Iowa's Healthy Water Act: Can Incentives Solve a Crisis Decades in the Making?

When Iowa House Democrats unveiled the Healthy Water Act last week, they positioned it as something rare in modern politics: a compromise solution that asks neither for punishment nor inaction. Instead, the five-point plan proposes partnering with farmers through financial incentives to address Iowa's mounting water quality crisis—one that may be literally killing Iowans.

The question is whether carrots without sticks can solve a problem that's been growing worse for decades despite years of voluntary measures.

The Crisis That Won't Stay Buried

Iowa has the second-highest cancer rate in the nation and is one of only two states where cancer rates are actually increasing. The Iowa Cancer Registry estimates that Iowa families saw 21,200 cancer diagnoses in 2025 alone. While some attribute this to aging populations or lifestyle factors, a growing body of research points to agricultural pollution as a significant contributor.

The primary culprit? Nitrate contamination from agricultural runoff. The Central Iowa Source Water Report found that Iowa rivers "often contain some of the highest nitrate levels in the US," far exceeding the federal safe drinking water standard of 10 milligrams per liter. Last summer, nitrate levels spiked so high that Central Iowa Water Works banned 600,000 residents from watering their lawns because filtering the contamination was overwhelming treatment facilities.

What the Healthy Water Act Proposes

The Iowa Healthy Water Act, introduced by House Democrats on January 22, 2026, includes five main components:

Tripled Nutrient Reduction Funding: Increase annual funding from $10 million to $30 million for the Iowa Nutrient Reduction Strategy, which helps farmers install wetlands, buffer strips, and other conservation practices.

Tax Credits for Conservation: Establish new income and property tax credits for farmers implementing water quality improvement strategies. Farmers could receive $5 per acre for participating in the state's nutrient reduction strategy.

Zero-Interest Loans: Create a loan program for agricultural technology that improves water quality, reducing the financial barrier for farmers wanting to implement better practices.

Restored Water Monitoring: Allocate $600,000 to fully restore the statewide water quality monitoring network. In 2023, the legislature reallocated $500,000 from this network, meaning three out of four nitrate monitors will stop operating unless funding is restored.

Grants and Technical Support: Provide resources to help farmers adopt cover crops, precision agriculture, and other best management practices.

Representative Austin Baeth, a physician from Des Moines, explained the urgency: "I am tired of diagnosing my patients with cancer, and I am tired of worrying whether I am harming my children every time I fill their cup from the tap."

The Science Behind the Concern

The connection between agricultural pollution and health impacts is becoming harder to ignore. A 2024 University of Iowa study found that people with nitrate detected in their drinking water had a 73% higher risk of dying from cancer compared to those without detectable nitrate. Even more concerning: every tenfold increase in drinking water nitrate levels was linked to a 69% higher risk of cancer death—even at levels below the federal Maximum Contaminant Level.

The CISWRA Currents of Change Report estimates that approximately 80% of the nitrate in Iowa waterways comes from agricultural activity: 40% from synthetic fertilizer, 20% from manure, and 20% from nitrogen fixation by soybeans. A 2025 study by Iowa scientists showed that pollutants in the Des Moines and Raccoon Rivers have increased by nearly 100% in the last 50 years.

Nitrates aren't carcinogenic on their own, but when ingested, they convert to N-nitroso compounds, most of which are cancer-causing. Nitrate exposure is also linked to thyroid disease, birth defects, preterm births, and methemoglobinemia (blue baby syndrome).

The Voluntary Approach Hasn't Worked

Iowa has relied on voluntary conservation programs for years, with minimal success. The state's Nutrient Reduction Strategy, launched in 2017, did not make a big difference in water quality during its first 10 years, according to independent analysis. The Iowa Environmental Council estimates that at the current pace of implementation, it will take Iowa "tens of thousands of years" to reach its water quality goals.

Meanwhile, the problem worsens. Data shows nitrate concentrations continuing to climb, agricultural runoff increasing, and health outcomes deteriorating. The voluntary approach has given farmers the choice to reduce pollution—and many have simply chosen not to, often because the economics don't pencil out without support.

The Political Reality

Despite House Democrats' attempt at a middle-ground approach, Republican leadership has shown little interest. House Speaker Pat Grassley argued that critics aren't giving proper credit for existing efforts: "We have to do a better job...of telling the actual story of what we've done," Grassley said, while also noting that agriculture shouldn't be blamed for water quality problems.

This disconnect reveals the fundamental political challenge: acknowledging the agricultural origins of water pollution risks alienating Iowa's powerful farm lobby, yet continuing to deny the connection leaves Iowans drinking contaminated water and developing cancer at alarming rates.

Representative Kenan Judge emphasized that farmers themselves want clean water: "Farmers want to take care of the land and take care of the water. Our approach, in both parties over the past, has been more finger pointing. We welcome that input from them."

Can Incentives Alone Work?

The Healthy Water Act represents an all-carrot, no-stick approach. It offers farmers significant financial support—tax credits, zero-interest loans, and grants—to adopt conservation practices. But it includes no mandates, no penalties for excessive pollution, and no regulatory teeth.

Critics argue this approach is insufficient given the scale and urgency of the crisis. After decades of voluntary measures failing to stem the tide of agricultural pollution, many question whether adding more carrots will suddenly change farmer behavior when previous incentives haven't.

Supporters counter that farmers are struggling economically—with foreclosures and farmer suicides at alarming highs—and that demanding dramatic changes without providing resources is both unfair and impractical. The bill explicitly recognizes that "it often isn't financially feasible to demand dramatic changes to farming practices without lending the tools and resources to do so."

The Path Not Taken

Other agricultural states face less severe water quality problems. Minnesota, despite significant agricultural activity, has far lower rates of nitrate pollution than Iowa. The difference? Minnesota implemented mandatory conservation measures and actually enforces water quality standards.

The Healthy Water Act consciously avoids this regulatory approach, betting instead that sufficient incentives can achieve voluntary compliance. Whether this represents pragmatic politics or inadequate response depends on your perspective—and perhaps on whether you're the one diagnosing cancer patients or worrying about what's in your children's drinking water.

What Happens Next

As a minority party proposal in the Republican-controlled Iowa House, the Healthy Water Act faces long odds. Without buy-in from House leadership, the bill likely won't receive committee hearings, much less floor votes.

Meanwhile, Iowa's water quality monitoring network—already defunded—will go completely offline in July 2026 without the proposed restoration funding. We'll literally stop measuring the problem just as research increasingly links it to Iowa's cancer crisis.

Representative Elinor Levin framed the bill as starting a conversation: "We're not talking about the end goal here. We're talking about beginning a conversation that recognizes the reality of Iowa's water quality problems now and starts working towards better water for all Iowans."

But how many more cancer diagnoses will Iowa see before that conversation leads to action? How many more summers will Central Iowa residents face lawn-watering bans because agricultural runoff overwhelms treatment facilities? How many more studies showing elevated health risks from nitrate exposure will be ignored?

The Iowa Healthy Water Act may not be perfect, but it represents one of the few serious legislative proposals to address Iowa's water crisis in years. Whether it becomes law or dies in committee, it at least acknowledges a truth that too many Iowa leaders have been unwilling to state plainly: our water is making us sick, and we need to do something about it.