Only 29 percent of Iowans “mostly support” the “direction Congressional Republicans are heading in health care legislation,” according to a new poll by Selzer & Co for the Des Moines Register and Mediacom. About 58 percent of the 800 Iowa adults surveyed between July 9 and 13 said they “mostly oppose” the GOP approach to the issue.

Although the question wording is not identical, the Selzer poll findings are consistent with Public Policy Polling’s recent survey of Iowa voters. About 27 percent of PPP’s respondents said they approve “of the Senate Republican’s health care repeal and [replace] plan that is currently being debated,” while 54 percent said they disapproved of the plan.

Tony Leys reported on the latest survey for the Register on July 15.

The new poll also reflects divisions within the Republican Party that are making it hard for the party’s leaders to get the bill passed. Among Iowa Republicans who oppose the direction of the congressional efforts, 51 percent say the proposed changes don’t go far enough and 45 percent say the proposed changes go too far. Republican leaders are trying to cobble together a bill that would appease Senate conservatives, who demand a full repeal of the Affordable Care Act, and moderates, who say they are trying to prevent tens of millions of Americans from losing their health insurance. […]

83 percent of Iowans want the country to continue barring insurers from denying coverage to people due to pre-existing health conditions, the poll shows. Seventy-five percent of Iowans want to retain a section allowing parents to keep their sons and daughters on their health insurance policies until age 26. Sixty-eight percent want to retain the Affordable Care Act’s expansion of the Medicaid program to cover more poor adults. And 59 percent of Iowans want the federal government to keep giving subsidies to help moderate-income Americans pay health insurance premiums.

As in previous Iowa Polls, the only major part of the Affordable Care Act failing to gain majority approval is a requirement that Americans obtain health insurance. Just 36 percent of Iowa adults support that section, compared to 60 percent who want it repealed.

Selzer’s poll was in the field before Senate Republican leaders rewrote the Better Care Reconciliation Act to make it even worse for people with pre-existing conditions.

The GOP bill includes formula changes that would significantly reduce future spending on Medicaid. Senators Chuck Grassley and Joni Ernst have both expressed support for rolling back the Medicaid expansion. Ernst told a town-hall crowd last week that Medicaid should be for “the elderly, the disabled and children”–that is, not the millions of low-income adults who gained coverage under the Affordable Care Act. Grassley’s latest form letter to Iowans who contacted him about this issue asserted,

those who are enrolled in Medicaid are in a program that can’t continue indefinitely at its current rate of spending. The changes proposed are to make the program sustainable for the most vulnerable people who currently need it and those who will need it in the future.

The Senate legislation would bring immediate relief to the 72,000 Iowans on Obamacare. The Medicaid changes would go into effect much more gradually giving Congress time to assess the results of the changes and make adjustments.

Facts don’t support Grassley’s claim about “immediate relief” for those who buy individual health insurance through Iowa’s exchange. The Congressional Budget Office calculated last month that the Senate Republican plan would increase premium payments and deductibles for middle-income Americans, especially those over age 50.

This past week, GOP leaders agreed to add an amendment favored by Senator Ted Cruz. The two leading health insurance industry associations have warned that proposal “would undermine protections for those with pre-existing medical conditions, increase premiums and lead to widespread terminations of coverage for people currently enrolled in the individual market.”

The CBO has not yet analyzed the latest version of the Republican bill. Senate Majority Leader Mitch McConnell had intended to bring the legislation to the floor this coming Tuesday or Wednesday, avoiding a CBO score. However, with Senator John McCain stuck in Arizona recuperating from an unplanned surgery, McConnell postponed the vote. At this writing, he does not have 50 senators willing to support a motion to proceed with debating the bill.

Any relevant comments are welcome in this thread. I enclose below contact information for Ernst’s and Grassley’s offices. Although Iowa’s senators appear to have made up their minds to support any Republican plan to replace Obamacare, a deluge of calls from worried or angry constituents cannot hurt.

UPDATE: Kathie Obradovich further discussed the divisions among Republicans in her column for the Sunday Des Moines Register:

While it’s true that 57 percent of Republicans think Congress is headed right on health care, a quarter of Republicans think it’s going in the wrong direction. To make things even more complicated, Republicans who oppose the congressional plans disagree on the reason why.

A slim majority of Republicans who oppose their party’s proposed changes, 51 percent, say it’s because they don’t go far enough. But 45 percent say it’s because the changes go too far. […]

A majority of Iowa Republicans also support keeping coverage for pre-existing conditions as it is and keeping young adults on parents’ plans. Pre-existing conditions has been one of the most difficult issues for the majority Republicans in Congress to wrestle. It’s extremely difficult to maintain this key provision while still claiming to “repeal” Obamacare. […]

Iowa Republicans have mixed feelings about Medicaid expansion: 48 percent say it should be left as it is; 44 percent would repeal it. The revised Senate bill, like the House version, rolls back the Medicaid expansion. This will be a political problem for Republican office-holders in Iowa when low- and moderate-income Iowans who voted for them start losing their health insurance.

I’m surprised so many Iowa Republicans support preserving the Medicaid expansion. The best news for Ernst is that some of the coverage losses among Medicaid recipients may be delayed until after 2020, when she is up for re-election. Grassley is unlikely to seek another term, since he will be in his late 80s in 2022.

JONI ERNST

Washington, DC
111 Russell Senate Office Building
Washington, DC 20510
Phone: (202) 224-3254
Fax: (202) 224-9369
.
Des Moines
733 Federal Building
210 Walnut Street
Des Moines, IA 50309
Phone: (515) 284-4574
Fax: (515) 284-4937
.
Davenport
201 West Second Street
Suite 806
Davenport, IA 52801
Phone: (563) 322-0677
Fax: (563) 322-0854
.
Sioux City
194 Federal Building
320 Sixth Street
Sioux City, IA 51101
Phone: (712) 252-1550
Fax: (712) 252-1638
.
Council Bluffs
221 Federal Building
8 South Sixth Street
Council Bluffs, IA 51501
Phone: (712) 352-1167
Fax: (712) 352-0087
.
Cedar Rapids
221 Federal Building
8 South Sixth Street
Council Bluffs, IA 51501
Phone: (319) 365-4504
Fax: (319) 365-4683
.
————————————————————
CHUCK GRASSLEY

Washington, D.C.
135 Hart Senate Office Building
Washington, D.C. 20510
(202) 224-3744
Fax: (202) 224-6020
.
Cedar Rapids 111 7th Avenue SE, Box 13
Suite 6800
Cedar Rapids, IA 52401
(319) 363-6832
Fax: (319) 363-7179
.
Council Bluffs
307 Federal Building
8 South 6th Street
Council Bluffs, IA 51501
(712) 322-7103
Fax: (712) 322-7196
.
Davenport
201 West 2nd Street
Suite 720
Davenport, IA 52801
(563) 322-4331
Fax: (563) 322-8552
.
Des Moines 721 Federal Building
210 Walnut Street
Des Moines, IA 50309
(515) 288-1145
Fax: (515) 288-5097
.
Sioux City
120 Federal Building
320 6th Street
Sioux City, IA 51101
Phone: 712-233-1860
Fax: 712-233-1634