# Health Care Reform



House passes first 2016 spending bills: How the Iowans voted

Catching up on Congressional news, last week the U.S. House approved a joint Republican framework setting top-line numbers for the federal budget as well as the first two spending bills for the 2016 fiscal year, which begins on October 1. Along the way, House members considered amendments covering a wide range of issues, from regulations on incandescent light bulbs to “prevailing wage” rules for federal construction projects to medical marijuana advice for Americans who receive their health care through the Veterans Administration.

Follow me after the jump for details on the latest votes by Iowa Democrat Dave Loebsack (IA-02) and Republicans Rod Blum (IA-01), David Young (IA-03), and Steve King (IA-04).

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Grassley, Ernst vote for Medicare reimbursement deal

Changes to entitlement programs rarely attract strong bipartisan support, but on Tuesday the U.S. Senate approved a bill to change how Medicare sets reimbursement rates for doctors by 92 votes to 8 (roll call). All of the no votes came from Republicans, but Iowa Senators Chuck Grassley and Joni Ernst both supported the bill. Follow me after the jump for background and details.

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Four reasons the Iowa caucuses will be a rude awakening for Ted Cruz

U.S. Senator Ted Cruz of Texas officially launched his presidential campaign this morning. Click here to watch his speech at Jerry Falwell’s Liberty University or here to read the transcript.

As an outsider candidate, Cruz will need a strong showing in the Iowa caucuses to have any hope of becoming the last man standing against the establishment favorite for the GOP nomination. I don’t see that happening.  

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Two ways 40,000 Iowans could lose their health insurance

At least 40,000 Iowans are in danger of losing their health insurance later this year, and not only because of the King v Burwell case before the U.S. Supreme Court. Regardless of how justices decide that case, Iowans could lose access to federal subsidies they need to buy insurance policies.

State legislators and Governor Terry Branstad could eliminate the risk by working together to establish a fully state-run health insurance exchange this year. But for reasons I can’t comprehend, I see no sense of urgency to prevent a potentially devastating outcome for thousands of families.  

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House repeals Obamacare again: How the Iowans voted

Yesterday the U.S. House approved a bill to repeal the Affordable Care Act by 239 votes to 186 (roll call). No Democrats supported the bill, and only three Republicans broke ranks with their party to oppose it. By some counts, it was the 56th time the Republican-led House has voted to repeal all or part of the 2010 health care reform law. Still, many newly-elected GOP lawmakers wanted a chance to weigh in after campaigning against Obamacare.

Iowa’s four representatives split along the usual party lines, with Rod Blum (IA-01), David Young (IA-03), and Steve King (IA-04) voting yes and Dave Loebsack (IA-02) opposed. Loebsack has occasionally voted for Republican bills that reverse specific provisions of the Affordable Care Act, but he has never supported any of the broad repeal bills.

I enclose below statements released by King and Young on yesterday’s vote.  During last year’s campaign, Young suggested that Obamacare was “here to stay” and said he would be “at the table trying to fix” the law if elected to Congress. In yesterday’s press release, Young advocated several GOP proposals on health insurance but added that Republicans “must continue to ensure coverage is provided to individuals even if they have preexisting conditions and that young people still struggling in the job market are able to continue to receive coverage under a parent’s plan.” King’s official comments said nothing about preserving any aspects of the current law. He emphasized that he filed the very first Obamacare repeal measure on the day after House members approved the bill in March 2010.

I highly recommend Dana Milbank’s entertaining account of the House debate on the latest bill. Excerpts are after the jump, but you should click through to read the whole Washington Post column.

UPDATE: According to Sahil Kapur,

The [Republican] party is divided on whether it should even attempt to craft a contingency health care plan of its own. Illustrating the dispute, Reps. Steve King (R-IA) and Jeff Duncan (R-SC) tried to propose an amendment that strips out the language calling for “replacement legislation.”

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Someone should investigate state's role in Iowa's health insurance coop failure

What has seemed likely since Christmas Eve was confirmed on Friday: Iowa’s non-profit health insurance coop is liquidating. At the end of this post, I’ve enclosed the e-mail CoOportunity Health members received on January 23. Members are strongly encouraged to enroll in other health insurance before February 15, the end of 2015 Open Enrollment under the federal health care reform law. In Iowa, only Coventry now sells policies through the exchange, allowing eligible people to receive federal tax subsidies to help cover the cost of insurance.

CoOportunity Health was created to sell individual, family, and small-business health insurance policies in Iowa and Nebraska. Its membership greatly exceeded projections, but so did the costs of insuring a population that had largely been uninsured before the 2010 Affordable Care Act went into effect in 2014.

Some politicians, like Senator Joni Ernst, have nothing to say about CoOportunity’s collapse beyond empty talking points about Obamacare. Others, like Senator Chuck Grassley and Representative Dave Loebsack (IA-02), are digging for answers on why federal officials didn’t do more to help the health insurance coop survive. Those are important questions.

As far as I can tell, no one in a position of power is examining how decisions by Iowa officials stacked the deck against CoOportunity ever becoming solvent. Did Iowa’s insurance commissioner Nick Gerhart seal the coop’s fate by bending over backwards to suit the 800-pound gorilla in Iowa’s health insurance market (Wellmark Blue Cross/Blue Shield)? Now that CoOportunity’s failure leaves only one company selling policies on Iowa’s health insurance exchange, what is Gerhart’s “plan B” if Coventry decides later this year against continuing to participate on the exchange for 2016?

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Tom Harkin's legacy: links and discussion thread

U.S. Senator Tom Harkin’s been giving a lot of interviews lately as he wraps up a 40-year career in Congress this month. I’ve posted some of the newsworthy excerpts after the jump, along with the full text of Senator Chuck Grassley’s widely-praised tribute to his colleague on the Senate floor.

Any relevant comments are welcome in this thread. UPDATE: James Q. Lynch’s feature for the Cedar Rapids Gazette on “The Harkin Legacy” is a good read.  

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House sues Obama administration over health care reform law

On Friday the U.S. House of Representatives filed a federal lawsuit challenging several aspects of how the Obama administration has implemented the 2010 Affordable Care Act. You can read the plaintiffs’ full case here (pdf) against two cabinet secretaries and the agencies they lead. The main arguments are that the Obama administration broke the law by delaying the employer mandate to provide health insurance, and also by providing certain payments to health insurance companies without having Congress appropriate those funds. The first point was expected, but the second argument surprised even those who have closely followed the political battle over Obamacare. Sarah Kliff explained the challenged payments and how they fit into the law. Ashley Parker reported for the New York Times, “If the lawsuit is successful, poor people would not lose their health care, because the insurance companies would still be required to provide coverage – but without the help of the government subsidy, the companies might be forced to raise costs elsewhere.”

In contrast, the legal challenge to delaying the employer mandate is more “symbolic,” as that provision of the Affordable Care Act will have gone into effect by the time this lawsuit works its way through federal courts.

House Republicans voted to authorize this lawsuit shortly before going on a long summer recess. Iowa’s four representatives split on party lines, with Republicans Tom Latham (IA-03) and Steve King (IA-04) supporting the measure and Bruce Braley (IA-01) and Dave Loebsack (IA-02) opposed, along with every other House Democrat present. At the time, the lawsuit was perceived as House Speaker John Boehner’s way of deflecting conservative sentiment toward drafting articles of impeachment. At times this fall, Congress-watchers wondered whether the lawsuit would go forward, as two major law firms worked on the case for a while before declining to participate in litigation. A conservative legal scholar eventually took the case.

Weekend open thread, with health care reform links

What’s on your mind this weekend, Bleeding Heartland readers? This is an open thread.

The enrollment period for 2015 health insurance coverage began today and runs through February 15. Approximately “23,000 people nationwide successfully submitted applications to enroll or re-enroll in health insurance plans” today at Healthcare.gov. The Obama administration has set a target of 9.1 million enrollees for 2015. As of this past April, approximately 29,000 Iowans had selected a health insurance plan through the federal marketplace. But roughly double that number are eligible to enroll in a marketplace plan.

Democrats in the Iowa Senate advocated for creating a state portal where Iowans could buy health insurance under the 2010 Affordable Care Act. However, Governor Terry Branstad and Iowa House Republicans refused to go along, perhaps hoping that the health care reform law would be overturned in court or soon after the 2012 presidential election. So, Iowa formed a “partnership” exchange, whereby the state regulates insurance plans, but citizens purchase those plans on the website created and maintained by the federal government. That political decision may prove costly for tens of thousands of Iowans and millions of people in more than 30 other states.

On November 7, the U.S. Supreme Court agreed to hear an appeal that could end tax credit subsidies for all Americans who purchase health insurance plans through the federal website. The SCOTUS blog has compiled links on the King v Burwell case here. Jonathan Cohn provides a concise explanation of how the lawsuit could “wreck Obamacare” if a Supreme Court majority finds in favor of plaintiffs, who argue that subsidies should be available only to people who purchase insurance on state exchanges.

Brianne Gorod argues here that the Supreme Court should “recognize what the statutory text makes clear, and the structure, purpose, and history of the statute all confirm: tax credits and subsidies should be available on all exchanges, state-run and federally facilitated.”

Michael Cannon argues the opposite side here: namely, that the Affordable Care Act “makes no provision for subsidies in federally established exchanges.”

Chief Justice John Roberts is a highly political, results-oriented judge rather than a consistent legal theorist. Will he seize this chance to destroy Obamacare, or will he allow the current system to survive, as he did in the Supreme Court ruling that left most of the Affordable Care Act intact?

The outcome of King v. Burwell should not affect roughly 105,000 Iowans who have received health insurance coverage under the Iowa Health and Wellness Plan, the compromise alternative to simple Medicaid expansion in this state. According to a report by the Iowa Policy Project, those people “previously were not eligible for Medicaid or who were enrolled only in the IowaCare program.” (IowaCare benefits were inferior to Medicaid in various ways.) Iowa hospitals have benefited from these policy changes, as they provided much less uncompensated care to uninsured Iowans during the first half of this year compared to the previous year.

UPDATE: Added after the jump excerpts from the Des Moines Register’s unsigned editorial published on November 17. The editors note the irony of conservatives who oppose the Affordable Care Act hoping that “activist judges” will help unravel it.

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Analysis shows Medicaid expansion is working in Iowa

The Iowa Hospital Association was one of many health care organizations that advocated strongly for Medicaid expansion. A new analysis of care provided by Iowa hospitals shows why.

Scott McIntyre highlighted the key findings on the Iowa Hospital Association’s blog yesterday.

During the first six months of this year, the number of people hospitalized in Iowa without insurance fell by 45.7 percent compared with the same period last year, an IHA analysis has found.  The analysis is based on data collected from 101 Iowa hospitals from January through June.

According to the study, out of about 159,000 hospital discharges from January to June in 2014 and 2013, 4,445 patients were uninsured this year compared with 8,181 in 2013.

[…] Because of Medicaid expansion, in a six-month span, Iowa hospitals cared for fewer uninsured patients in all settings, including patients admitted for inpatient care as well as those seeking care at hospital emergency rooms and at outpatient clinics.  Similar results are being seen in other states that expanded Medicaid under the Affordable Care Act. […]

For the period January 1-June 30, overall inpatient admissions at Iowa hospitals declined 4.4 percent compared with the same period in 2013.  Within that decline, the number of uninsured hospitalized patients with no source of payment for their health care fell by 45.7 percent in 2014.

Additionally, fears that expanding coverage would make care so easily accessible that use of hospital emergency rooms would rise to unprecedented levels have not materialized, the IHA analysis found.  Total visits to emergency rooms increased less than 1 percent when comparing the six-month spans in 2013 and 2014, despite approximately 30,000 patients with new policies purchased through the Health Insurance Marketplace.

With more Iowans now insured, hospitals’ charity care losses fell 18.5 percent, yielding a total six-month improvement of $32.5 million.

During the state legislature’s 2013 session, Iowa House Republicans and Governor Terry Branstad refused to expand Medicaid, but agreed to create an “Iowa Health and Wellness Plan” as a compromise. The arrangement was more complicated and more expensive than simply expanding Medicaid as foreseen under the 2010 federal health care reform law. Nevertheless, the deal was well worth it and is benefiting tens of thousands of Iowans.  

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IA-Sen: Final Braley/Ernst debate liveblog and discussion thread

In a few minutes, Bruce Braley and Joni Ernst will hold their third and final debate. KCAU in Sioux City and ABC-5 in Des Moines are televising the debate locally, and C-SPAN is showing it nationwide. I’ll be liveblogging after the jump.

Before the first debate, I was concerned that Braley might lose his cool, but he did well both that night as well as in last Saturday’s debate.

UPDATE: C-SPAN has the debate video archived here, for those who missed it.

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IA-03: Trouble on David Young's right flank (updated)

Prominent central Iowa conservatives are voicing concerns about David Young, the GOP nominee in the third Congressional district. Young can’t afford to run too far to the right in his race against former State Senator Staci Appel. He needs to keep the margin close in Polk County, because the Republican voter registration advantage in IA-03 isn’t large enough to save him if he gets blown out among suburban moderates. Consequently, Young has taken several middle-of-the-road positions during the general election campaign. During his first debate against Appel, he offered qualified support for a minimum wage increase. Last week, he told the Des Moines Register’s editorial board that he favors some form of legal status for some undocumented immigrants living in the U.S.

Speaking at a health care forum in Des Moines yesterday, Young said the Affordable Care Act is “here to stay,” so Congress will “have to work to make it better.” Whereas many Republicans have pledged to repeal “Obamacare,” Young said he’ll “be at the table trying to fix it.” That pragmatic stance contradicts his promise in a pre-primary television commercial to make Obamacare disappear.

Although Young has Iowa Right To Life’s support for the general election, some “pro-life” activists haven’t forgotten that he once told a journalist abortion should be legal in cases of rape or incest.

Social conservative talk radio host Steve Deace laid out his case against voting for Young in a Facebook post yesterday. I’ve enclosed excerpts after the jump. Many Iowa Democrats dismiss Deace as irrelevant, but his show is broadcast on two stations in the Council Bluffs area (the second-largest metro in IA-03) and one station in Des Moines. During the next three weeks, you can be sure Deace will urge listeners not to vote for Young.

Casting a protest vote will be easy for right-wing Republicans, because two conservative candidates qualified for the ballot in IA-03. Bleeding Heartland posted background on Libertarian Ed Wright and independent Bryan Jack Holder here.

UPDATE: On October 14, Deace bashed Young on his website and featured on his radio broadcast a segment on “John Boehner’s next plan to screw conservatives.” Pointing to a blog post claiming the U.S. House speaker wants to expand his majority “so the crazies you hate will be irrelevant” in Congress, Deace commented, “Another reason not to vote for David Young, as if he hasn’t provided enough of them already.”

SECOND UPDATE: The Iowa Republican publisher Craig Robinson had a go at Young’s “schizophrenic” campaign. I’ve added excerpts at the end of this post.  

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IA-04: Steve King's finally up on tv, plus the latest from Jim Mowrer

Four weeks before election day, six-term Representative Steve King has finally started running television commercials in Iowa’s fourth Congressional district. His Democratic challenger has been on the air for two months already, thanks to strong fundraising over the past year.

King’s introductory spot has the cinematic look and feel of his 2012 campaign commercials, and echoes that year’s strategy of making a virtue out of his “outspoken” and “straight-talking” nature. The video and transcript are after the jump.

I’ve also enclosed below Jim Mowrer’s recent comparative ad, which has King threatening to back out of the candidates’ only scheduled debate later this month.

So far, neither the Democratic Congressional Campaign Committee nor the National Republican Congressional Committee is advertising in IA-04, which suggests to me that both sides see King ahead. However, Mowrer’s campaign has called the race a “dead heat,” pointing to a survey by DFM Research, commissioned by a railway workers’ labor union. That poll of 450 IA-04 residents identified 375 likely voters, among whom 46 percent support King and 43 percent Mowrer, with 11 percent undecided. I wish there were more independent polling of Iowa’s Congressional races.

Any comments about the IA-04 race are welcome in this thread. For what it’s worth, I thought the video of King and his wife reading “mean tweets” about him was kind of funny. Here’s the thing, though: nasty comments about King on Twitter don’t harm anyone, other than perhaps hurting his feelings. In contrast, King’s mean-spirited policy stands hurt lots of people, particularly Americans on food assistance, those earning the minimum wage, and DREAMers who are denied opportunities because King and his allies have blocked a House vote on immigration reform.  

UPDATE: Jennifer Jacobs reports that Donald Trump will headline a fundraiser for King in a West Des Moines gated community on October 18. It will be Trump’s first appearance in Iowa since the August 2013 Family Leadership Summit.

SECOND UPDATE: The DCCC has cancelled air time it had reserved in Sioux City for the two weeks leading up to November 4.

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IA-Sen: First Braley/Ernst debate liveblog and discussion thread

In a few minutes Representative Bruce Braley and State Senator Joni Ernst will start their first debate at Simpson College in Indianola. You can watch the debate on KCCI-TV in the Des Moines viewing area and on C-SPAN across the country (in central Iowa that’s channel 95).

I previewed what I see as the biggest potential pitfalls for each candidate here. I’ll be liveblogging after the jump and will also update later with some reaction to the debate.

UPDATE: KCCI has posted the debate video online. I cleaned up some typos and filled in gaps in the liveblog below.

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IA-02: First Miller-Meeks ad draws contrast with Loebsack

Dr. Mariannette Miller-Meeks is on the air with her first television commercial in her third campaign against Representative Dave Loebsack in Iowa’s second Congressional district. Her debut ad from the 2010 campaign contained entirely negative material about the incumbent. In contrast, the new spot jumps quickly from saying Loebsack is part of the problem to positive statements about Miller-Meeks. That strikes me as a more effective message, especially for reaching voters in counties that weren’t part of IA-02 during her previous two Congressional campaigns. Notably, Miller-Meeks is emphasizing her credentials as a doctor and a veteran. This ad says nothing about the three years she spent in state government running the Iowa Department of Public Health.

After the jump I’ve enclosed the video and transcript of “Problem.” I am seeking comment from Miller-Meeks’ campaign on where the commercial is running. The 24 counties in IA-02 are located in five separate media markets (Cedar Rapids, Quad Cities, Des Moines, Ottumwa-Kirksville, and Quincy, Illinois), making it fairly expensive to reach all voters in the district.

Any comments about the IA-02 campaign are welcome in this thread. I consider this race an uphill battle for the challenger.

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IA-02: First Loebsack and Miller-Meeks debate live-blog and discussion thread (updated)

Four-term Democratic incumbent Dave Loebsack and his three-time Republican challenger Mariannette Miller-Meeks are debating in Iowa City tonight, starting at 7 pm. Iowa Public TV is live-streaming the event here. I’ll post updates after the jump.

Any comments about the race in Iowa’s second Congressional district are welcome in this thread.

UPDATE: The archived video is now available at IPTV’s site. My comments are below.  

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IA-04: Jim Mowrer's third ad focuses on Social Security

Today Democratic candidate Jim Mowrer started running his third television commercial across Iowa’s fourth Congressional district. In look and feel, the 30-second spot closely resembles Mowrer’s first and second television ads, featuring the candidate’s own voice and the same acoustic background music. While the previous ads focused on Mowrer’s public service, the new one mentions an earlier part of his biography: the family tragedy that cemented his commitment to preserving Social Security. I’ve posted the video and transcript after the jump.

Mowrer’s new ad does not mention six-term Republican incumbent Steve King by name. Rather, the Democrat says he disagrees with those who “want to weaken Social Security.” King has voted for the House Republican Study Committee budget, which would increase the Social Security full retirement age and put Social Security’s cost of living adjustments on the “chained Consumer Price Index.” (Bleeding Heartland has explained before why chained CPI would be disastrous for lower- and middle-income Social Security recipients.) More than 100 of King’s House GOP colleagues rejected the Republican Study Committee budget.

King has also repeatedly voted for House Budget Committee Chair Paul Ryan’s budget plans, though in recent years Ryan has backed off from Social Security cuts he once advocated.

To my knowledge, King has not run any radio or television commercials this year. Nor has he given the appearance of being worried about Mowrer’s challenge. His lackluster fundraising let Mowrer build up a financial advantage. In addition, King has been relying on his son and daughter-in-law to run the campaign, rather than the professionals he brought in to manage his 2012 re-election bid against Christie Vilsack.

Mowrer talked about his family’s experience with Social Security during his appearance on the Des Moines Register’s soapbox at the Iowa State Fair. He also noted that King has voted to raise the retirement age.

King focused on health care reform during his soapbox speech, calling Obamacare “a malignant tumor that is metastasizing and feeding upon America’s God-given liberty.”

Any comments about the IA-04 race are welcome in this thread.

P.S.- Like Mowrer, Representative Dave Loebsack (D, IA-02) grew up in a family that relied on Social Security survivor benefits to keep food on the table.

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New Iowa caucus links and discussion thread

More than a half-dozen potential presidential candidates have visited Iowa since Bleeding Heartland’s last news roundup on the field. Any comments about the 2016 Iowa caucus campaign are welcome in this thread. Lots of links are after the jump.

Lest anyone think that ordinary people are unable to influence public discourse, consider this: Rand Paul’s latest Iowa visit will likely be remembered for how he ran away from the DREAMers who confronted Representative Steve King.

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Who's right about impeachment prospects: John Boehner or Steve King?

U.S. House Speaker John Boehner doesn’t want to impeach President Barack Obama. His plan to sue the president is a gambit to appease Republicans bent on fighting the president’s alleged failure “to faithfully execute the laws.” At this week’s meeting of the House GOP caucus, both Boehner and Greg Walden, head of the National Republican Congressional Committee, urged colleagues not to talk about impeachment, saying such talk only helps Democrats. Today, Boehner assured a roomful of reporters, “We have no plans to impeach the president,” claiming that such speculation was “all a scam started by Democrats at the White House.”

There’s no question Democrats have been hyping the impeachment speculation, to remarkably successful effect. The Democratic Congressional Campaign Committee took in $2 million over four days from e-mail appeals warning of Republican plans to oust the president.

But it’s a stretch for Boehner to claim Democrats dreamed up the impeachment “scam.” Dave Weigel posted a good overview of Republicans inside and outside Congress calling for impeachment within the past year, and especially within the past month.

Just a few days ago, Iowa’s own Representative Steve King predicted House Republicans will be motivated to launch impeachment proceedings if President Obama uses executive orders to give “amnesty” to undocumented immigrants. After the jump I’ve posted excerpts from those comments, as well as King’s latest op-ed piece on immigration policy (which does not mention impeachment).  

To put it mildly, King and Boehner don’t always see eye to eye on political messaging. With House leadership strongly opposed, I’m skeptical Republicans aligned with King would be able to force a vote on articles of impeachment, let alone pass such a measure. Too many people remember how calls to impeach President Bill Clinton backfired during the 1998 midterm elections. But it’s worth noting that House Republicans proceeded with efforts to remove Clinton despite the verdict voters delivered in 1998. A recent national poll indicated that even as Obama’s approval ratings remain low, two-thirds of Americans oppose impeaching him. The same poll suggested that a majority of Republican respondents favor impeachment.

What do you think, Bleeding Heartland readers? Any relevant comments are welcome in this thread.

P.S. – Great piece by Lynda Waddington on King saying, in effect, that Obama can’t feel true patriotism because “he was not raised with an American experience.”

UPDATE: Added new comments from King below. He isn’t currently pushing for impeachment but thinks the president might want to be impeached because of a narcissistic personality and “messiah complex.”

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Branstad staffer Adam Gregg will run for Iowa attorney general

No Republican stepped up to run against Iowa Attorney General Tom Miller in time to appear on the primary election ballot, but yesterday Adam Gregg announced that he will seek the GOP nomination for attorney general at the state party convention later this month. Gregg worked in private practice for the Des Moines-based Brown Winick law firm before joining Governor Terry Branstad’s staff as a legislative liaison in 2012. (He’s quitting that job to run for office.) His press release touted his work to help pass “the largest tax cut in Iowa’s history, historic education reform, and a state based, Iowa alternative to Obamacare.” The tax cut refers to the property tax reform approved during the 2013 legislative session. The Iowa Health and Wellness Plan is more accurately described as an alternative to Medicaid expansion rather than an alternative to “Obamacare.” Iowa is still implementing the 2010 Affordable Care Act.

Gregg promised “to fight everyday for Iowa families, Iowa farmers, and our constitutional freedoms,” to “be an advocate for open government,” and to “hold Washington, DC accountable when the federal government oversteps its bounds.” Around the country, many Republican state attorneys general have used the job to grandstand against federal policies they don’t like for ideological reasons. Sounds like Gregg will be emulating that model.

I don’t give him much chance of beating Tom Miller. Four years ago, Brenna Findley got in the race early and ran a strong and well-financed campaign, only to come up well short amid a huge Republican landslide. Running a statewide campaign will raise Gregg’s profile, though, and possibly open doors to future political jobs. The Des Moines rumor mill expects Miller to retire rather than seek another term in 2018. In that case, Gregg could join Findley as prominent candidates in a much more winnable race.

IA-03: David Young's coherent campaign message

From the earliest days of David Young’s campaign for U.S. Senate to the earliest weeks of his bid to represent Iowa’s third district in the U.S. House, I’ve been skeptical that many rank and file Republicans would vote for a career Congressional staffer in a competitive primary. I still view Young as an underdog going into next Tuesday’s vote. However, he has been working hard in the IA-03 counties and has put together a stronger campaign than most first-time candidates could manage.

Follow me after the jump for an overview of Young’s campaign themes, including videos and transcripts of the two television commercials he has run so far.  

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IA-03: New Matt Schultz tv ad focuses on Obamacare

Matt Schultz’s Congressional campaign released its second television commercial yesterday. Unlike the first Schultz ad, which highlighted the candidate’s record as Iowa Secretary of State, the new 30-second spot focuses on repealing Obamacare, a “disaster” for the country. After the jump I’ve posted the video and transcript of “Repeal It.”

Incidentally, the 2010 health care reform law is not “government-run health care.” That would more accurately describe a Canadian-style single-payer system (which would work much better).

Schultz claims in the ad that Obamacare will cost the country “almost 2 trillion dollars,” but the latest estimates from the Congressional Budget Office and the staff of the Joint Committee on Taxation indicate that the Affordable Care Act will cost the federal government less than previously thought. The law’s insurance coverage provisions are now expected to cost about $1.38 trillion over the next ten years. Considering all features of the health care reform law, CBO and JCT expect “that the ACA’s overall effect would be to reduce federal deficits.”

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Weekend open thread: End of 2014 legislative session edition

What’s on your mind this weekend, Bleeding Heartland readers? This is an open thread: all topics welcome.

The Iowa legislature got out of town on May 2, 110 calendar days after the 2014 session began. That’s ten days after lawmakers’ per diem payments ran out but earlier than in any year since 2010, when Democrats held majorities in both chambers. After the jump I’ve posted closing remarks delivered by the top Iowa Senate Democrats (Majority Leader Mike Gronstal and President Pam Jochum) and the top Iowa House Republicans (Speaker Kraig Paulsen and Majority Leader Linda Upmeyer). A series of posts next week will focus on some of the more significant legislative results from the session, as well as important bills that never did pass.

I’ve also enclosed Gronstal’s prepared remarks on the final Iowa Senate vote of the session: granting subpeona power to the Government Oversight Committee to continue investigating various scandals in Governor Terry Branstad’s administration. Gronstal emphasized that the resolution is “narrowly drafted” and “not a criminal investigation. The goal is not to convict people. The only goal is to find out what went wrong [in state government] and how to fix it.” The resolution passed by voice vote just before the Senate adjourned on Friday morning. Iowa Senate Minority Leader Bill Dix blasted what he called a “dangerous” and “underhanded partisan move.” He claimed the “disruption of separation of powers” will invite “a state constitutional crisis,” and that the Oversight Committee’s investigation is politically motivated.

Finally, in non-legislative news, Patrick Caldwell reported for Mother Jones this week on a remarkably shady deal involving Danny Carroll in 1996. At the time, Carroll was a real estate agent in the Grinnell area and an Iowa House Republican. He currently chairs the Republican Party of Iowa–though probably not for much longer. After reading Caldwell’s piece, I want to know why anyone supposedly committed to Christian values would participate in a scheme to take advantage of an elderly widow with debts.  

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Weekend open thread: Church and state edition

What’s on your mind this weekend, Bleeding Heartland readers? This is an open thread: all topics welcome.

The non-profit advocacy group Secularity USA brought world-famous evolutionary biologist Richard Dawkins to Des Moines on Saturday. I couldn’t make it to the event; if you were there, please share your impressions. The mission of Secularity USA is to raise public awareness “of the dangers of religious bias in government and promoting the traditional separation of church and state.” While Dawkins is a well-known atheist, Secularity USA seeks to unite “religious and nonreligious supporters of church-state separation.”

Governor Terry Branstad signed a proclamation this week inviting “all Iowans who choose to join in thoughtful prayer and humble repentance according to II Chronicles 7:14 in favor of our state and nation to come together on July 14, 2014.” I wouldn’t go so far as one blogger, who declared that Branstad “signed away separation of church and state,” but it does seem inappropriate for the governor to lend his support to such a specific religious movement. The “Prayer 7-14-14” group, which is calling for the national day of prayer, sounds pretty far out there. Endorsing this project is different from routine appearances by governors at prayer breakfasts, or the prayers that typically open daily sessions in the Iowa House and Senate.

I wonder whether the governor’s staff sensed that he crossed a line, because I didn’t see any announcement of this event on the governor’s official news feed. Normally that feed highlights several proclamation signings each week. It mentioned more than half a dozen other documents Branstad signed this past week–including, ironically, a proclamation for Muslim Recognition Day. Perhaps Branstad viewed inviting Iowans to pray on July 14 as nothing more than empty pandering to the FAMiLY Leader contingent, which is promoting the national prayer day. The governor hasn’t elevated social conservative goals in most of his public speeches or in his legislative agenda.

Former Vice Presidential nominee Paul Ryan headlined an Iowa GOP fundraiser in Cedar Rapids last night. O.Kay Henderson posted the audio at Radio Iowa. As usual for Ryan, he said little about social conservative priorities, focusing instead on federal budget and tax issues, Obamacare, and the need for Republican unity. But he did nod to his religious heritage by urging his audience to give up “infighting,” “tunnel vision,” and “acrimony” for Lent.

Last month I never managed to post a thread on one of this year’s biggest news stories related to church-state separation: the U.S. Supreme Court considering what has become known as the Hobby Lobby case. After the jump I’ve posted six links on the oral arguments in that case, which will determine whether two corporations are entitled to a religious exemption from the 2010 health care reform law’s contraception mandate.  

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Kathleen Sebelius legacy discussion thread

U.S. Health and Human Services Director Kathleen Sebelius is stepping down, news broke last night. Hours earlier, Sebelius told members of Congress that an estimated 7.5 million Americans had signed up for health insurance through the state and federal exchanges created under 2010 health care reform law. A statement from the HHS department hailed her “work on Head Start, to expanding mental health coverage, to advancing cutting-edge health care research and, of course, her unwavering leadership in implementing the Affordable Care Act.”

Naturally, instant commentaries on Sebelius’ departure have highlighted the disastrous rollout of the Healthcare.gov website. I thought she should have resigned last fall. Even though the technical failure wasn’t entirely her fault, someone should have been held accountable. Igor Volsky took a more generous view, praising Sebelius’ work with Republican governors on alternatives to Medicaid expansion. She also convinced some of them, including Iowa’s Terry Branstad, to “form partnership health care exchanges in which the federal government and the state would share responsibilities in running the marketplaces.”

All in all, I think Sebelius could have done the country more good by staying in Kansas. As governor, she could have continued to block new coal-fired power plants and veto lunatic bills coming out of the state legislature. Plenty of people could have done at least as well, if not a better job, running HHS and implementing the Affordable Care Act.

What do you think, Bleeding Heartland readers?

President Barack Obama will appoint Office of Management and Budget Director Sylvia Mathews Burwell to replace Sebelius. Juliet Eilperin and Amy Goldstein reported, “Although Burwell does not have an extensive background in health-care policy, she is known for her strong management skills and has experience in issues of poverty and global health issues from her time at the Bill and Melinda Gates Foundation. Moreover, she is popular on Capitol Hill. The Senate confirmed her as OMB director 96 to 0 almost exactly a year ago.” Some Republicans are already praising her, and in any event, the 60-vote threshold for confirming presidential appointees no longer applies in the Senate.

Mid-week open thread: Ripoffs, real and imagined

Here’s an open thread: all topics welcome.

The Iowa Policy Project has called wage theft “an invisible epidemic” costing Iowa workers an estimated $600 million each year. Click here for a few examples of how wage theft works. Last week the Iowa Senate approved on party lines a bill to address common forms of wage theft (full text here). However, that bill is not moving in the Republican-controlled Iowa House.

Joseph Williams published a depressing account of his short career in low-wage retail after losing his journalism job. Even though he made more than minimum wage, it wasn’t enough to cover basic expenses. Williams also experienced wage theft and the small humiliations inflicted by “loss prevention” policies.

The Center for Public Integrity’s Daniel Wagner wrote a disturbing piece about aggressive debt collection tactics targeting Americans doing military service.

Sometimes feeling cheated and getting a raw deal are very different things. After the jump I’ve posted an excerpt from a Detroit News feature on a Michigan woman now starring in a television commercial attacking health care reform as “unaffordable.” Turns out she will save quite a bit of money under her new “Obamacare” health insurance–but she doesn’t believe it. Classic case of cognitive dissonance.

Your unintentional comedy for the week is a letter to the editor from the March 7 Des Moines Register, in which a man complains of being ripped off at a “Duck Dynasty” speaking engagement.

After shelling out a considerable sum for a VIP meet-and-greet session, I arrived to stand in line with over 300 other VIP patrons. I was told I would have 7.5 seconds with each of Willie and Phil Robertson. When I finally made it to their table, I was rushed through in seconds. I handed my Bible to Phil for an autograph and he scribbled an illegible name. My “VIP Seating” ended up being in the 15th row next to non-VIP patrons who paid nearly one-tenth the price of my experience.

When the program started, Willie spoke about the makings of their show. Phil then took the stage with a few minutes of duck-calling, followed with a lengthy rant about how Americans are being denied the rights written in the United States Constitution.

Disgusted, I got up and left before it ended. The event was nothing but a marketing scheme that took money from hard-working Americans.

A marketing scheme–who could have guessed? But seriously, isn’t it blasphemous to ask a television celebrity to sign your Bible?

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No rebates coming for Wellmark health insurance policy-holders

Iowans who buy health insurance through Wellmark Blue Cross and Blue Shield won’t be getting premium rebates anytime soon. Wellmark has a near-monopoly on Iowa’s individual and employer health insurance market. After the company announced last summer that it would not participate in the state’s health insurance exchange during its first year of operation, Democratic State Senators Jack Hatch and Matt McCoy questioned why the company was holding about $1.3 billion in reserves. The senators argued that the Iowa Insurance Division had previously justified Wellmark’s large cash reserves on the grounds that the company would be selling policies through the health exchange created under the 2010 Affordable Care Act. Hatch and McCoy asked Iowa Insurance Commissioner Nick Gerhart to study the issue, and in November, Gerhart retained Risk and Regulatory Consulting to investigate Wellmark’s reserve levels.

The consultants’ report, made public yesterday, concluded that Wellmark’s cash reserves are “reasonable and prudent.” Click through to read the full six-page report at the end of the article by Tony Leys of the Des Moines Register.

I’ve enclosed below a few excerpts from Leys’ report, Hatch’s letter to Gerhart last July, which provides background on the issue, and the joint statement Hatch and McCoy released yesterday. They noted that Wellmark “will be using its current reserves to protect them from risks that do not exist for them; namely, the Insurance Marketplace Exchange.” Hatch and McCoy added that the report “puts to rest the notion that the ACA could ever be the basis for a future premium increase by the company, at least in the next three years.”

After many years of double-digit percent increases in health insurance premiums, Wellmark did not raise premiums for many of its individual customers this year, presumably to deter them from shopping for a better deal on Iowa’s exchange. I predict Wellmark will cite the 2010 health care reform law as an excuse for raising premiums again before too long. Iowa individuals and families can purchase policies on the exchange from either Coventry or Co-Oportunity Health. Only Co-Oportunity is selling employer health insurance plans through Iowa’s exchange.

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Anti-abortion bill splits Iowans on party lines

The U.S. House approved a bill yesterday that would make the “Hyde amendment” banning federal taxpayer funds for abortions a permanent law rather than a restriction requiring annual approval. Pete Kasperowicz reported for The Hill,

Republicans noted that Democrats just a few weeks ago approved the Hyde Amendment as part of the omnibus spending bill. They said that approval shows how noncontroversial the permanent measure should be. But Democrats countered that the bill is unnecessary precisely because Congress continues to approve the rider annually.

“This bill is a hoax,” said Rep. Louise Slaughter (D-N.Y.). “Federal taxpayer [money] is not spent on abortion.” […]

During the floor debate, Slaughter said the bill is really an attack on ObamaCare, because it would end the payment of federal subsidies to people who use the healthcare law to buy health insurance that covers abortion. Slaughter said that change would chip away at women’s rights by imposing a financial hurdle to getting an abortion and accused Republican men of coming up with a policy that no woman wants. […]

Republicans said ObamaCare needs to be tweaked because it requires taxpayers to subsidize the purchase of health plans that cover abortion, which frustrates the intent of the Hyde Amendment.

The “No Taxpayer Funding for Abortion Act” passed by 227 votes to 188, with very few representatives crossing party lines. As expected, Iowa Republicans Tom Latham (IA-03) and Steve King (IA-04) supported the bill, while pro-choice Democrats Bruce Braley (IA-01) and Dave Loebsack (IA-02) voted no. So far, I’ve only seen public comment on this vote from King; his news release is after the jump.  

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2014 State of the Union discussion thread (updated)

President Barack Obama addresses both houses of Congress tonight. The big policy news will be a new executive order requiring federal contractors to pay workers hourly wages of at least $10.10. The move could affect hundreds of thousands of workers. Last year the president proposed increasing the federal minimum wage to $9.00 per hour, but Senator Tom Harkin and other liberal Democrats argued for raising the wage to $10.10. Obama indicated his support for that wage level in November.

I will update this post later with highlights from tonight’s speech and reaction from Iowa’s Congressional delegation. Meanwhile, this thread is for any comments about the substance or the politics of the State of the Union address.

On a related note, I hope Treasury Secretary Jack Lew is right about the president refusing to negotiate with Congressional Republicans over raising the debt ceiling.

UPDATE: Click here for the full transcript of the president’s speech, as prepared. I’ve added some Iowa reaction after the jump.

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Strengths and weaknesses of Brenna Findley in an IA-03 GOP primary

I was skeptical about these rumors, but according to Craig Robinson of The Iowa Republican, Governor Terry Branstad’s legal counsel Brenna Findley “has been meeting people about a congressional run in the Third District.” Findley told the Des Moines Register “that she appreciates the encouragement, but she’s focused on her job” in the Branstad administration. That phrasing falls short of ruling out a Congressional bid.

Follow me after the jump for first thoughts on strengths and weaknesses Findley might bring to a GOP primary campaign. At the end of this post, I’ve enclosed background on the potential candidate from her 2010 campaign bio and the news release announcing her appointment as legal counsel.  

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Self-awareness is not Steve King's strong suit

Via Bret Hayworth’s blog at the Sioux City Journal, I see that Representative Steve King (R, IA-04) took offense at a report that House Speaker John Boehner used an unprintable word to refer to him. The incident allegedly happened at the height of last summer’s furor over King’s views on the children of undocumented immigrants. Hayworth writes that King responded to the report with a statement:

“There can be honest disagreements about policy without using hateful language. Everyone needs to remember that,” King said. “I want to be clear. There’s no place in this debate for hateful or ignorant comments from elected officials. What he said does not reflect the values of the American people or the Republican Party, and we all need to do our work in a constructive, open and respectful way.”

You read that right: Steve King sees “no place in this debate for hateful or ignorant comments from elected officials.”

This from the guy who made “cantaloupe calves” a national symbol of the GOP’s hostility to undocumented immigrants.

This from the guy who created a visual aid re-naming the State Children’s Health Insurance Program (SCHIP) “Socialized Clinton-style Hillarycare for Illegals and their Parents.”

For the record, I don’t care what Boehner called King in an angry moment. I do care that King’s faction of the House GOP caucus seems to have successfully blocked comprehensive immigration reform during this Congress. President Barack Obama thinks an immigration bill will pass this year, but I’ll believe it when I see it.

UPDATE: King’s statement may have been crafted for humorous effect, as his phrasing mirrored Boehner’s comments about King last summer. But get real: calling someone an expletive is not as “hateful” and “offensive” as saying DREAMers are 100 times more likely to be drug mules than valedictorians.

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IA-Sen, IA-02: Braley and Loebsack vote for another GOP bill on Obamacare

For the second time in a week, Iowa’s Democratic representatives in the U.S. House Bruce Braley (IA-01) and Dave Loebsack (IA-02) voted for a bill calling attention to problems with the federal government’s implementation of the 2010 Affordable Care Act. Depending on whom you believe, the Exchange Information Disclosure Act is either an effort to improve oversight and transparency through weekly updates or what Representative Henry Waxman called an attempt to impede the new law by “drowning the Department of Health and Human Services in red tape.” Nevertheless, 33 Democrats including Braley and Loebsack joined all of the Republicans present to approve the bill yesterday (roll call). I haven’t seen any comment on this bill from them or from Representatives Steve King (IA-04) and Tom Latham (IA-03), who both supported it.

No matter how many anti-Obamacare bills Braley and Loebsack vote for, their opponents and outside conservative groups will run campaign ads attacking them for having helped pass the 2010 health care reform law. In fact, Americans for Prosperity (a right-wing group funded by the Koch brothers) is running television commercials in Iowa right now targeting Braley, the Democratic candidate to replace Tom Harkin in the U.S. Senate. The commercials focus on the so-called “lie of the year,” President Barack Obama’s claim that “If you like your health care plan, you will be able to keep your health care plan.” Scroll to the end of this post to read the Braley’s campaign’s response, which includes the ad script. In November, Braley and Loebsack voted for a bill that would let some consumers stay on insurance plans that don’t comply with all Affordable Care Act requirements.

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Highlights from Branstad's 2014 Condition of the State address

Governor Terry Branstad delivered his annual “Condition of the State” address to Iowa lawmakers this morning. By Branstad’s standards, it was not a partisan speech. He drew several standing ovations from legislators in both parties, and it’s easy to imagine the Democratic-controlled Iowa Senate embracing most of the policies he advocated. In fact, immediately after the speech, Senate Majority Leader Mike Gronstal told Iowa Public Television’s Dean Borg that he “didn’t hear anything” he disagreed with. Gronstal did get in a quick jab at the governor, though, pointing out that Branstad hailed “predictability” for the state budget, which is what statehouse Democrats are seeking for school districts. During the last two years, House Republicans and Branstad have refused to comply with Iowa law requiring the legislature to set allowable growth levels for K-12 school districts a year in advance.

Highlights from the governor’s speech are after the jump. Click here to read the full text, as prepared. Any relevant comments are welcome in this thread.

Stylistic note: for a guy who’s been in politics as long as Branstad has, he keeps his eyes glued to his script a lot. Experienced public speakers typically make more eye contact with the audience.  

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Braley, Loebsack back latest Republican anti-Obamacare bill

As Republicans prepare to make “Obamacare” a central argument against any incumbents who voted for the 2010 health care reform law, many House Democrats are looking for political cover. So it was on Friday, when a third of the Democratic caucus voted for the latest Republican bill in the U.S. House targeting the law. Pete Kasperowicz reported for The Hill,

The one-sentence bill says that no later than two business days after any security breach on an ObamaCare site is discovered, “the Secretary of Health and Human Services shall provide notice of such breach to each individual.” […] The White House said it opposed the bill, arguing the government already has plans to tell people if their information has been compromised. […]

Democrats said the GOP was trying to stir up fears about HealthCare.gov and the other enrollment sites by raising the idea that people’s personal information could be stolen.

“There have been no successful security attacks on HealthCare.gov, and no one has maliciously accessed personal information,” said Rep. Frank Pallone (D-N.J.). “This is just another one of those scare tactics, and I just hope that my colleagues, both Democrats and Republicans, are not fooled by this.”

The roll call on the “Health Exchange Security and Transparency Act” shows that Iowa Representatives Bruce Braley (IA-01) and Dave Loebsack (IA-02) were among the 67 House Democrats who joined all the Republicans present to approve this bill by a large margin. Neither called attention to the vote with a press release. After the jump I’ve posted the statement from Representative Steve King (IA-04), who has long been one of the most vocal critics of the Affordable Care Act. I didn’t see any statement from Tom Latham (IA-03), who also voted for this bill.

Like the last anti-Obamacare measure Braley and Loebsack supported, this bill will neither become law nor insulate the Democrats from attacks during this year’s campaigns for U.S. Senate or Iowa’s second Congressional district.  

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New Year's Day open thread

Happy new year to the Bleeding Heartland community. Here’s an open thread. I’m among the minority of Iowans not watching the Outback Bowl today, but for what it’s worth, I do hope the Hawkeyes beat Louisiana State. LSU jumped out to an early lead.

Several new laws take effect in Iowa today, notably the alternative to expanding Medicaid, just approved by the federal government in mid-December. Under the plan, federal funds will cover Medicaid for Iowans earning up to 100 percent of the federal poverty level and private health insurance for Iowans with incomes between 100 and 138 percent of the federal poverty level. In theory, the Iowa Health and Wellness Plan is supposed to cover between 100,000 and 150,000 people, roughly half of our state’s uninsured population. Problems with the federal health insurance exchange website may leave a lot of people with a gap in coverage, though. The Iowa Department of Human Services has advised roughly 16,000 Iowans who applied for coverage through Healthcare.gov and may be eligible for Medicaid to apply again to the state agency. If they apply by January 31, they can get coverage retroactive to today.

Teen drivers in Iowa face new restrictions under Senate File 115, which passed both chambers with large bipartisan majorities last year. After completing driver’s ed and having an instruction permit for six months, teenagers will have an intermediate license for 12 months (extended from six months under the previous statute). Also, the teen driver’s parents have the option to limit the driver to having no more than one unrelated minor passenger in the vehicle. Rod Boshart explained more details about the new law, intended to reduce the risk of traffic accidents involving young drivers.

Boshart also reports, “Thousands of commercial property owners in Iowa face a Jan. 15 deadline to apply in their counties for a new tax credit established” in the compromise property tax bill approved at the end of last year’s legislative session with strong bipartisan support.

As of today, it is legal in the state of Colorado to sell marijuana to people over age 21 at certain licensed stores. Drivers with Colorado license plates were already among the groups more likely to be pulled over by Iowa State Patrol. I would guess that profiling will increase.

In some parts of the country, black-eyed peas are considered a lucky food to eat on New Year’s Day. I’m not a fan of “hoppin’ John,” the most traditional preparation, but I’ve posted the recipe for my favorite black-eyed peas dish after the jump.  

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Branstad, federal officials reach agreement on Medicaid expansion alternative

Governor Terry Branstad announced today that his administration and officials in the U.S. Department of Health and Human Services have struck a deal over the Iowa Health and Wellness Plan, our state’s alternative to a straightforward Medicaid expansion. Earlier this week, federal officials approved most of the proposal but rejected a provision that would have kicked some low-income Iowans off the plan if they failed to pay monthly premiums. Under the tentative agreement, Iowa would still be able to charge premiums to some people who did not meet wellness criteria, but those people would not lose coverage for not paying the premiums. A statement released by the governor’s office is after the jump.

Branstad had the option of appealing the HHS decision, and Iowa House Speaker Kraig Paulsen suggested yesterday that Iowa officials should fight for the whole plan state legislators approved in May. Iowa Senate Majority Leader Mike Gronstal argued that the governor should “take the deal” federal officials approved: “It wasn’t the whole nine yards, but it was about 8.9 yards. It was most of what we asked for.” Commenting on this evening’s news, Senate President Pam Jochum said, “Hallelujah. Amen. […] I can’t imagine the governor would have wanted to be held responsible for 55,000-plus people losing coverage come Jan. 1.”

Any relevant comments are welcome in this thread. Charging even small health insurance premiums to people making less than $11,000 a year is stupid in my opinion, but this compromise is better than no coverage for tens of thousands of Iowans.

P.S.- Can’t help noticing how just like the messaging from his re-election campaign, the governor’s press releases invariably mention Lieutenant Governor Kim Reynolds whenever possible. I doubt she played any role in these negotiations or the governor’s decision not to appeal the HHS decision on the Iowa Health and Wellness Plan.

UPDATE: Added comments from Representative Bruce Braley (D, IA-01) below. Last week he wrote to Health and Human Services Secretary Kathleen Sebelius urging the federal government to approve a waiver for Iowa.

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