“I love to visit places like Crescent, ’cause they do everything right,” Health and Human Services Secretary Robert F. Kennedy Jr. told reporters after touring Crescent Community Health Center in Dubuque on Wednesday.
“From the very beginning, the focus was on removing barriers and ensuring access to care — regardless of income, insurance, or background,” Crescent says on its site. The center opened in 2006, and the following year, it was designated a Federally Qualified Health Center (FQHC).
The FQHC program was created in 1965 as part of President Lyndon Johnson’s War on Poverty. FQHCs are community-based outpatient health centers that provide access to a full-range of health services to otherwise underserved populations.
“They treat people’s medical, dental, mental health, substance use, and other health care needs,” is how the Health Resources and Services Administration (HRSA), the division of the U.S. Department of Health and Human Services that administers the FQHC program, describes its clinics.
“They have doctors, dentists, therapists, social workers, eye doctors, obstetricians/gynecologists, pediatricians, case managers, and other medical staff… They have doctors, dentists, therapists, social workers, eye doctors, obstetricians/gynecologists, pediatricians, case managers, and other medical staff.”
Some FQHCs, including Crescent, also have a pharmacy. All FQHCs have governing boards, and the majority of members of those boards must be made up of patients of the center. FQHC fees for services are determined using a sliding scale based on a patient’s income and family size. There is a special system of enhanced Medicaid and Medicare payments that centers rely on for much of their funding.
There are approximately 14,000 FQHCs in the United States, including 14 in Iowa. The centers provided health care for 20 percent of the nation’s rural population in 2025, according to HRSA. Crescent provides serves to a 10-county area.
During a brief meeting with reporters on Wednesday after his tour of Crescent, Kennedy praised the comprehensive nature of Crescent’s approach to health care. The secretary said that most healthcare systems in the U.S. have problems caused by “the fragmentation, the specialization, the perverse incentives where the whole human being is not being treated, where the outcomes are not being paid attention to.”
“The opposite is true here,” he said, standing next to Crescent CEO Chad Wolbers.
Kennedy noted that his uncle, Sen. Edward Kennedy of Massachusetts, was an early champion of the FQHC program and supported them until his death in 2009. Sen. Kennedy was one of America’s leading liberal voices during his almost half-century in the U.S. Senate, and a strong advocate for expanding public health programs and expanding access to government-funded those programs for all Americans. Sec. Kennedy, notably less liberal than his uncle, has also played a significant role in public health matters for many years, but a very different one than the senator’s.
For decades RFK Jr. has been a leading anti-vaccine voice, often recycling already discredited conspiracy theories for public consumption. His visit to Iowa this week comes as the state is experiencing a measles outbreak.
“As of August 16th, twelve confirmed cases of measles have been identified, with evidence of person-to-person spread,” the Iowa Department of Health and Human Services said in a news release on Sunday. The release included a list of seven public locations the infected people visited while contagious and the times of their visits. The locations are in Des Moines, West Des Moines, Clive and Bloomfield.
“People who are not vaccinated against measles, or who are unsure whether they are immune, should talk with their healthcare professional or local public health agency about MMR vaccination,” the department said.
Kennedy was asked about the measles outbreak after his Crescent tour on Monday. A reporter from KCRG asked the secretary if his and the Trump administration’s questioning of vaccine effectiveness and their efforts to roll back vaccination requirements for school children have played a role in the largest U.S. measles outbreak in 35 years, and what the Trump administration is doing to limit the spread of measles in schools.
“Well, we’re doing everything that we can,” Kennedy replied. “There’s an international measles epidemic right now. Our country’s doing better than any country in the world in controlling that epidemic.”
According to Kennedy, declining vaccination rates are due to people losing confidence in public health officials during the COVID-19 pandemic. Kennedy did mention that the height of the pandemic occurred in 2020, while President Trump was still in his first term and in charge of the nation’s public health policy. He did not mention President Trump’s often dishonest and almost cartoonish statements about the pandemic that contradicted those made by disease experts in his administration. He also did not mention his own very public opposition to vaccine mandates at the time, and his many false statements, then and now, about dangers posed by vaccines.
“I spoke with Kim Reynolds yesterday about the 20 cases [sic] that you have here in Iowa,” Kennedy said. “I told her we have the Epidemic Intelligence Service ready to act anytime that they need us.”
Once the secretary finished his response to the measles question, an aide thanked the reporters and said, “That’s all the time we have.” Kennedy left. He had spoken to reporters for just over seven minutes.
Crescent CEO Chad Wolbers spoke to reporters after Kennedy’s departure. Wolbers said he was grateful to Kennedy for his visit.
“We had a great discussion, we had a wonderful tour,” he said. “I think they welcomed our points, some of those aren’t necessarily congruent with some of the positions [of the Trump administration]. But overall, the common ground is that we view FQHCs as doing their job.”
Asked about the points of difference, Wolbers first mentioned the 340B pharmacy program FQHCs and federally designated “safety net” hospitals rely on to provide low-cost medications to patients. The Centers for Medicaid and Medicare, which are part of Kennedy’s department, has proposed cuts in funding for the program.
The proposed cuts would “reduce Medicare spending on 340B drugs by an estimated $4.85 billion in 2027,” and “reduce revenues among safety-net hospitals [and FQHCs] while increasing revenues among for-profit hospitals, among other differences,” the Kaiser Family Foundation recently reported.
“We want that program to be protected,” Wolbers said. “… I think they heard us on that point, despite some of the structural changes that are maybe on the horizon for that program.”
He also listed a second topic of concern they discussed — the Medicaid cuts the Trump administration is implementing.
“I think the other point they heard from us is HR 1, the One Big Beautiful Bill, and some of the changes that will impact our Medicaid patients,” Wolbers said.
Between 58 percent and 60 percent of Crescent’s patients rely on Medicaid. Another 14 to 15 percent are uninsured. The cuts “will be a funding challenge for us,” Wolbers said.
“We have a $25 million budget here at Crescent, and that’s probably going to impact us to the tune of $1.4 million [according to the] best estimates and projections.”
Wolbers said he hopes the administration will review and possibly reconsider the cuts in the near future.
Dozens of people gathered outside Crescent on Monday to protest Kennedy’s visit and his policies. “Vaccines save lives,” they chanted.
“He’s cut the Affordable Care Act,” Kathy Dolter, who participated in the protest, told the Dubuque Telegraph Herald. “They’ve cut HHS; they cut Medicaid funding in schools. They cut the FDA. They cut the CDC. You’ve got a cyclosporiasis outbreak. We’ve got measles outbreaks. They’ve cut cancer research funding.”
Dolter, a former Army nurse who holds a Ph.D. in nursing, was dean of nursing at Kirkwood Community College for 10 years. Dolter was a candidate earlier for the Democratic nomination for the open House seat in Iowa’s 2nd Congressional District. She currently serves on the Dubuque County Board of Health.
“It’s just amazing that he is so brazenly able to show up here today, when he’s done all this to hurt America,” Dotler said.
