Lahn pushes privatized Medicaid, defends attack ad, and calls for school choice expansion at Iowa fair

By John Damon | Just The News Iowa

BRITT — Republican gubernatorial candidate Zach Lahn made his case for continuing privatized Medicaid in Iowa, defended a controversial campaign ad, and outlined plans to expand school choice and local food in schools during a stop at the Hancock County Fair on Saturday.

Lahn, who is challenging Democratic nominee Rob Sand in the race for governor, said delivering healthcare through the private sector with government oversight is a bipartisan approach already used by 42 states, including many Democratic ones.

“I don’t think the government would do a good job of delivering healthcare for the people of Iowa,” Lahn said. “I think that the private sector can do a great job delivering this, but the government has to hold them accountable. We have to make sure we’re getting the right care, proper payment, and also I will not allow any of these companies to use AI in denying coverage from people.”

Lahn’s comments come as he defends the continuation of Governor Kim Reynolds’ healthcare policies, which shifted Medicaid to managed care organizations. Critics, including Sand’s campaign, argue the system has led to worse care and higher costs.

Emma O’Brien, a communications staffer for Sand, said Lahn wants to continue “failed health care policies.”

“Zach Lahn has spent his career as a political operative trying to kick people off their health insurance,” O’Brien said. “Now, he’s promising to continue Iowa’s failed privatized Medicaid system, spearheaded under Gov. Reynolds, which has led to worse care and higher costs for Iowans.”

Lahn defends attack ad that Sand called ‘dishonest’

During a town hall in Fort Dodge on Monday, Sand railed against an attack ad paid for by the Lahn campaign. The advertisement featured edited clips from KCCI broadcasts in which anchors say the “auditor’s office took no action” when millions of dollars in state funds went missing.

“The only thing that he ran for six weeks after the general election was an attack on me and my record that was so fundamentally dishonest that the TV station, when they saw their anchor’s words being taken out of context, actually made a news story about the television ad to tell people how dishonest it was,” Sand said.

In 2024, $53 million in court debt payments were misallocated due to a computer error in Iowa’s judicial payment systems. Republican lawmakers criticized Sand, who also serves as state auditor, for failing to alert lawmakers or intervene. Sand said in December 2024 that his office had been in contact with officials from the state judicial branch and Department of Transportation multiple times after being notified of the issue in October 2022, and that the office remained in contact with the judicial branch in conducting investigations. He also said the auditor’s office did not have staff equipped to investigate computer errors.

Lahn argued Saturday that the ad is not dishonest and that Sand had the authority to step in.

“They’re not false. He is not doing his job,” Lahn said. “In 2025, his office had the statutory authority to get involved in that, and they didn’t do it. Once they miss their audit, he is statutorily allowed to get involved into that, and at the very least, provide help.”

Lahn calls for expanding ESA program for private schools

Lahn spoke with voters at the fair who told him education is a top concern. He said he wants to expand the Education Savings Account (ESA) program, which provides taxpayer funds for private school expenses regardless of family income, while simultaneously improving public schools. He argued that market-based competition will make both better.

“My job as governor is to make sure we have the number one public schools in the country,” Lahn said. “I just had a superintendent at one of my stops today say to me he wants competition. He welcomes competition. He just needs to be unburdened to compete, and so my job is to find these superintendents who want to compete with innovative models and cut out the red tape, give them innovation waivers and a budget to do it, so they know we’re behind them.”

Lahn advocates for local foods in schools

Lahn also said he spoke with U.S. Secretary of Agriculture Brooke Rollins about wanting to put more locally sourced food in Iowa public schools.

“One of my biggest initiatives is how do we get more food served in public schools that is grown in the state of Iowa,” Lahn said. “We need to create a new market for small farmers because a lot of this food that’s being served in public schools is already under a USDA food subsidized program, but only the big guys can get in it.”

Lahn optimistic about potential in blue counties

Lahn expressed optimism about his chances in Democratic-leaning Iowa counties such as Polk and Johnson, where he performed well in the primary election.

“I think if you look at where we overperformed the most in the primary, it was Polk County,” Lahn said. “We had a lot of support, and we also had a lot of young people and a lot of non-primary voters come out to support us because we have a message that’s very different, very Iowa-centric. We want to make Iowa the healthiest place to raise a family, tackle the cancer crisis, clean up our water. These are things that Polk County, Johnson County care about.”

Lahn’s campaign continues to focus on conservative principles of limited government, market-based solutions, and local control as he seeks to unseat Sand in November.

Frequently asked questions

What is privatized Medicaid in Iowa?

Privatized Medicaid in Iowa uses managed care organizations (MCOs) to deliver healthcare services to enrollees, with state oversight. Governor Kim Reynolds implemented the system, and Lahn supports continuing it, arguing the private sector is more efficient than government-run healthcare.

Why did Sand criticize Lahn’s attack ad?

Sand said the ad took KCCI news anchors’ words out of context regarding the $53 million misallocation of court debt payments. Lahn maintains the ad is accurate and that Sand had statutory authority to act but did not.

What is the Education Savings Account program in Iowa?

The ESA program provides taxpayer-funded accounts that families can use for private school tuition and other educational expenses, regardless of income. Lahn wants to expand the program, arguing competition will improve both private and public schools.