By Casey Jarmes | The News-Review
SIGOURNEY – Iowa Senator Chuck Grassley held a Q&A with healthcare workers at Keokuk County Hospital and Clinics on April 22, leading to tough conversations about the state of the country as it enters the second Trump term.
One attendee, a therapist, stated she was deeply concerned about potential cuts to social security and medicare, noting that a lot of her patients rely on those programs for mental healthcare. Grassley claimed there was nothing to be concerned about regarding medicare, but did note that the House was discussing changes to the budget for medicaid. He stated that both congress and the Iowa Legislature are considering adding work requirements for “able bodied” people.
“If you’re able to work, we shouldn’t discourage people from working,” said the Senator.
“Some of my chronically mentally ill people appear very able bodied, but mentally they are not capable of holding a job. So I have concerns about that as well,” replied the therapist.
The therapist also asked about rumors that the Social Security Administration would begin communicating exclusively through X, formerly known as Twitter, the social media platform owned by billionaire presidential advisor Elon Musk. The White House has denied these rumors. The therapist stated that a lot of older people can’t access social media and stated she was concerned that Musk was still receiving government contracts while working for the White House. Grassley claimed that Musk was just an advisor to the president and can’t make decisions.
“I think he’s a little more than an advisor, in my opinion,” said one attendee.
Grassley claimed there was no possibility of Social Security benefits being cut. An attendee stated that the problem was that Social Security infrastructure was being ruined from the bottom up via mass lay-offs, resulting in the agency not having enough people to function efficiently. In February, an executive order signed by President Donald Trump forced the agency to lay off 7,000 Social Security employees, 12% of its staff. Grassley claimed that Musk was stopping fraud and trying to keep Social Security employees from working from home.
Hospital CEO Matt Ives explained that the clinic is one of only a few independent critical access hospitals in Iowa and is likely the smallest in the state. He brought up hospital networks like UnityPoint Health, saying they had come out of nowhere and were now everywhere. He claimed that corporations like UnityPoint were receiving $120 million in subsidies from Centers for Medicare & Medicaid Services (CMS) and that it made it hard for independent hospitals like his to get by. He said Grassley should look at money going to large corporations when looking for ways to find savings. Grassley stated that UnityPoint doesn’t own hospitals, but has a working relationship with them. Ives stated that they put the cost on hospitals, which inflates medicare costs. Ives claimed these companies were taking advantage of loopholes to have hospitals subsidize them. Grassley stated changing CMS was a double edged sword that could harm critical access hospitals as well.
An attendee asked why they couldn’t stop scams, like constant spam calls or a scam where a company tried to send her mother unneeded braces and have medicare pay for them. Another attendee stated that scammers try to force their providers to sign orders ordering treatment, then call and threaten to sue the clinic when the providers do not. Grassley stated that most prosecution under the False Claims Act used to be at defense contractors, but that most false claim fraud is now healthcare related.
An attendee asked about President Trump’s January 24th firing of more than a dozen inspectors general, the independent watchdogs that work to prevent fraud and waste within government agencies, without the legally required explanation or advanced notice. Several of the fired inspectors general were at the time of the firing actively investigating companies owned by Trump advisor Elon Musk. Following the firings, Grassley, who is the Chairman of the Senate Judiciary Committee, and Senator Dick Durbin wrote to Trump, asking for an explanation. The attendee stated she had written to Grassley about this multiple times and asked for an update.
“He seems to just keep letting people go, and Elon just keeps letting people go, and there’s just generic explanations like ‘they’re not doing their job,’” said the attendee.
Grassley claimed to be a protector of inspectors general and stated they were an important part of checks and balances. He noted that the president is allowed to fire inspectors general, but is required to give congress notice and explanation of why inspectors general are fired.
“This is the first president that’s said he thinks it’s an imposition on his power under the Constitution to be the chief executive,” said Grassley. “Now, if a president doesn’t enforce the law, all we did, it was Durbin and me who wrote that letter, we want to know the reasons for firing those people. They shouldn’t have been fired until 30 days after we got that notice.”
Grassley stated that every president does illegal things, noting that former President Joe Biden had attempted to find other ways to forgive student loan debt after being told his initial avenue for doing so, via the HEROES Act, was unconstitutional. Grassley stated that Trump still hadn’t responded to him.
“If these laws are put in place, then who’s going to make people follow them?” asked the attendee. “There’s an awful lot of things going on that nobody is making these people be accountable.”
Grassley responded by claiming that Biden hadn’t enforced immigration law. Grassley stated that the only thing he could do is impeach the president. Another attendee brought up the bipartisan immigration bill championed by Biden in February of last year, which failed to pass after Trump pressured Republicans to vote against it, according to the attendee, because Trump didn’t want immigration to be fixed during Biden’s term. Grassley noted that Trump wasn’t even the president at the time. Grassley was one of the Republican senators that voted against the bill in 2024. The attendee asked if Grassley was staying on the inspectors general issue. Grassley said he was, but that Biden had ignored 158 letters sent to him during his term and that it was typical for Senators to not receive responses.
An attendee raised concerns about the “dismantling of everything,” stating she knows that government programs are broken and need attention, but not all at once. She stated she never wanted to be political, but has to now for the sake of her grandchildren and their children.
“It’s like just so chaotic, we don’t even know what to be concerned about, or which thing to address first or question…We’re so confused about what to prioritize, and it seems like it’s been intended to be that way,” said the woman. “That we’re supposed to be up in arms about everything and nothing gets done, or nothing gets addressed…We don’t have the checks and balances in place, or we’re not seeing it utilized, and so anybody can do anything. They lose their jobs by the thousands, that’s not the way to operate government, and I know you know that.”
“I think you’ve got to back up on saying the checks and balances aren’t working,” said Grassley. “Every day you read in the paper about the courts saying Trump can do this, or he shouldn’t have done that, or he can do it. The courts are stepping in all the time, and they should.”
Another attendee asked if Grassley thought everything Trump was doing was fine. He stated that “of course” he didn’t, stating he didn’t approve of firing inspectors general or putting tariffs in place, because he believes in free trade. An attendee complained about tariffs changing from day to day, calling it ridiculous.
“Well, it’s ridiculous if it doesn’t work out, but it’s a little early to say whether or not it will work out,” said Grassley.
Grassley was asked if he had ever seen a mess like this before.
“During the last two years of the Nixon administration,” said the senator.
The woman who raised concerns about the dismantling of everything also raised concerns about the volatility Trump’s tariffs are bringing, their effect on the stock market and on the U.S.’s international relationships.
“I feel like our relationship with our allies, it’s going to take years to repair that damage…This is a world economy, you know? You can’t live in a bubble, and for years we’ve said we can’t,” she said. “And I think that we’re just stripping down relationships that I don’t know how many generations it’s going to take to build trust again…We need the steel, we need resources from other countries. We don’t rely on ourselves. And we’re not going to build factories in two years to be self reliant, and I don’t think we should. I think we need to be a global economy and help the world survive too.”
Grassley claimed that Trump had successfully sold the country on tariffs, because he received the most votes since Reagan was re-elected, both popular and electoral. This is untrue. Trump received 77,302,580 votes in 2024, less than the 81,283,501 Biden received in 2020. The 312 electoral votes he received in 2024 are also less than the number received by both of Barack Obama campaigns, both of Bill Clinton campaigns, and George Bush’s 1988 campaign.
“He sold the country on the fact that we’ve been taken advantage of, and he’s going to make sure we aren’t taken advantage of anymore, and that’s why he’s going down this route,” continued Grassley. “I wish I could satisfy you that it’s going to work, because I don’t know anybody really knows it’s going to work, but he’s got Japan and India now, big economies coming to negotiate, but 100 countries indicated that they want to negotiate tariffs down. And if he’s successful in doing it, and that could be a big if, but if he is successful he’d be more successful than what we’ve been doing through the World Trade Organization.”
The News-Review brought up the imprisonment of hundreds of people, most of them Venezuelan immigrants, without trial, at CECTOT, a maximum security prison in El Salvador, at the hands of the Trump administration, who has claimed that these men are gang members. The imprisonment of these people was justified by the Trump administration under the Alien Enemies Act, which gives the president the ability to arrest citizens of nations that are at war with the United States, despite the fact that the United States is not at war with Venezuela or any other country currently. The Trump administration has repeatedly been ordered by judges to halt the flights to El Salvador.
On March 15, District Court Judge James Boasberg ordered the U.S. government to bring back people sent to El Salvador, even if it meant turning planes around midair; ten minutes later, another flight containing prisoners took off, bringing more immigrants to the prison. The next morning, El Salvadoran dictator Nayib Bukele, who is being paid millions by the Trump administration to keep these prisoners, mockingly tweeted “Oopsie…Too late,” accompanied by a laughing emoji, which was then shared by White House Communications Director Steven Cheung, who added a meme of Denzel Washington saying “Boom!” from the movie “Training Day,” by Secretary of State Marco Rubio, and by Elon Musk, who added his own smiling emoji. Rubio also responded to a video of the plane arriving posted by Bukele with “Thank you for your assistance and friendship, President Bukele.”
The deportations to El Salvador have gained nationwide attention in particular due to the case of Kilmar Abrego Garcia, the Maryland man sent to El Salvador by accident following an administrative error. Abrego Garcia illegally immigrated to the U.S. in 2011, when he was 16, to escape gang threats. In 2019, an immigration judge granted Withholding of Removal status to Abrego Garcia, giving him the ability to live and work legally in the United States. On April 10, the Supreme Court unanimously ruled that Abrego Garcia’s removal to El Salvador was illegal and ordered the Trump administration to facilitate his return. Despite this, Abrego Garcia remains imprisoned in El Salvador, and the White House has repeatedly claimed, through press conferences and memes posted on X, that he will never return to the United States.
The News-Review asked Grassley about his thoughts on the deportations to this El Salvadoran prison and, in particular, his thoughts on the matter of due process. “I think, without a doubt, that if you go through the entire record, with two court appearances that said he didn’t have a basis for asylum, that due process has been accomplished,” Grassley said, referring to Abgrego Garcia and the 2019 court decision that gave him permission to continue living in the United States.
Of course, Abgrego Garcia is only one of hundreds given a life sentence in a foreign prison without trial. Grassley was asked about the other hundreds of people imprisoned in CECTOT. “That’s playing out in the Supreme Court now,” Grassley said. “We’ll have to wait until the Supreme Court decision is done.”
Grassley was asked, regardless of what the court says, if he thought people should be sent to CECTOT without trial. “They’re entitled to due process, but the courts are dealing with that and have, well, they’re waiting for the fifth circuit court of appeals in Texas to make a final decision,” Grassley said. “That’ll probably be appealed to the Supreme Court. Now that’s in regard to the Venezuelans that the administration were trying to move right away, so due process is playing out in the fifth circuit court of appeals.”
Grassley was asked about a post Trump had made on TruthSocial a night before the Keokuk County Q&A, where the President complained about being “stymied” by the Supreme Court, writing “We cannot give everyone a trial, because to do so would take, without exaggeration, 200 years.”
“They have to do what the court says, and when the court gets done with their decision, we’ll know for sure what they have to do and what they don’t have to do,” Grassley replied.
He was asked what the steps were if the Trump administration didn’t do what the court said. “Well, the President has said that he’s going to abide by the court decisions, but appeal,” Grassley said.
Grassley was asked, bluntly, if he believed the Trump administration was acting in good faith and complying with the intentions of the court. “So far they have and I expect them to continue,” Grassley said.
