.

Pillar 2: Lower Costs for Working Families

For four years, Iowa families watched the cost of everything climb while their paychecks struggled to keep up. Groceries, gas, housing, and utilities all became harder to afford. I came to Washington to reverse that, and we've delivered real, tangible relief that Iowa families can feel in their budgets. This pillar is about one thing: making life more affordable for the people who work hard and play by the rules.

Taking Action to Make America Affordable Again

Delivered for Iowa

• Passed the largest tax cuts in American history. For years, Iowa families watched Washington take a bigger and bigger bite while their paychecks bought less and less. The Working Families Tax Cuts flipped that, boosting take-home pay and putting money back where it belongs, in the pockets of the people who earned it. This wasn't relief for the well-connected. It was relief for the waitress, the welder, and the young family trying to get ahead.
• Eliminated taxes on Social Security for about 90% of seniors. After a lifetime of hard work, no Iowa senior should have to choose between their prescriptions and their groceries. Through a new $6,000 deduction, and up to $12,000 for married couples, Iowa retirees on fixed incomes keep more of what they already earned, money that goes straight to the kitchen table, the pharmacy counter, and staying in the homes they've lived in for decades.
• No tax on tips. The people who refill your coffee and clear your table work some of the hardest jobs in Iowa, often for modest wages that depend on the generosity of others. Now they keep more of every tip they earn, up to $25,000 deductible. For Iowa restaurant workers alone, that's roughly $59 million staying in their pockets in the first year, money that used to disappear to Washington now going toward rent, gas, and groceries.
• No tax on overtime. When a nurse picks up a double, or a factory worker stays late, or a trucker logs the extra miles, that overtime is time away from family, and they've earned every dollar of it. Now they keep an average of $3,100 more a year. That's a car payment. That's a kid's braces. That's a family breathing a little easier at the end of the month.
• Doubled the Child Tax Credit to $2,200 per child. Raising kids in this economy is expensive, and Iowa parents feel it every trip to the grocery store. This doubled credit is helping nearly 40 million families, including thousands across Iowa, cover the diapers, the shoes, the school supplies, and everything else that comes with raising the next generation.
• Stopped Wall Street from buying up Iowa neighborhoods. For too long, hedge funds and out-of-state investment firms have been outbidding Iowa families for the very homes they wanted to raise their kids in, paying cash, sight unseen, and driving prices out of reach. My housing law, the most significant in a generation, bans it. It also cuts the red tape that makes homes expensive to build and lowers the cost of buying or renting. Iowa homes belong to Iowa families, not Wall Street.
• Lowered prices at the pump with year-round E15. Every time gas prices climb, it hits Iowa families twice, once at the pump and once at the kitchen table. Year-round E15 means cheaper fuel for Iowa drivers and a stronger market for the corn growers and ethanol producers whose livelihoods power our rural economy.

Still Fighting For

• Lowering everyday costs. Groceries still cost too much. Energy still costs too much. Iowa families are still stretching every paycheck to cover the basics, and I won't be satisfied until the cost of living reflects the hard work Iowans put in. The fight to make life affordable again isn't finished.
• Protecting Iowa farmers from a rigged fertilizer market. When a handful of companies control the market, farmers pay whatever they're told. I'm keeping the pressure on until competition returns and input costs come down for good.

Pillar 3: Affordable and Accessible Health Care

I spent decades as a physician before I ever ran for office, caring for patients, running a practice, and seeing firsthand how a broken health care system fails the people who need it most. Rural Iowans shouldn't have to drive hours for care, seniors shouldn't be buried in costs, and no patient should be blindsided by a bill they never saw coming. And taxpayer-funded health care should go to the Americans it was built for, not to those who broke our laws to get here. This pillar brings a doctor's perspective to Washington and puts patients first.

Making America Healthy Again

Delivered for Iowa

• Ended taxpayer-funded health care for illegal aliens. Medicaid was created as a safety net for Americans in need, the senior in the nursing home, the child with a disability, the family that hit hard times. When people who broke our laws to get here draw down those same dollars, it's the most vulnerable Iowans who get squeezed. I voted to stop it, protecting the program for the people it was actually built to serve.
• One blood test that can catch dozens of cancers early. As a physician, I know the truth about cancer: caught early, it's often beatable, and caught late, the odds get much harder. I wrote the law, now signed, opening the door for Medicare to cover breakthrough blood tests that detect dozens of cancers at their earliest, most treatable stage. In a state with rising cancer rates, earlier detection means more Iowans get the chance to beat it.
• Delivered the largest investment in rural health care in American history. For families in small-town Iowa, having a hospital nearby can be the difference between life and death, the ER minutes away instead of an hour, a cancer diagnosis met with care right in the community, a loved one treated close to home instead of hours away. I led the effort to pass $50 billion to strengthen rural health care nationwide, and Iowa led the country, becoming the first state to put its money to work. $209 million is already flowing in the program's first year alone to keep care close to home, expand cancer treatment, and train the next generation of Iowa doctors.
• One of only 12 Republicans to cap insulin at $35. As a physician, I know insulin isn't optional. In 2022, I was one of only 12 House Republicans to cross party lines and vote to cap insulin at $35 a month for Americans on Medicare. I fought for seniors who depend on this life saving medicine, and I’m not done fighting.
• Funded early detection to catch breast cancer sooner. Too many young women are told they're "too young" to worry about breast cancer, right up until the day they're diagnosed, often later and with a more aggressive disease. As a doctor, I know early detection saves lives. That's why I led the EARLY Act, which the House passed 394-6 to fund the education and screening that gives these women a fighting chance.
• Got sick Iowa kids to specialists faster. When your child has a rare or complex condition, waiting months for a Medicaid approval to see an out-of-state specialist isn't just frustrating, it's frightening. I led the law that cuts that wait, so an Iowa family in crisis can get their child to the doctor who can help. 
• Restored commonsense work requirements. There is dignity in work, and there's nothing compassionate about a system that expects nothing of able-bodied adults while the truly vulnerable wait for care. Now, able-bodied adults are asked to work, train, volunteer, or go to school just 20-hours a week, the same expectation nearly every other benefit program has had for years. Seniors, children, pregnant women, Iowans with disabilities, veterans, and caregivers are fully exempt and fully protected, which is exactly how you keep Medicaid strong for the people who truly need it.

Still Fighting For

• Cutting health insurance premiums by at least 11%. Iowa families are being crushed by premiums that climb every year while the coverage gets worse. I wrote the bill to lower premiums for every American, whether you get insurance through work or buy it on your own. The House passed it. It's sitting in the Senate, and Iowans can't afford to keep waiting.
• Taking on the drug middlemen. When an Iowa family can't afford their prescription, there's a good chance a middleman marked it up along the way. Pharmacy benefit managers profit in the shadows by driving up drug prices, and I'm fighting to drag them into the light, force real competition, and make sure the savings reach patients instead of getting pocketed.
• Making $35 insulin available to more Americans. Too many Americans with private insurance are still forced to choose between paying their bills and paying for lifesaving insulin. That’s why I’m leading the bipartisan INSULIN Act of 2026 to cap out-of-pocket insulin costs at $35 a month for Americans with private insurance, with no deductible. I fought for this protection for Medicare seniors. Now I’m fighting to extend it to everyone who needs it.
• Putting prices on the wall. No Iowan should get a medical procedure without knowing what it costs, then get blindsided by the bill weeks later. Hospitals bury their prices in online files nobody can find. My bill requires hospitals, labs, and imaging centers to post their prices in plain sight, so patients can see the cost before they ever get the care.
• Stopping opioid addiction before it starts. So many opioid tragedies begin with a routine prescription after surgery. As a physician, I've seen where that road can lead. My bipartisan bill, backed by more than 100 members of both parties, expands access to non-opioid pain treatment so seniors and families have a safer choice, and fewer Iowans ever start down that path.
• Rooting out Medicaid fraud. Every dollar a fraudster steals is a dollar that isn't there for an Iowa senior in a nursing home or a child with a disability. I wrote legislation to catch the fraud and protect the vulnerable Iowans this program exists to serve.

Pillar 4: Back Law Enforcement and Eliminate Government Fraud

Safe communities are the foundation of everything else. Iowa families deserve to feel secure in their homes and neighborhoods, and the brave men and women who wear the badge deserve our unwavering support, not the demonization pushed by the radical left. At the same time, every tax dollar lost to fraud is a dollar stolen from the hardworking Iowans who earned it. This pillar backs the blue and holds fraudsters accountable.

Backing the Blue & Holding Criminals Accountable

Delivered for Iowa

• Stood with our officers when it counted. Every day, Iowa's police officers kiss their families goodbye and run toward danger the rest of us run from. I proudly voted to honor them during National Police Week and to condemn the reckless "defund the police" movement that put targets on their backs. 173 House Democrats voted no. During Police Week. That tells you everything you need to know about whose side they're on.
• A raise for every officer working overtime. The officer working a double on a holiday, missing dinner with his kids to keep your family safe, has earned every dollar of that overtime. No Tax on Overtime lets him keep an average of $3,100 more a year. That's why the Fraternal Order of Police, representing over 300,000 officers, stood up and endorsed it.
• More trained officers on the street. Departments across Iowa are struggling to recruit, and thin blue lines make everyone less safe. I backed a $750 million investment to recruit, train, and equip the next generation of law enforcement, so the officer who answers your 911 call is ready when it counts.
• Went after the buyers who fuel human trafficking. Behind every trafficking victim is a monster willing to pay, and for too long the demand side got a pass. I backed the law giving police the tools to go after the buyers who drive this evil trade and to protect the vulnerable, often children, from exploitation.
• Dragged $162 billion in wasted spending into the sunlight. Washington lost $162 billion on projects that ran over budget or years behind schedule, and no one was required to tell the American people who footed the bill. The House passed my Billion Dollar Boondoggle Act to expose every one of those failures. Iowans balance their checkbooks every month. Washington should have to show its work too.

Still Fighting For

• Ending large-scale government fraud. When bad actors loot programs meant for children and families, they're stealing straight from every Iowa taxpayer who plays by the rules. I'm cracking down on the fraudsters and slamming shut the loopholes that let them get away with it.
• Keeping taxpayer benefits for Americans. The safety net Iowans fund with their hard-earned money exists for Americans in need, period. I'm closing every loophole that lets people who broke our laws collect benefits meant for citizens and legal residents.
• Clawing back improper payments. Washington ships out hundreds of billions in payments it can't even verify every year, your money, gone with no accountability. I'm demanding agencies find it, stop it, and answer for every dollar.

Pillar 5: Restore Trust in Government

The American people have lost faith in Washington, and frankly, they have every reason to. Too many politicians treat public office as a path to personal profit while the people they serve get left behind. I believe elected officials should answer to their constituents, not their stock portfolios. This pillar is about restoring the integrity, accountability, and trust that self-government depends on.

Serving Constituents, Not Portfolios

Delivered for Iowa

• Washington should live within its means, just like every Iowa family has to. Every family in Iowa balances a budget. Every small business makes the numbers work. Yet Washington spends with abandon and hands the $40 trillion bill to our kids and grandkids. I voted for a constitutional amendment to force a balanced budget, because our children shouldn't inherit the consequences of Washington's recklessness.
• Zero individual stocks. That's what I own, and my husband too. Iowans are tired of watching politicians walk into Congress and walk out millionaires. I took an oath to serve my constituents, not a stock portfolio. I don't own a single individual stock, and neither does my husband. If you write the laws, you shouldn't cash in on them, which is exactly why I voted to ban congressional stock trading for good.

Still Fighting For

• Finishing the job on the stock trading ban. The House passed it, and not one Republican voted no. Now it's sitting in the Senate while the American people wait for Washington to do the obvious right thing. The Senate needs to send it to the President's desk, no more excuses.
• Extending the ban to the administration. The same rules should apply to Cabinet officials and everyone in the executive branch. No one who shapes federal policy, at any level, should be able to trade on it, and I'm writing the legislation to make sure they can't.
• Stopping members of Congress from betting on their own votes. Lawmakers shouldn't be allowed to wager money on the outcomes of the very votes they cast. It's a conflict of interest so obvious it shouldn't need a law. Apparently, in Washington, it does, and I'm leading the fight to ban it.
• No paychecks during shutdowns. When Washington fails and the government shuts down, members of Congress shouldn't keep collecting a paycheck. Iowans don't get to stop working when their leaders drop the ball, and neither should we.

This is my promise to Iowa: I will never stop fighting to lower your costs, protect your family, back the men and women who keep us safe, and restore a government worthy of your trust. 

Iowa first. Always.