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Gubernatorial Candidates Address the Issues

Lahn, Sand on rural health, aging in place

Katherine Shaver,

AARP

Published September 01, 2026

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Iowa’s race for governor is considered one of the most competitive in the country, with voters choosing a replacement for Kim Reynolds (R) on Tuesday, Nov. 3. Reynolds did not seek another term.

Democrat Rob Sand, a former assistant Iowa attorney general, has served as state auditor since 2019.

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Republican Zach Lahn, a farmer and businessman, is running for his first public office.

AARP asked the candidates about issues important to Iowa’s older voters. The interviews were conducted in June and July and have been edited for space and clarity.

How would you make it easier for Iowans to continue living in their own homes or communities as they grow older, particularly in rural areas?

LAHN: I live in a rural area myself.... When we talk about affordability, we have to look at what has been causing a lot of the price increases to happen — the home price increases, the property tax increases — and in Iowa specifically, we have had issues of a lot of our homes starting to be bought by large companies from out of state who are treating them as rental properties, and they’re driving up the price of housing, and thus driving up property taxes as well. We do plan to freeze property taxes as we work to put in place other measures to slow the growth of government on the local level ... but also banning these institutional investors from buying homes in the state.

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SAND: We have to be focused on making sure that nobody who owns their home loses their home because of property taxes.... I also think we need to do more to support rural Iowa in general. I have a track record of doing this in the auditor’s office. We changed the rule so that our employees can live anywhere in the state.... The more working-age families we have out there in rural areas, the more economic activity there is, the better the economy is doing out there, the less those places depend on an older population.

Iowa is facing a shortage of primary care, mental health and other providers. What would you do to bolster the state’s health care workforce?

SAND: Reversing the privatization of Medicaid would go a long way towards doing that. Many people have left the [health care] workforce because they can’t stand trying to deal with these [managed care organizations] to get paid for the work they’ve done. I also think it’s really important to end the culture wars. It’s harder to recruit doctors here because they’re continually having restrictions on how they do their work, particularly related to maternal care and pregnancies. People don’t want to practice in that environment. And if we want to make sure that we have health care providers here to take care of Iowans, we’re going to need to make sure we also pay them at a competitive wage.

LAHN: Much of what we’re talking about kind of intertwines. We’re losing our kids faster than 46 other states. We’re training many of them up, and they’re leaving.... We have to invest in our trade schools, in our community colleges, and provide good benefits for people who will stay here. I’m looking at options like if you will commit to staying in Iowa and working in a rural community, and you’re trained in nursing or some of the therapy occupations … can we forgive some of your tuition or a decent amount of it?

There’s been a lot of discussion about access to health care in rural areas. What would you do to improve access to quality health care for Iowans?

LAHN: In the short term, there are some funding needs.... However, that is sort of a Band-Aid, because ultimately what we have to be able to do is stop the need for more money in the future. We do that by promoting growth, especially in our rural communities. Are there opportunities for us to provide benefits if somebody on Medicaid would, instead of going 10 minutes into town, go 10 to 15 minutes out of town to use a rural health care provider?

SAND: Number one, I’m not a supporter of the Big Beautiful Bill.... We have seen health care facilities in Ottumwa and Centerville close because of the cuts from the Big Beautiful Bill. We’ve also seen other places say they are at risk to close because of it. We need to have functioning health care in rural Iowa. Otherwise, people can’t live there.

SAND: One of the things that would improve everyone’s life is to tell both the Democratic and Republican parties that they can no longer force us to pick between the lesser of two evils.... If we change that, we can foster a lot more unity, as well as a lot more places of agreement.... A lot of the problems that older Iowans face — affordability, nursing care issues, nursing home issues, transportation — are as bad as they are because our political system is more focused on serving the people who are in it and getting them reelected than it is on actually solving problems for ordinary people.

LAHN: This one is pretty near and dear to my heart, with my grandmas being up in age, and also my own parents. I see what’s really important to them. There’s a big desire to have family close by…. If you look at our campaign, the number one point is how do we keep our kids in the state? That ultimately helps to build the culture.... Keeping our kids here, keeping our families tight knit, I think is one of the best things we can do.

More information on the candidates at zachlahn.com and robsand.com.

As a nonpartisan, nonprofit organization, AARP does not endorse candidates or make political donations.

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Katherine Shaver is a Washington, D.C.–area freelance writer for AARP who has covered state issues affecting people age 50 and older — including advocacy, fraud prevention, and public policy. She draws on more than 30 years of journalism experience, including a long career at The Washington Post.

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