Guest columnist

Iowa is at the forefront of improving health care delivery. Today, our state ranks among the top four for affordability and the top 10 for accessibility. That’s a testament to the work of small businesses, local providers, and others committed to building better coverage options.

But a new proposal out of Washington threatens to undo those hard-fought gains. The Trump administration announced plans to move forward with sweeping tariffs on imported medicines. If it does, it will disrupt access to essential treatments and saddle Iowans with higher costs at the pharmacy and through their insurance premiums.

Medicines aren’t optional. The United States imports around $128 billion of pharmaceutical products from Europe a year. About one-third of the active ingredients in U.S. medicines also come from European sources, including components for advanced therapies and cancer treatments. You can’t just “buy American” if the medicine your doctor prescribed is only manufactured overseas.

Tariffs on these products won’t land on foreign governments. They will land on Iowa patients, businesses, and taxpayers. Roughly half of all Iowans get their insurance through an employer, and more than 99% of businesses in the state are small businesses — which are particularly vulnerable to health care cost spikes.

If tariffs take effect and drive up the price of medicines, insurers will face higher spending. They will likely respond by raising premiums and shifting more costs onto consumers. That would put additional pressure on families and could force employers in Des Moines and across the state to reduce benefits.

Need a break? Play the USA TODAY Daily Crossword Puzzle.

For people with serious illnesses like cancer — and recent reports reveal Iowa has the “second highest rate of new cancers” in the nation — those added costs would be especially damaging. When prices go up, people are more likely to delay care, skip doses, or abandon treatment entirely.

The Trump administration seeks to justify this move by pursuing tariffs on foreign imports that threaten national security. That rationale doesn’t hold here. Importing cancer drugs from Ireland, Germany, and Switzerland doesn’t undermine our security — it ensures continuity of care for Americans.

I do share the administration’s concerns about our dependence on China for some medicines and key raw materials. That’s a genuine national security risk, and it deserves attention. But targeting European allies won’t fix that problem — it will only create new ones for Americans already navigating a complex health care system.

Patients don’t pick their diagnosis or where their treatment is made. When a Des Moines resident with breast cancer is prescribed an oncology treatment that works, they shouldn’t face a higher bill — or be denied timely access — just because it’s sourced from Switzerland.

By all means, let’s be tough on real threats. But we must prevent Iowans from becoming collateral damage if all medicines are swept up in this trade dispute.

Josh Steuterman is a Des Moines resident and health plan account manager who helps clients position their companies to save money and resources, while providing world class healthcare benefits for each of their team members.