The business rebuilt and recently hosted U.S. Sen. Charles Grassley, a Republican who focused on rural economic development during this stop on his 99-county tour of Iowa.

“You have a beautiful facility here,” said Grassley, as he visited with Tony Nielsen, owner, and Jeff Eischeid, manager. Gov. Kim Reynolds also recently visited the Manson K.C. Nielsen location, which has 25 employees, including a mix of long-term staff and four new hires.

As Grassley visited with the K.C. Nielsen team and other Calhoun County business professionals, topics like high inflation, labor shortages in rural Iowa, security concerns related to America’s southern border, and the importance of rural economic development generated a lot of discussion.

During the question-and-answer session, members of the public asked Grassley for updates about progress on the next Farm Bill. Despite pushing hard for work to be completed early in the year on the Farm Bill, progress has stalled. In late May, the House Agriculture Committee completed a markup of H.R. 8467, the Farm, Food, and National Security Act of 2024 (also known as the 2024 Farm Bill).

-Messsenger photo by Darcy Dougherty Maulsby
Sen. Charles Grassley, R-Iowa, speaks with Theresa Hildreth, Calhoun County Economic Development director, and Jeff Eischeid, manager of the K.C. Nielsen dealership in Manson.

While there has been concern about proposed billions of dollars in cuts to food assistance programs, Grassley and some of his colleagues think $24 billion could come from provisions related to federal COVID-19 spending. In any case, Grassley isn’t optimistic that a new Farm Bill will be approved in 2024.

“I think it’s next year before we get a Farm Bill,” he said.

Theresa Hildreth, executive director of the Calhoun County Economic Development Corporation, asked about pharmacy benefit managers (PBMs). Hildreth recently attended a meeting of Iowa pharmacy professionals, where speakers noted that there are 609 pharmacies in Iowa. About half (310 pharmacies) are located in rural Iowa.

“There’s concern that 42 percent of those rural pharmacies will close in the next 12 months, due to the challenges associated with PBMs,” Hildreth said. “This is a big issue, since PBMs are a middle group between the pharmaceutical companies and consumers.”

Grassley agreed that the PBM issue is a major concern. From congressional hearings to political messaging efforts, PBMs have been at the center of recent drug pricing conversations.

PBMs occupy a central role in the drug price supply chain as negotiators, administrators, and decision-makers about which drugs will be most accessible to consumers. But there is a lot the public and policymakers still do not understand about how pharmacy benefit managers determine which drugs patients can access, the processes PBMs use to decide how much plans and patients will pay for drugs, and the extent to which PBM business practices may contribute to high drug prices.

Grassley is paying attention to these issues, since the U.S. Department of Veterans Affairs and other federal agencies spend a lot of money on pharmaceutical drugs. The Veterans Health Administration is America’s largest integrated health care system. He’s pushing for more transparency with PBMs.

“You as the taxpayers should know what’s going on,” Grassley told the group in Manson. “Transparency leads to accountability.”

Hildreth also asked Grassley what local business leaders and other local residents can do to assist him as he represents Iowans.

“There are so many positive stories here in rural Iowa,” she said. “It’s important to show what’s working well and also do what we can to help our lawmakers serve more effectively.”

Before he left Manson, Grassley encouraged his constituents to stay in touch with him.

“The essence of representative government is dialogue,” he said. “I want to hear your opinions.”