# Health



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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Branstad has no case against expanding Medicaid (updated)

Five years ago this week, I was hospitalized with an infection that might have become life-threatening or permanently debilitating had I not had health insurance coverage, which allowed me to receive a relatively early diagnosis. Every day in this country, uninsured people hunker down, hoping their health problem will go away without an expensive doctor’s visit. That’s one of many reasons studies have shown that expanding Medicaid saves lives.

Governor Terry Branstad sounds determined not to expand Medicaid, but none of his arguments can withstand scrutiny.

UPDATE: Branstad confirmed on February 23 that he will not agree to expand Medicaid. Added details and other related news below.

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Cleaner air coming near three of Iowa's largest coal-fired power plants

MidAmerican Energy has agreed to reduce coal emissions at one of its Iowa power plants by the end of 2014 and to phase out seven coal-fired boilers at three Iowa power plants by April 2016, thanks to legal action by the Sierra Club. The settlement announced yesterday means that in future years, fewer people near or downwind of the plants in Council Bluffs, Bettendorf, or Sergeant Bluff will suffer the “devastating impacts of coal on the human body.”

Follow me after the jump for details on this very big news for Iowa air quality.

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Iowa reaction to Obama's gun law proposals

Today President Barack Obama and Vice President Joe Biden revealed a list of proposals designed to reduce gun violence. The full transcript from the press conference is here. It’s embarrassing that we needed a presidential order to allow the Centers for Disease Control to study this issue.

After the jump I’ve posted excerpts from the president’s remarks and a statement from Representative Steve King (R, IA-04). I also included some comments from Iowa legislators about possible state legislation related to guns or gun violence. I will update this post as needed with more comments on these issues. UPDATE: Added Senator Tom Harkin’s comments.

SECOND UPDATE: Added comments from Representative Dave Loebsack (D, IA-02).

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Branstad's new property tax plan and other Condition of the State news (updated)

Governor Terry Branstad just finished delivering his annual Condition of the State speech to Iowa House and Senate members. He unveiled a new property tax reform plan, which would cut commercial property taxes by 20 percent over four years. Previously the governor had called for cutting commercial property taxes by 40 percent. Branstad also urged legislators to approve the key points of education reform proposals he released yesterday. Finally, he outlined three policies that, in his view, would help Iowa become the healthiest state in the country.

Links and more details are after the jump. I will update this post later with more information and reaction. The video of Branstad’s speech will be available on IPTV.org and will be broadcast statewide on Iowa Public Television at 6:30 pm on January 16.

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Themes from the Iowa legislature's opening day in 2013

The Iowa House and Senate began their 2013 session yesterday with the usual welcoming speeches from legislative leaders and the ritual of choosing desks for each lawmaker in the chambers. Judging from this photo, returning legislators get first dibs.

As was the case in 2012, social issues like abortion and same-sex marriage were absent from the opening-day speeches. Republican leaders emphasized the need to cut both property and income taxes. Iowa House Speaker Kraig Paulsen also claimed credit on behalf of Republicans for Iowa’s improving fiscal condition. House Majority Leader Linda Upmeyer spent a fair amount of time criticizing Congress before calling for state action to improve education and cut taxes. House Speaker Pro Tem Steve Olson repeated some themes of last year’s election campaign and quoted U.S. Senator Marco Rubio of Florida. Similarly, Senate Minority Leader Bill Dix concentrated on tax reforms.

Senate Majority Leader Mike Gronstal focused on education and workforce training programs to address “Iowa’s skill shortage.” Senate President Pam Jochum focused on health-related issues: improve mental health services, helping elderly people stay in their own homes, and expanding Medicaid, which she described as “the biggest opportunity for this session to make a positive difference for Iowans.” Iowa House Minority Leader Kevin McCarthy emphasized the need for bipartisan work on a range of issues: education, mental health care delivery, the transition to a new maximum security prison, and protecting natural resources.

Follow me after the jump for excerpts from the opening-day speeches by legislative leaders (as prepared for delivery). I included the full text of Jochum’s remarks, because her personal journey says a lot about who she is. Jochum also paid a lovely tribute to former Republican State Senator Pat Ward, who died last year.  

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NRA "blame everything but guns" links and discussion thread

Politicians and commentators continue to react to recent comments by National Rifle Association Executive Vice President Wayne LaPierre. He broke the NRA’s weeklong silence following the Sandy Hook elementary school shooting with a December 21 speech (falsely billed as a “press conference”) and an appearance on NBC’s “Meet The Press” two days later.

LaPierre rejected any new restrictions on guns or ammunition and blamed a wide range of cultural influences for mass shootings. He suggested that Congress should respond by funding armed security officers in every school in the country.

This thread is for any comments about the root causes of violence or policies that could prevent future gun-related tragedies. I’ve enclosed lots of relevant links and analysis after the jump.

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Steve King gains new platform for battling USDA

U.S. House Agriculture Committee Chair Frank Lucas announced today that Representative Steve King (IA-04 in the new Congress) will chair the Subcommittee on Department Operations, Oversight, and Nutrition. King has been one of the loudest critics of the U.S. Department of Agriculture in recent years. His new position will give him a more visible platform to battle policies championed by U.S. Secretary of Agriculture Tom Vilsack–the husband of King’s most recent Congressional challenger, Christie Vilsack.

King opposed the USDA’s settlement in the Pigford case, which involved longstanding government discrimination against African-American farmers. He also objected to the hiring of a claimant in the Pigford settlement to a prominent USDA position. Though King has tried and failed to block spending on the Pigford settlement, chairing a subcommittee may allow him to investigate what he describes as “fraud” in USDA payments to African-Americans.

Regarding the USDA’s nutrition programs, King wants to spend less on the Supplemental Nutrition Assistance Program (commonly known as food stamps) than the Obama administration. He wants to overhaul the USDA’s new school lunch standards and has sponsored a bill to overturn restrictions on calories and portion sizes for children in public schools. In King’s view, “nutrition Nannies” at the USDA, led by Vilsack, have “put every kid on a diet.” Vilsack announced earlier this month that school districts will have more time to adapt to the new rules, but he defended the standards as an important weapon against the childhood obesity epidemic. I expect King to hold hearings on this issue in early 2013.

After the jump I’ve posted King’s press release about his new position. He vowed to make sure tax dollars are spent wisely in USDA programs.

Following the 2010 elections, King was expected to become chairman of the House Judiciary Committee’s subcommittee on immigration issues, but House leaders feared he was too much of a lightning rod for that job.

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Iowa political reaction to the Sandy Hook school massacre (updated)

The horrific mass killing at Sandy Hook elementary in Newtown, Connecticut has dominated news coverage since Friday, and almost everyone I know has been talking about the tragedy. But only a few Iowa politicians have publicly discussed the events or possible ways to prevent similar crimes.

Remarks by Senator Tom Harkin, Representative Dave Loebsack, State Senator Rob Hogg, and Governor Terry Branstad are after the jump. I’m disappointed but not surprised that the governor is not open to any new restrictions on assault weapons or large ammunition clips. Senator Joe Manchin of West Virginia, who like Branstad has an “A” rating from the National Rifle Association, today called for moving “beyond rhetoric” on gun control. His comments are also below.

I’ve sought comment from other members of Iowa’s Congressional delegation and will update this post if I hear back from any of them. UPDATE: Added Representative Bruce Braley’s comments below.

SECOND UPDATE: Added Senator Chuck Grassley’s comments during a December 17 radio interview.

LATER UPDATE: Added comments from Iowa Department of Education Director Jason Glass.

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Health care exchange and Medicaid expansion news roundup

Last week Iowa Governor Terry Branstad confirmed that Iowa will pursue a “partnership” health insurance exchange next year, rather than setting up its own insurance exchange for implementing the 2010 health care reform law, or letting the federal government set up an exchange for Iowa.

In addition, the governor again signaled that he is against the now-optional Medicaid expansion for states, because he believes it would become too expensive for Iowa in the future.

Links and recent news about health care reform in Iowa are after the jump.

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More proof smoking bans save lives

How about a little good news on a lousy day? A new study confirms previous research, which showed public smoking bans reduce hospitalizations for heart attacks and other life-threatening problems. The Iowa Smokefree Air Act, which went into effect in July 2008, has likely prevented many premature deaths.

UPDATE: The smoking ban was controversial while it was debated in 2008. Below I’ve listed all of the state legislators who had the courage to send that bill to Governor Chet Culver’s desk.  

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Gunman commits worst U.S. school massacre ever

Details are sketchy, but at least one gunman opened fire at Sandy Hook Elementary School in Newtown, Connecticut this morning, reportedly killing more than 20 people. As of noon central time, the latest reports indicate that 18 children may have been murdered along with nine adults, including the killer.

White House spokesman Jay Carney told reporters at a briefing, “today is not the day” to discuss gun control legislation. Of course it isn’t. Tomorrow won’t be the right time either, and neither will next week or next month or next year. Democratic Party officials are no longer willing to advocate for gun control in public, and the Republican Party might as well be a wholly-owned subsidiary of the National Rifle Association. Americans just have to accept that dangerously unstable or mentally ill people will be able to acquire almost any kind of weapons and ammunition, and from time to time will slaughter innocent people.

I can’t imagine what those children and the victims’ families are going through in Connecticut, and I’m too upset to look up more links about this tragedy. Feel free to share your own reasoned comments or enraged rants in this thread.

UPDATE: Shooter Adam Lanza killed 20 children and six adults, including his mother, before apparently killing himself. A lot of details and links are on this page at the Mother Jones site.

Conservatives are quick to say crimes like these aren’t about guns. Not holding my breath waiting for them to increase funding for mental health services.

After Australia reformed its gun laws in 1996, gun-related homicides and suicides began to decline more sharply, even as the overall homicide rate continued to drop. There have not been any mass shootings in Australia since that time.

Weekend open thread: Deer hunting edition

What’s on your mind this weekend, Bleeding Heartland readers? Iowa’s deer hunting season began on Saturday. Dates, rules and regulations are on the Department of Natural Resources website. Hunters can use any kind of ammunition in Iowa, but non-toxic options like copper kill more effectively, leaving higher-quality meat without exposing humans, birds, or other wildlife to lead.

The overpopulation of deer has been on Senator Chuck Grassley’s mind ever since he was a passenger in a car that hit a deer in October. He is on a mission to lengthen the hunting season by raising awareness about the dangers of deer on the roads. After the jump I’ve compiled all of Grassley’s recent twitter posts on the subject. His comments about deer have attracted a cult following and typically get hundreds of “re-tweets.”

Disease related to this year’s drought has brought the deer population to its lowest level since 2003. In fact, statistics from the DNR and the Iowa Department of Transportation indicate that the deer-vehicle crash rate is “at its lowest level in 25 years.”

This is an open thread: all topics welcome.

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Beware of toxic toys when holiday shopping

The Iowa PIRG Education Fund released its 27th annual report on dangerous toys today. The five most common hazards in products marketed for children are: lead, phthalates, magnets, choking hazards, and noisy toys.

You can download the full text of “Trouble in Toyland” here (pdf). I’ve posted the executive summary after the jump. U.S. PIRG has created this toy safety interactive website, which consumers can access on smartphones.

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Study links children's emotional stability to strong early bond with a parent

New research published by psychologists at the University of Iowa suggests that “infants who have a close, intimate relationship with a parent are less likely to be troubled, aggressive or experience other emotional and behavioral problems when they reach school age.”

In addition, “a young child needs to feel particularly secure with only one parent to reap the benefits of stable emotions and behavior, and […] being attached to dad is just as helpful as being close to mom.”

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Childhood hunger, poverty growing in Iowa

Although Iowa’s unemployment rate is below the national average, and state government closed out the 2012 fiscal year with a record surplus, a growing number of Iowa children live in poverty and are hungry or malnourished at least some of the time. The Des Moines Register recently launched a series of reports on “unprecedented challenges for Iowa kids.” Follow me after the jump for some depressing highlights.

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Royce White is a brave man

A win-at-all-costs mentality pervades sports culture, with praise heaped on athletes who put the team’s needs first. For instance, Kerri Strug is best known for vaulting on a sprained ankle at the 1996 Summer Olympics. The vault aggravated an injury that ended her gymnastics career, but she is still hailed as a hero for helping the U.S. women’s team win gold.

This week former Iowa State basketball player Royce White, a first-round draft pick for the Houston Rockets, did not show up for training camp. The reason was unprecedented: he is insisting on a plan to address his anxiety and obsessive-compulsive disorder. By making his health a priority, and leveling with the public about his reasons for doing so, White may encourage many other people to seek help for serious mental illnesses.

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Pre-election Iowa Congressional voting news roundup

Following a month-long summer recess, members of the U.S. House and Senate worked for less than three weeks before adjourning in late September until after the general election. Congress will hold only “pro-forma” sessions for the next month, presumably to prevent President Barack Obama from making recess appointments.

Follow me after the jump for a review of how the Iowans voted (or did not vote) on the most significant legislation that came up during the past few weeks.  

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Weekend open thread: What were we thinking? edition

Hunter Oatman-Stanford’s fantastic article for Collectors Weekly on “The Top 10 Most Dangerous Ads” inspired this post. Click through to see some amazing advertisements from the last century: A 1923 paint book for boys and girls, encouraging kids to have “fun with the whole ‘Lead Family’ of products,” 1950s ads encouraging mothers to give 7-Up to young children, 1969 ads promoting sugar as a diet aid (“Sugar just might be the willpower you need to curb your appetite”), and even a 1947 ad proclaiming, “DDT is good for me-e-e!” Oatman-Stanford gives the background on the health impacts of the advertised products.

All topics are welcome in this open thread, particularly memories about idiotic things that were once widely accepted in our culture. No partisan warfare here, please: if you want to talk politics, try to focus on wrongheaded consensus ideas like Iowa’s film tax credit program or the deregulation of the banking sector in the 1980s.

P.S. – I’m not nostalgic for most of the dangerous playground equipment of my childhood, like see-saws and metal monkey bars sets over solid concrete, but I have to agree with the Retro Junk blog, those merry-go-rounds were fun.

Job-creating regulations strike Ottumwa

Some politicians at the federal and state level would have you believe that rules intended to protect public health and the environment are “job-killing regulations.” Congressional Republicans and some Democrats have voted several times to block air quality rules that would force certain industrial plants to retrofit. Although the Obama administration has enacted promising rules to reduce air pollution from coal-fired power plants, President Barack Obama has occasionally validated Republican scaremongering over pollution regulations. For instance, he delayed new smog rules from going into effect in 2011, citing a concern for “reducing regulatory burdens and regulatory uncertainty, particularly as our economy continues to recover.”

The reality of pollution control looks different. It looks like hundreds of construction workers getting a job, and Ottumwa-area businesses reaping the benefits.

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"Burdensome" is in the eye of the beholder

Governor Terry Branstad issued two new executive orders last week. One directive rescinded 12 executive orders issued between 1998 and 2009, including two that were intended to make state government operate more efficiently. Branstad’s other order granted “stakeholder groups” new levers for blocking potentially “burdensome” administrative rules.

Highlights from the new and the disappeared executive orders are after the jump.

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A wake-up call for college athletics

I’ve spent part of this morning reading former FBI Director Louis Freeh’s “Report of the Special Investigative Counsel Regarding the Actions of The Pennsylvania State University Related to the Child Sexual Abuse Committed by Gerald A. Sandusky.” It’s a depressing commentary on the “football is king” culture that seems to have held sway at Penn State.

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Iowa Congressional voting catch-up thread: energy policy

The U.S. House is back in session this week, and it’s time for Bleeding Heartland to catch up on Congressional news from before the July 4 recess. After the jump I’ve posted details about how the Iowans voted on various bills and motions related to energy policy.

As a bonus, I’ve included some textbook sleight of hand by the Democratic Congressional Campaign Committee. DCCC press releases hammered Republicans Tom Latham and Steve King for backing “Big Oil” interests during House debate on the Strategic Energy Production Act. But the DCCC glossed over the fact that Latham’s opponent in Iowa’s third district, Representative Leonard Boswell, was one of 19 House Democrats to vote with Republicans for final passage of that very bad bill.  

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Weekend open thread: New fiscal year, new Iowa laws

What’s on your mind this weekend, Bleeding Heartland readers? Many laws approved during the 2012 legislative session go into effect today. After the jump I’ve posted links about some of the new laws and the end of the road for the Malcolm Price Laboratory School in Cedar Falls. I also included excerpts from a good article by Steve Gravelle, who examined the impact of Iowa’s public smoking ban four years after it became statewide law.

This is an open thread.

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