# Health Care Reform



Seeking information on a push-poll in IA-02

I’ve heard several accounts of a push-poll going around Iowa’s second Congressional district since shortly before Thanksgiving. The call apparently asks about four-term incumbent Dave Loebsack, his declared Republican opponent Mark Lofgren, and his 2008 and 2010 opponent Mariannette Miller-Meeks, who appears likely to run for Congress again. Some Republican-aligned entity clearly paid for the calls, because the script alleges that millions of people have lost their health care (a reference to many health insurance plans being cancelled for not meeting new federal requirements). The script also suggests that Loebsack lied about the health care reform law he voted for in 2010.

I encourage Bleeding Heartland readers to stay on the line and take notes whenever you receive a push-poll or a legitimate survey testing messages for or against any candidate. If you received a call like this recently in IA-02, any details you can remember would be helpful, such as the question wording, question order, or who paid for the call (should be mentioned at the end). You can either post information in this thread or contact me confidentially: desmoinesdem AT yahoo.com.

One person thought the call came from “Victory Polling.” The Davenport-based political consulting firm Victory Enterprises has a polling division and has been doing work for Lofgren’s campaign. It’s also possible that the National Republican Congressional Committee or some conservative group that gets involved in House races would pay for calls hitting Loebsack on health care reform.  

Federal government approves most of Iowa's Medicaid expansion alternative

The U.S. Department of Health and Human Services has granted a waiver for Iowa’s alternative to the Medicaid expansion foreseen under the 2010 health care reform law. Governor Terry Branstad signed the Iowa Health and Wellness Plan compromise into law in June, and state officials submitted a formal request for a waiver in August. Iowa elected officials from both parties as well as many non-profit organizations with a stake in the outcome had urged Health and Human Services to approve the plan.

However, Governor Terry Branstad may appeal today’s decision, because federal officials rejected a provision he insisted on during negotiations with Democrats in the Iowa legislature.

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IA-Sen: Strengths and weaknesses of Mark Jacobs

Catching up on news from last week, former energy company chief financial officer Mark Jacobs is now an official candidate for the U.S. Senate. His campaign is on the web here, on Facebook here, and on Twitter here. Scroll to the end of this post to read his announcement speech in full, or listen to it at Radio Iowa. The key excerpt: “Jobs are my top priority. In fact, you can’t spell Jacobs without jobs. And if you send me to the United States Senate, I will make jobs for Iowa my number one priority.”  

Here’s my first take on Jacobs’ strengths and weaknesses in the crowded Republican field. Any comments about the Senate race are welcome in this thread.  

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Grassley accuses Democrats of diversion as Republicans filibuster another nominee (updated)

Republicans in the U.S. Senate again blocked a vote on one of President Barack Obama’s judicial nominees yesterday. Robert Wilkins has served on the U.S. District Court for Washington, DC since his unanimous confirmation in 2010. But a cloture motion on Wilkins’ nomination to the U.S. Court of Appeals for the District of Columbia Circuit failed with just 53 votes out of the 60 needed to end debate. Iowa’s Senator Chuck Grassley is the ranking Republican on the Senate Judiciary Committee and has led recent filibusters on two other nominees to the D.C. Circuit, claiming the court’s workload does not justify additional judges. In a floor statement that I’ve posted after the jump, Grassley made the same assertion but added a new twist:

There is no crisis on the D.C. Circuit, because they don’t have enough work to do as it is. […]

Even though we have a very real and very serious crisis facing this country because of Obamacare, the other side is desperately trying to divert attention to anything but the Obamacare disaster.

I’ve also posted statements below from the National Women’s Law Center and the Alliance for Justice, which again called for Senate rules reform. Nothing in the U.S. Constitution says that presidential nominees need a super-majority to be confirmed by the Senate.

UPDATE: I did not realize that Judge Wilkins filed the lawsuit against the Maryland State Police “that helped popularize the term ‘driving while black'” during the 1990s.

I’ve added some clips at the end of this post on the growing momentum for changing Senate rules to end fillibusters of judicial nominees.

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Paul Ryan's going to need a better message than that (updated)

Roughly 800 people came to Altoona on Saturday night to celebrate Governor Terry Branstad’s birthday and raise money for his re-election campaign. The featured speaker was House Budget Committee Chair and 2012 Vice Presidential nominee Paul Ryan. Listening to his remarks at Radio Iowa’s website, I didn’t hear a serious contender for the presidency in 2016.

Three big things were missing from Ryan’s speech.

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IA-Sen, IA-02: Braley, Loebsack run for the hills on health care reform (updated)

All four Iowans in the House of Representatives voted today for the Keep Your Health Plan Act “that allows insurance companies to offer health plans that were cancelled for not meeting new requirements under ObamaCare.” Bruce Braley (IA-01) and Dave Loebsack (IA-02) were among the 39 Democrats who crossed party lines to support the bill, joining Tom Latham (IA-03), Steve King (IA-04), and almost all the Republicans present.

Braley and Loebsack both voted for the Affordable Care Act in 2010 and have opposed most of the Republican bills to repeal the health care reform law. For instance, Iowa’s representatives split on party lines when the House voted in August a bill “to prevent the IRS from enforcing any aspect of ObamaCare,” and when the House voted in July to delay the individual mandate to purchase health insurance.

However, occasionally Braley and/or Loebsack have gone along with GOP efforts to alter the Affordable Care Act. In 2012, Loebsack voted with Republicans to repeal a 2.3 percent tax on medical device manufacturers. In July of this year, Braley joined Republicans to pass a bill delaying the employer mandate to provide health insurance for one year. (President Barack Obama had already announced his decision to delay the employer mandate, despite the financial and political costs of doing so.)

Given the media firestorm over some Americans losing the health insurance plans Obama promised they could keep, I’m not surprised Braley and Loebsack ran for cover today. Both had narrow escapes in 2010 and may face tough election campaigns in 2014.

After the jump I’ve enclosed comments from some of the Iowans in Congress on today’s vote and on the president’s administrative “fix” that may allow some people to keep insurance policies that would have been cancelled for not meeting ACA requirements. (Few Iowans need this fix, because Wellmark and most other health insurance providers were already allowing Iowans to keep their individual policies for another year.) I also enclosed details on why Obama has threatened to veto the bill that passed the House today. Senator Tom Harkin is determined to prevent it from passing the U.S. Senate.

UPDATE: Added a statement from Latham below. Also, the Koch-funded group Americans for Prosperity wasted no time in signaling that they will attack Braley on “Obamacare” regardless of this vote. I doubt he’s gained any political protection for the U.S. Senate race.

SECOND UPDATE: Added new comments from Braley.

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Health exchange website fiasco links and discussion thread (updated)

Three weeks into the launch of exchanges where millions of Americans are supposed to shop for private health insurance, the federal Healthcare.gov website is still a disaster. At a White House press conference today, President Barack Obama promised a massive effort to fix the problems and highlighted other benefits of the 2010 Affordable Care Act.

After the jump I’ve posted news and analysis related to the botched rollout of the health insurance exchanges. Any comments related to the 2010 health care reform law are welcome in this thread. It’s worth noting that Democrats in the Iowa legislature favored creating a state-run exchange, which would have eliminated the need for Iowans to purchase insurance through the screwed-up federal website. But Governor Terry Branstad insisted on a state-federal partnership, under which the federal government would administer the website for finding health insurance.

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Possible 2016 presidential candidates comment on budget/debt ceiling deal

Most Americans are relieved the federal government will be fully operational again this week, but the short-term deal on the 2014 budget and debt ceiling isn’t popular on the right wing of the Republican base. I got a kick out of this “Tea Party Insult Generator” based on real comments posted to House Speaker John Boehner’s Facebook page.

Of the members of Congress who may run for president in 2016, only Representative Peter King of New York voted yes on the deal to reopen the government (the House roll call is here, and the Senate roll call is here). King isn’t a real contender for the GOP nomination anyway; he would be running for president to send a message.

House Budget Committee Chairman and former Vice Presidential nominee Paul Ryan voted no last night, as did Senators Rand Paul, Marco Rubio, and Ted Cruz. After the jump I’ve posted statements from all of those politicians about the deal. Their talking points will make a good impression on likely Iowa Republican caucus-goers, even if the events of the last few weeks have hurt the GOP on the generic Congressional ballot.

Any comments about the federal budget, debt ceiling, or next presidential campaign are welcome in this thread.  

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Medical Device Manufacturers About to Get a Sweet Deal

(Thanks to JonMuller for an illuminating look at the medical device excise tax, which Congressional Republicans have been trying to repeal. Iowa's representatives have split along party lines over eliminating this tax.   - promoted by desmoinesdem)

Imagine you own a business.  There’s a knock on the door.  It’s the government, and they’re here to help.  “We’re going to give everyone enough money to buy your product.  We’re not going to make anyone buy it, but it won’t cost them anything if they do.  Your profit is going grow 20%, but we’re going to take half of the new profit so we can afford to pay people to buy it.  But you get to keep the rest.

That’s essentially what happened with the Affordable Care Act (ACA) with respect to Medical Device Manufacturers (MDM).  MDM’s started paying a 2.3% excise tax on the sale of their wares in January 2013.  The logic behind the compromise was as simple as the opening scenario.  Prior to ACA, 30 million to 50 million people were either uninsured or uninsurable.  As a practical matter, people without insurance go without hip and knee replacements and similar procedures.  They just limp.

While there may well be more knee replacements, there will be many more people with insurance, and virtually everyone will have access to insurance if they need it.

Now the winds are shifting.  Tea Party Republicans, ostensibly opposed to deficit spending, have shut down the government and are threatening to cause the first credit default in US history.  In a particularly ironic twist, a compromise is emerging, most recently championed by Sen. Susan Collins, a Republican from Maine, to repeal the tax on MDMs.

In other words, the government will be greatly expanding the market and increasing the profits of MDMs, but will not ask for anything in return for that expanded market.  The result will be an increase in the deficit of $30 billion over the next 10 years.

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More Iowa Congressional voting and reaction to the government shutdown

It’s time for a new post on how Iowa’s representatives in the U.S. House and Senate are handling the ongoing shutdown of non-essential federal government operations. (Click here for details on Congressional votes and Iowa political reaction up to October 1.)

Thousands of Iowans who work for the federal government or serve in the National Guard still have no idea when they’ll receive their next paycheck. The best news I’ve heard all week is that an estimated 66,000 Iowa women and children who receive benefits through the WIC program will get their checks for October, at least.  

Although there has been no progress toward an agreement on a continuing spending resolution, I’ve noticed one big change in Iowa Congressional voting during the last few days. Whereas Representatives Bruce Braley (IA-01) and Dave Loebsack (IA-02) were sticking with most of their fellow Democrats in earlier votes on federal spending, this week both Braley and Loebsack have joined House Republican attempts to fund the federal government in bits and pieces. Follow me after the jump for more details.

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Lingering question about Iowa Medicaid expansion debate answered?

During the past year, Republican governors have been split on expanding Medicaid as foreseen under the 2010 Affordable Care and Patient Protection Act. The U.S. Supreme Court made Medicaid expansion optional for states in its decision upholding most of the health care reform law. More than a dozen GOP governors were happy to opt out, but many prominent state leaders came around to supporting the Medicaid expansion, including Chris Christie of New Jersey, John Kasich of Ohio, Susana Martinez of New Mexico, Rick Snyder of Michigan, and even Jan Brewer of Arizona. Kasich has emphasized the moral imperative to give the poor better access to health care. Snyder has made a more pragmatic case, citing the over-use of emergency rooms by the uninsured and the burden that uncompensated hospital care places on businesses and insured individuals. Christie emphasized cost savings to New Jersey taxpayers.

Despite Governor Terry Branstad’s posturing against the health care reform law before and after the Supreme Court’s ruling, I figured he would eventually come around like Snyder and Christie did. Branstad used to be president of a medical school in Des Moines, so I thought he would be influenced by the Iowa Hospital Association’s case for Medicaid expansion. I expected him to return from a meeting with U.S. Health and Human Services Secretary Kathleen Sebelius saying he had negotiated a great deal for Iowa on Medicaid.

Instead, Branstad stuck to his guns throughout the 2013 legislative session, insisting on a more costly alternative that would cover fewer Iowans. I suspect that he promised to sign the final compromise only because Iowa Senate Democrats appeared unwilling to approve commercial property tax changes or education reform without a deal to expand health care access to low-income Iowans.

Branstad’s not a policy wonk. He’s always been strongly influenced by other people’s advice. So one question in my mind was, who kept telling him to ignore the Iowa Hospital Association, county officials and many other health care organizations and advocacy groups, which lobbied for Medicaid expansion?

This week Iowans may have gotten the answer.

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Branstad signs Medicaid expansion alternative

Governor Terry Branstad signed into law today a bill setting Iowa’s health and human services budget for the next fiscal year and establishing a new “Iowa Health and Wellness Plan” for low-income Iowans not currently covered by Medicaid. The full text of Senate File 446 is available here. Division XXXIII contains the language on the Iowa alternative to expanding Medicaid, a compromise struck in the closing days of the legislative session last month.

After the jump I’ve posted some links and comments on today’s news. As far as I can tell, Branstad has not yet explained why he is happy to accept federal funding for the Iowa Health and Wellness Plan, likely to be more expensive than expanding Medicaid would have been. Earlier this year, he made a huge fuss about how we can’t afford such a program because of the federal deficit, and how we can’t trust the feds to live up to their funding promises.

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IA-Sen: Sam Clovis hints at decision soon

Conservative talk radio host and Morningside College professor Sam Clovis plans a press conference on June 10, Bret Hayworth reported for the Sioux City Journal yesterday. Clovis has previously said he may run for Iowa’s open U.S. Senate seat. He declined to specify whether he will announce a Senate campaign on Monday, but said he will disclose news “that affects my future” and “is a commitment for something down the road.” These comments seem to indicate that Clovis is leaning toward running:

“I’m a very principled man, a man of great integrity, so that is a skill set that I think is very much there,” he said.

“I’ve been a natural leader my whole life and I think those are, again, skills that are very lacking in Washington. Because we don’t have people who are willing to stand up and tell people the truth and then stick to their principles to make sure that happens. Everything seems to be about self-interest, nothing seems to be about the people of the country.”

Clovis added, “I’ve been an executive, I’ve been in business, non-profit, for-profit, education, military service second to none, a very distinguished career there. So I have all of the credentials that one would need to be a person that one would look to to lead and do the things that are necessary to lead this country, particularly if one pursued public office in the United States Senate.”

I have no idea whether Clovis can raise enough money to run a credible statewide campaign, but having hosted a radio show for the past two years, he probably has better communication skills than any other potential Republican candidate. As a self-described “red-meat conservative,” Clovis would compete aggressively in a primary. Both of the declared GOP Senate candidates have vulnerabilities: Matt Whitaker failed to stake out a clear position on “Obamacare,” and David Young (amazingly) was not familiar with the “fair tax” proposal.  

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IA-Gov: Jack Hatch is in (sort of)

State Senator Jack Hatch announced on twitter and Facebook this evening that he will “take the next step on the road to Terrace Hill in 2014” tomorrow. It’s no surprise, since he had previously signaled his intention to challenge Governor Terry Branstad.

I will update this post tomorrow with details from Hatch’s announcement. His campaign website is here. Any comments about the governor’s race are welcome in this thread.

UPDATE: Added the official bio from Hatch’s website after the jump.

SECOND UPDATE: At a press conference on May 29 (audio at Radio Iowa), Hatch said he is exploring a run for governor and will tour Iowa for three months before deciding whether to pursue the campaign by the end of the summer. He hopes to raise $1 million by the end of this year. Hatch indicated that he will not run for governor if either Tom Vilsack or Chet Culver decide to seek the office again.

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Health insurance compromise will be key issue in Iowa Senate district 27 (updated)

Many questions remain to be answered about Iowa’s new plan to provide health insurance to low-income citizens, but this much is clear: resolving the impasse over Medicaid expansion will be a major theme in State Senator Amanda Ragan’s re-election campaign next year.

Follow me after the jump for background on Ragan and more details about Iowa Senate district 27, sure to be targeted by both parties in 2014.  

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Last-minute Iowa legislative scramble is nothing to brag about

The Iowa Senate wrapped up its work for the year shortly after midnight on May 23, and Iowa House members adjourned about 11 hours later. Lawmakers in both parties have been congratulating themselves for compromising on some big issues that ended in stalemate the previous two years. Rod Boshart compiled an excellent list of what the legislature did and didn’t approve during 2013.

We all can appreciate the desire to finish a big project before a holiday weekend, and since legislators stopped receiving per diem payments weeks ago, they understandably wanted to get out of town as quickly as possible. However, I found it disturbing that votes were held before most lawmakers, let alone members of the public, had time to digest final conference committee deals on education reform, an alternative to Medicaid expansion, property taxes, and the health and human services budget. Transparency isn’t just a buzzword. Had journalists and advocacy groups been able to look over the last-minute compromises, people might have discovered problematic language or even simple drafting errors, which could produce unintended consequences after Governor Terry Branstad signs these bills into law.

I have a lot of questions about the final education reform bill and the plan to provide health insurance to low-income Iowans, particularly those earning between 101 percent and 138 percent of the poverty level. I also need more time to sort through the budget numbers and final changes to the standings bill. After the holiday weekend Bleeding Heartland will examine the important results of the legislative session in more detail. For now, I’ve posted after the jump details on who voted for and against the major bills approved this week.

UPDATE: In the May 24 edition of the On Iowa Politics podcast, statehouse reporters Mike Wiser and James Lynch discussed how the big issues came together “behind closed doors,” with no public scrutiny or oversight. Lynch commented that to his knowledge, the conference committee named to resolve the impasse over Medicaid expansion never formally met, except perhaps for one organizational meeting. Lynch recounted one occasion when Iowa House Republican Dave Heaton was briefing journalists about the health care talks, and the journalists asked when that happened, since there hadn’t been any public notices of conference committee meetings. According to Lynch, Heaton replied, “We’re not having meetings, but we’re meeting.” Senate President Pam Jochum said that negotiations between Democratic State Senator Amanda Ragan and House Majority Leader Linda Upmeyer produced the “key to Iowa’s health care compromise.” Notably, Upmeyer didn’t have a prominent role in passing the House health insurance plan, nor was she named to the conference committee assigned to merge the House and Senate proposals.

Speaking to journalists on May 22, Senate Majority Leader Mike Gronstal and Jochum weren’t able to answer a specific question about compromise wording reached regarding Medicaid coverage of abortions. That was no minor issue–it was the last sticking point holding up approval of the health and human services budget. In effect, Gronstal told journalists, you can see the wording after the final bill is published.

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IA-Sen candidates mostly unknown, Quinnipiac poll shows

All of the candidates seeking to replace U.S. Senator Tom Harkin will need to work hard on raising their name ID in the coming year, judging from the new Quinnipiac University poll. Quinnipiac surveyed 1,411 registered Iowa voters between May 15 and 21, producing a margin of error of +/- 2.61 percentage points. Representative Bruce Braley, who is so far unchallenged in the Democratic primary, is the best known of the Senate contenders, but even so, 57 percent of respondents said they had not heard enough about him to form an opinion. Braley was in positive territory (27 percent favorable/14 percent unfavorable) among the respondents who expressed an opinion.

Quinnipiac asked Iowans about five potential Republican candidates for Senate. Although Secretary of State Matt Schultz holds a statewide office, 81 percent of respondents said they had not heard enough about him to form an opinion. About 11 percent had a favorable view of Schultz, 7 percent unfavorable.

The other possible GOP candidates were even less well known. Former U.S. Attorney Matt Whitaker’s numbers: 8 percent favorable, 4 percent unfavorable, 86 percent haven’t heard enough. State Senator Joni Ernst: 5 percent favorable, 3 percent unfavorable, 92 percent haven’t heard enough. Iowa GOP chair A.J. Spiker: 2 percent favorable, 6 percent unfavorable, 91 percent haven’t heard enough. Senator Chuck Grassley’s staffer David Young: 3 percent favorable, 2 percent unfavorable, 94 percent haven’t heard enough.

Several of those Republicans are much more widely known among GOP activists. Still, the Quinnipiac poll indicates that the eventual nominee will have plenty of work to do before the June 2014 primary. Then again, the competitive GOP race will generate a lot of media coverage next spring, while Braley could be fighting to keep his name in the news without a rival on the Democratic side.

Speaking of Republican competition, Sioux City-based college professor and talk radio host Sam Clovis may run for Senate. He told Bret Hayworth of the Sioux City Journal that he is “deeply steeped in the intellectual aspects of conservatism” and could appeal to the primary voters who are “ready for a red-meat conservative.” The Iowa Republican’s Craig Robinson reported that Young has resigned his position on Grassley’s staff, is buying a house in Dallas County, and has retained consultants and a pollster for a Senate race. Meanwhile, Whitaker is already moving to the right on “Obamacare.”

New hope for Medicaid expansion in Iowa?

When news broke last week of a tax compromise skewed toward business, I wondered why Senate Democrats would agree to pass that bill without progress toward Medicaid expansion, one of their top priorities. Governor Terry Branstad was saying legislators should adjourn after approving a budget, education reform and the tax deal, returning later this year for a special session on health insurance coverage for low-income Iowans. In my opinion, Democrats would be insane to give Republicans what they want on taxes now, hoping for Medicaid expansion later.

Today several signs point toward a possible deal on Medicaid coverage before the end of the legislative session.

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IA-Sen: Steve King finally admits he's not running

Representative Steve King announced on twitter Friday night, “I will not run for Senate in 2014. A Senate race takes me out of urgent battles in Congress that can’t wait until 2015. Many thanks to all.”

Those battles include immigration reform, where King is a leading voice House Republican voice against any path to legal residency or citizenship. He has also pledged to block the implementation of the 2010 health care reform law.

King’s decision should not surprise anyone. He could not win a statewide election for any office in Iowa. I believe that if his internal polling showed the “path to victory” he claimed to see, he would be in the Senate race already. In contrast, he is favored to hold the Republican-leaning fourth Congressional district for the next decade. His likely Democratic opponent Jim Mowrer will face a steep uphill battle.

Any relevant comments are welcome in this thread. The statement posted on King’s Congressional campaign website is after the jump.

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Iowa Senate rejects Branstad's alternative to Medicaid expansion

Less than 24 hours after the Republican-controlled Iowa House approved language to enact Governor Terry Branstad’s Healthy Iowa Plan, the Iowa Senate voted on party lines today (26 to 24) to reject the House version of Senate File 296. A conference committee will now attempt to work out a compromise on whether to expand Medicaid to all Iowans earning up to 138 percent of the poverty line, as the 2010 federal health care reform law envisioned.

After the jump I’ve posted a video of Senate President Pam Jochum speaking on the Senate floor today to contrast Medicaid expansion with the governor’s plan. I’ve also enclosed details on Branstad’s highly implausible claim that his plan would cost poor Iowans less out of pocket than expanding Medicaid. Senate Democrats have pointed out that Iowans living in poverty could never afford the co-pays and premiums envisioned in the Healthy Iowa Plan.

Finally, I’ve added below excerpts from the Iowa Hospital Association’s latest blog post explaining why Medicaid expansion is a better choice than the governor’s plan.

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Republican lawmaker voices doubts on alternative to Medicaid expansion

For months, I’ve been wondering if and when some Republican lawmakers would balk at supporting Governor Terry Branstad’s “costs more, covers less” alternative to expanding Medicaid in Iowa.

For the first time yesterday, an Iowa House Republican said he may not vote for Branstad’s plan. I doubt it’s a coincidence that the wavering lawmaker is unusually knowledgeable about health care services in Iowa.

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Iowa Medicaid expansion news roundup (updated)

Last week Governor Terry Branstad finally introduced legislation to enact his Healthy Iowa Plan instead of the Medicaid expansion foreseen under the 2010 federal health insurance reform law. Strangely, neither the governor’s office nor the Iowa House Republican caucus held a news conference or even posted a press release about House Study Bill 232. The bill arrived at the statehouse on Thursday, April 4, after many legislators had left for the weekend.

So far House and Senate Republicans appear united behind Branstad’s approach, while the governor’s office strives to counter the obvious case against his plan (costs more, covers less). I’ve posted arguments for both sides and other news links after the jump.

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UPDATED: Three Democrats planning to run in Iowa House district 99

Several Democrats have already announced plans to run for Iowa House district 99 in Dubuque next year. State Representative Pat Murphy has represented part of that city for more than 20 years. He is leaving the state legislature to run for Congress in Iowa’s first district.

After the jump I’ve posted background on Kevin Lynch, Steve Drahozal, Abby Finkenauer and Greg Simpson, along with a map of House district 99 and the latest voter registration totals. More candidates may emerge in this strongly Democratic House seat before the filing deadline in March 2014. One or more of the current candidates may opt out of the race before the filing deadline.

APRIL 5 UPDATE: Erin Murphy of the Dubuque Telegraph-Herald reports that Lynch has decided not to pursue this campaign. According to a Bleeding Heartland reader in Dubuque, both Drahozal and Finkenauer (but not Lynch) addressed county Democrats at the off-year caucus in March.

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Iowa Senate approves Medicaid expansion along party lines

Last night the Iowa Senate approved Senate File 296, a bill to expand Medicaid, on a strictly party-line vote of 26 to 23. You can listen to the entire Senate debate (approximately 90 minutes) at Radio Iowa. I’ve posted highlights from the debate after the jump, along with the full list of 52 organizations that have registered their support for Senate File 296. Some corporations and organizations have have registered their lobbyists as undecided on Senate File 296, but at this writing, not a single organization is registered against the Medicaid expansion.

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Weekend open thread: Not learning from experience edition

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

Governor Terry Branstad didn’t draw the right lessons from Indiana’s experience when he proposed his Healthy Iowa Plan as an alternative to expanding Medicaid. Below I’ve posted excerpts from Laura Hermer’s recent commentary on the Healthy Indiana Plan.

Iowa’s top economic development official, Debi Durham, still can’t answer basic questions about why the state offered more than $100 million in tax incentives to a company that was going to build a fertilizer plant in Iowa anyway. Follow me after the jump for Durham’s non-responsive response on the Orascom deal during this week’s “Iowa Press” program.

Speaking of which, the Branstad administration is stonewalling Iowa Watchdog reporter Sheena Dooley’s efforts to obtain more information about the Orascom deal.

UPDATE: For the hundredth time, family budgets are not comparable to the federal budget. Plus, Michael Tomasky summarizes three basic principles of fiscal policy that should be conventional wisdom already: “Modest deficits are perfectly sustainable. Budget cutting, far from being ‘responsible,’ hurts the economy. And balanced budgets don’t create jobs-it’s the other way around.”

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How Harkin and Grassley voted on the Senate budget and amendments

The U.S. Senate approved a budget for fiscal year 2014 at 4:38 am on Saturday after voting on amendments for most of the night. The budget passed by 50 votes to 49 (roll call). Iowa’s Senator Chuck Grassley and the rest of the Senate Republicans voted no, joined by four Democrats representing red states. The rest of the Democrats, including Senator Tom Harkin, voted for the budget.

As is often the case, Senate votes on various amendments were more interesting than the final party-line vote on the budget. Follow me after the jump for details on how Grassley and Harkin voted on some of those amendments. I’ve also enclosed statements from Grassley and Harkin.

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House approves Paul Ryan's budget: How the Iowans voted

Yesterday the U.S. House approved a fiscal year 2014 budget prepared by House Budget Committee Chairman Paul Ryan. The bill also sets budget levels for fiscal years 2015 through 2023. Bleeding Heartland covered Iowa reaction to the latest Ryan budget here. After the jump I have details on yesterday’s vote and statements released by members of the Iowa delegation.

Despite the spin from some Congressional Republicans and Governor Terry Branstad, it’s important to remember that Ryan’s budget is not balanced and will not be balanced even 10 years from now. Both the non-partisan Tax Policy Center and the Center on Budget and Policy Priorities have noted that Ryan does not say how he would offset trillions in lost revenue from income tax cuts he proposes. In addition, the Ryan budget “understates defense spending by $100 billion over the next ten years” and assumes that the 2010 health care reform law will be repealed, which obviously won’t happen. The Ryan plan isn’t about eliminating the federal deficit, it’s a plan to end Medicare as a single-payer program and change the role of the federal government in the lives of low-income Americans.

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Branstad running out of excuses not to expand Medicaid (updated)

Iowa Senate Democrats offered Governor Terry Branstad a compromise this week to address his concerns that the federal government will not keep its promises to fund the Medicaid expansion provided under the 2010 health care reform law. Follow me after the jump for details on their latest offer and a cost comparison of Medicaid expansion and Branstad’s “Healthy Iowa Plan.”

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Iowa reaction to Paul Ryan's new budget

U.S. House Budget Committee Chair Paul Ryan presented his new federal budget blueprint today. As before, he would end Medicare as a single-payer system for all Americans under age 55, slash spending on programs for the poor such as food stamps and Medicaid, and cut taxes for some, though the details there are fuzzy. He would not cut the defense budget or Social Security. Ryan says his budget would be balanced in 10 years, but he relies on some assumptions that won’t happen, such as repeal of the 2010 health care reform law.

I’ve enclosed Iowa political reaction to the Ryan budget below and will update this post as needed.

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Latest Iowa Medicaid expansion news and discussion thread

Expanding Medicaid in Iowa would add nearly $2.2 billion to the state’s economy, create an estimated 2,362 jobs, and save state government about $1.6 billion, according to a new study. For now, Governor Terry Branstad is sticking to his alternative plan for covering some low-income Iowans, but Senator Tom Harkin predicted last week that federal officials will not approve a waiver for Branstad’s approach.

Follow me after the jump for details on those stories and more about Medicaid in Iowa. I’ve also enclosed a moving personal statement State Senator Mary Jo Wilhelm delivered today about Iowans who can’t afford health insurance.

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Weekend open thread: Jobs and prosperity

What’s on your mind this weekend, Bleeding Heartland readers? The Bureau of Labor Statistics released a better than expected jobs report on Friday, but not all the numbers were encouraging. States have continued to cut jobs even after the end of the “Great Recession,” and the “sequester” federal budget cuts will lead to more public-sector job losses later this year. Disappearing state government jobs are a drag on the national economy.

Surprise, surprise: the Iowa Chamber Alliance thinks shoveling more taxpayer dollars to large corporations is the best way to create jobs. The Iowa Policy Project disagrees and points out that Iowa is already writing large subsidy checks to some companies that paid no income tax in 2012. UPDATE: Forgot to mention that Iowa just agreed to give the Principal Financial Group $22.5 million in tax credits for its $285 million renovation plan in downtown Des Moines. Why should Iowa taxpayers underwrite office remodeling for a profitable company? That’s part of the cost of doing business.

Conservatives who think high tax rates can’t coexist with economic prosperity should explain why “the average Canadian household is now richer than an average American household for the first time ever.” My guess is the answer is related to Canada’s efficient, single-payer health care system (no medical bankruptcies or huge out of pocket costs because of health problems).

Senator Tom Harkin has introduced a bill to raise the minimum wage from $7.25 to $10.10 over three years before “before indexing it to keep up with the rising cost of living.” Indexing the minimum wage to inflation should have happened a long time ago.

This is an open thread.

Will Branstad's "Healthy Iowa Plan" fly? (updated)

Governor Terry Branstad announced his administration’s alternative to Medicaid expansion this morning at his regular weekly press conference. The “Healthy Iowa Plan” would cover approximately 89,000 Iowans with income below the federal poverty level. In contrast, Medicaid expansion would cover up to 150,000 Iowans with income below 133 percent of the poverty level.

Details on the new plan are after the jump. Early reaction from Senate President Pam Jochum suggests that the Iowa Senate will not be inclined to approve this proposal. I also question whether the U.S. Department of Health and Human Services will grant a waiver for Branstad’s plan. Federal officials have already denied requests from Branstad and other governors to allow a smaller Medicaid expansion than what the 2010 health care reform law provides.  

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Iowa counties would save millions from Medicaid expansion

Cutting property taxes has long been a policy goal for Governor Terry Branstad, so why is he rejecting a path to save Iowa counties tens of millions of dollars a year on mental health services? As Tony Leys reported yesterday for the Des Moines Register, the Iowa Department of Human Services has estimated that expanding Medicaid as foreseen under the 2010 federal health care reform law would save counties between $27 million and $60 million each year.

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Latest news on the conflict over expanding Medicaid in Iowa

This week New Jersey’s Chris Christie became the eighth Republican governor to recognize that only a chump would turn down 100 percent federal funding to provide Medicaid coverage to low-income constituents. But Governor Terry Branstad doubled down on his determination not to allow Medicaid to expand in Iowa.

While some advocates are hoping Republican legislators will help pass a Medicaid expansion bill by a veto-proof majority, that scenario appears extremely unlikely. A prolonged standoff between Branstad and Iowa Senate Democrats seems unavoidable.

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