An advocacy group run by former Iowa House Speaker Chris Rants “is operating with the primary purpose of influencing political campaigns” in violation of federal tax code, according to the watchdog group Citizens for Responsibility and Ethics in Washington.

Last month CREW filed Internal Revenue Service complaints against ten 501(c)(4) groups, which claim non-profit status as “social welfare” organizations but spent a large share of their funds on political activity during the 2014 election cycle. One of them was the Iowa-based Legacy Foundation Action Fund, for which Rants serves as president and secretary. (The fund did not seek to influence any Iowa elections in 2014.) CREW also filed criminal complaints against six of the ten groups for “falsely representing the amount of money they spent on political activity in 2014”; the Legacy Foundation Action Fund was not among them.

Although Rants’s 501(c)(4) does not disclose its donors, CREW was able to determine that most of its 2014 funding came from American Encore, a “secretive” 501(c)(4) group “formerly known as the Center to Protect Patient Rights.” American Encore has been described as “the linchpin” of the Koch brothers dark money network. The Legacy Foundation Action Fund reported $980,000 in “contributions and grants” on its 2014 tax return; $880,000 of that amount came from American Encore.

More details on CREW’s IRS complaint are below. Rants responded via e-mail, “I am confident that Legation Foundation Action Fund is in compliance with the IRS rules. Legal counsel is reviewing the tax returns and we will file any amendment necessary to ensure the tax returns accurately reflected the organizations actives.”

UPDATE: Oldson won this race by a 67 percent to 33 percent margin.

One of the most closely-watched state legislative results tonight will be the contest between seven-term State Representative Jo Oldson and Democratic challenger Eddie Mauro in Iowa House district 41. The district covering parts of the west and south sides of Des Moines contains more than twice as many Democrats as Republicans, so the winner of today’s primary will almost certainly be elected in November, even if the GOP nominates a candidate late here. (No one filed in time to run in the GOP primary.)

Both campaigns have been working the phones and knocking on doors for months. Iowa’s two largest labor unions, AFSCME and the Iowa Federation of Labor, as well as the National Abortion Rights Action League have been doing GOTV for Oldson, as have a number of her fellow Iowa House Democrats. As of May 24, the early voting numbers in House district 41 were higher than for any other state House race.

Bleeding Heartland posted background on Oldson and Mauro here. I’ve encouraged my friends in the district to stick with Oldson. She has been a reliable progressive vote on major legislation, and she was among only thirteen House Democrats to vote against the costly and ineffective 2013 commercial property tax cut. I have no problem with an entrenched incumbent facing a primary challenge. No one is entitled to hold a legislative seat for life. But even if women were not already underrepresented in the Iowa House–which they are and will continue to be–I would need a better reason to replace a capable incumbent than the reasons Mauro has offered in his literature and in an interview with me last month. Excerpts from that interview are below, along with examples of campaign literature Democrats in House district 41 have been receiving in the mailbox and at the doorstep.

“Mark me down as Never Trump,” State Senator David Johnson said today, becoming the most prominent Iowa Republican elected official to renounce the presumptive presidential nominee. The longtime Senate incumbent told the Des Moines Register’s William Petroski he became a no-party voter because of Donald Trump’s “racist remarks and judicial jihad.”

“I will not stand silent if the party of Lincoln and the end of slavery buckles under the racial bias of a bigot,” Johnson said, referring to Trump. His criticism was prompted by Trump’s comments that a judge presiding over a lawsuit involving his business was biased because of his Mexican heritage. […]

“If Mr. Trump is the nominee, he becomes the standard bearer for a party that’s on the verge of breaking apart. He simply cannot unify the GOP. If there is a profound split, I’ll gladly re-join Republicans who are dedicated to equality and justice for all, and let Mr. Trump lead his supporters over the cliff,” Johnson said. […]

“There are consequences to the decision to suspend, for now, my Republican registration. I am fully aware of that,” Johnson said. “As I have for the past 18 years, I will put a high priority on constituent service. Many of the voters who elected me are supporting Mr. Trump. I respect that, but disagree that he is qualified to lead the nation and the free world.”

Johnson represents one of the most heavily Republican state Senate districts, covering five counties in northwest Iowa. Ted Cruz carried two of those counties (Lyon and Osceola) by a relatively wide margin, while Trump carried the other three (Dickinson, Clay, and Palo Alto) by slim margins. Johnson endorsed former Texas Governor Rick Perry for president in early 2015, eventually backing Carly Fiorina last October.

Conservation funding aside, I rarely find myself in agreement with Johnson. But kudos to him for speaking out while Senator Chuck Grassley, Governor Terry Branstad, and others tried to sidestep Trump’s steadfast assertion that a federal judge is biased because “he’s Mexican.”

UPDATE: A reader asked whether Johnson had endorsed Representative Steve King’s re-election, given King’s long history of offensive statements regarding Latinos. Johnson was not on the list of state legislative supporters the King campaign released on May 24.

King himself has not yet endorsed Trump, for reasons unrelated to the presidential candidate’s comments about immigrants.

SECOND UPDATE: Added below excerpts from Johnson’s interview with Ben Jacobs of The Guardian.

Rhonda Shouse, a Medicaid recipient and member of Iowa’s Mental Health Planning and Advisory Council, is a leading advocate for Iowans affected by Medicaid privatization. She is an admin for the MCO Watchdog Facebook group and has previously shared resources to help people report problems with managed-care providers. The Cedar Rapids Gazette published a shorter version of this commentary last week. -promoted by desmoinesdem

Iowa Medicaid Enterprises (IME) Director Mikki Stier wrote a guest column on Iowa’s Medicaid Modernization which appeared in the Cedar Rapids Gazette, Fort Dodge Messenger, and Sioux City Journal in April. I am writing in response to Ms. Stier’s column.

If IME considers making it more difficult for Medicaid beneficiaries to get much needed items such as catheters, diapers, medication, transportation to medical appointments, and permission for guardians to represent their wards, then Iowa’s Medicaid Modernization is a huge success. These were not obstacles under the old Medicaid system.

In IA Health Link’s first month, the bulk of the problems point directly to the Department of Human Resources and IME to adequately provide the MCOs with accurate information. It is likely due to the unrealistic time frame established by Governor Terry Branstad, or DHS, depending on who tells the story of who came up with the idea for Iowa’s Medicaid Managed Care program. Most states that have moved to a managed care approach have moved only portions of their beneficiaries at a time and done so over a two to five year period.

It is very unfortunate that Governor Branstad, DHS, and IME have been perpetrating a public relations campaign for more than a year now to misinform Iowans on how their tax dollars will be spent, who Medicaid beneficiaries are, and how services will be delivered to approximately half a million Iowa residents. Healthcare should not be a partisan political issue.

The Iowa House and Senate adjourned for the year this evening. As usual, the health and human services budget was one of the last deals Senate Democrats and House Republicans agreed on. Both sides gave significant ground on oversight of Iowa’s recently-privatized Medicaid program; a future post will look more closely at the terms of that agreement. In another example of history repeating itself, key negotiators had trouble finding common ground on what to do about Planned Parenthood funding through the Iowa Family Planning Network.

The outcome of last year’s budget talks left little doubt that Republicans wouldn’t achieve their goal of creating a new state family planning program, excluding abortion providers. Yet House Speaker Linda Upmeyer had promised a “deliberate and unwavering battle” on “pro-life issues,” and specifically to make defunding Planned Parenthood a “priority” for her caucus.

I’ve been wondering what Democrats might offer Republicans in exchange for preserving status quo language on state funding for Planned Parenthood’s non-abortion services.

As it turned out, they didn’t have to make any real concession.

When the filing deadline passed for major-party candidates to run in Iowa’s June 7 primary, seven Republican state senators up for re-election this year had no challengers: Randy Feenstra (Senate district 2), Dennis Guth (Senate district 4), Mark Segebart (Senate district 6), Mark Costello (Senate district 12), Amy Sinclair (Senate district 14), Tim Kapucian (Senate district 38), and Ken Rozenboom (Senate district 40). Recruitment continued, as special district conventions may nominate candidates for seats where no one filed in time to be on the primary ballot.

Based on 2012 election results and incumbent weirdness, the most potentially competitive of the uncontested GOP-held Iowa Senate seats was arguably Guth’s. Democrats announced on April 25 that Susan Bangert will run in Senate district 4. I enclose below a map of this district and details about its recent voting history, along with background on Guth and Bangert.

Also on Monday, Dennis Mathahs confirmed plans to drop out of the Democratic primary in Iowa House district 75 in order to run against Kapucian in Senate district 38. A future post will preview that race.

For six years running, the Democratic-controlled Iowa Senate has confirmed almost all of Republican Governor Terry Branstad’s nominees unanimously or nearly so. But every year, one or two Branstad nominees don’t get through. On Thursday Dr. Mariannette Miller-Meeks became the first (and probably the only) nominee to fail an Iowa Senate confirmation vote this year.

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

On April 1, three months later than originally planned, Iowa officially switched to a managed-care model for the Medicaid program. Erin Murphy explained here how privatization will affect almost all of our state’s roughly 560,000 Medicaid recipients.

Many Iowans on Medicaid are learning that their current health care providers are now out of network, a particular concern for those who have special medical needs. The Mayo Clinic in Rochester, Minnesota has not signed contracts with any of the three insurance companies selected to be managed-care providers in Iowa. KCRG’s Katie Wiedemannn reported on March 31 about a 9-year-old cancer patient whose scheduled treatment at Mayo has been delayed because of the new policy. I am aware of other families whose children on Medicaid have relied on out-of-state medical specialists to treat their children’s rare genetic or chronic conditions.

Iowa House Republican leaders have refused to act on an extensive Medicaid oversight bill that cleared the Senate with bipartisan support. However, they promise to unveil their own Medicaid oversight proposal soon. Senate Democrats will seek to add many oversight provisions to the human services budget, which is often one of the last bills to be resolved before lawmakers adjourn for the year.

One major red flag: Iowa hired only “two ombudsmen to investigate and work as advocates for the 560,000 poor or disabled people” on Medicaid. As Jason Clayworth reported for the Des Moines Register in January, a working group that studied the issue recommended hiring 134 more ombudsmen at a possible cost of $17 million annually.

Rhonda Shouse has been among the most vocal opponents of Medicaid privatization. She shared with Bleeding Heartland some resources for recipients who run into problems with their new managed-care providers. I enclose those below.

Some good public health news: state lawmakers recently approved a bill that would allow “First responders, emergency medical service providers, police, firefighters and licensed health care professionals” to maintain a supply of the drug Naloxone (also known as Narcan). The medication can prevent death after an overdose of heroin or prescription opioid pain-killers, both of which have become more prevalent in Iowa, as in many other states. Senate File 2218 passed the upper chamber the Senate unanimously and cleared the House by 93 votes to 2 (the dissenters were Republicans Stan Gustafson and Mike Sexton). Several groups representing law enforcement or medical professionals lobbied for this bill. At this writing, Governor Terry Branstad has not yet signed it.

UPDATE: Branstad signed the bill about the overdose drug on April 6.

Two bills to address the impending privatization of Medicaid died in the Iowa House this week. Effective April 1, some 560,000 Iowans on Medicaid will have their health care services managed by one of three private insurance companies. Last month, three Republicans joined Iowa Senate Democrats to pass approved Senate File 2125, which would terminate the state’s contracts with the managed care companies. Last week, six GOP senators voted with their Democratic colleagues for Senate File 2213, which would strengthen oversight of Medicaid by the Iowa Department of Human Services and the state legislature.

To stay alive after the Iowa legislature’s second “funnel” deadline today, non-appropriations bills must have been passed by one chamber and by a committee in the other chamber. However, the bill to end privatization and the oversight bill both died in House Human Resources subcommittees. To my knowledge, the only bill related to Medicaid privatization that remains alive is Senate File 2260, which would prohibit the Iowa DHS from releasing to managed care organizations certain information about board members of non-profits that provide Medicaid services in Iowa.

Speaking to journalists yesterday, Iowa Senate President Pam Jochum described the House failure to act on the oversight and termination bills as a “disappointment” but added, “I can assure you the fight over Medicaid is not done. You will see the human services budget bill contain many of the measures that we believe are needed to protect Iowa’s most vulnerable citizens.” Click here for a detailed summary of the oversight bill’s provisions. Maridith Morris described here how privatization will affect services available for her nephew on Medicaid.

House Speaker Linda Upmeyer told statehouse reporter Erin Murphy that Senate Democrats spent too long “working on killing the Medicaid modernization plan,” while passing the oversight bill too close to the funnel deadline: “That’s an 80-page bill that arrived very late last week. So we will look at oversight. We will work on oversight. But that bill just could not be managed in the time frame we were given. So we’ll look at opportunities.”

For the last five years of divided control at the statehouse, the human services budget has been one of the last bills to be resolved before lawmakers adjourn. Count on history to repeat itself this spring, because negotiations could drag on for months over Medicaid oversight and the near-certain Republican effort to eliminate Planned Parenthood funding for contraception services. A Bleeding Heartland post in progress will cover the family planning funding debate, as well as the fate of abortion-related legislation in the Iowa House and Senate this year.

Maridith Morris is a nurse and the Democratic candidate in Iowa House district 39. -promoted by desmoinesdem

This picture is my nephew Fin. He is an adorable, happy little guy and I love him to pieces. Fin has autism spectrum disorder. Fin is just one vulnerable Iowan who is going to be hurt by Medicaid privatization.

At Fin’s age, early intervention therapy is crucial for his positive outcomes. Therapy can mean the difference between him becoming a high functioning adult, one who is able to live independently, work, and pay taxes and a disabled adult needing tax payer support. Despite the crucial nature of Fin’s therapy, the rush to privatize Iowa’s Medicaid puts those services in jeopardy. To receive therapy, Fin’s parents will have to transport him from Indianola to appointments at Blank Children’s Hospital in Des Moines because services are no longer in network in Indianola.

Since Terry Branstad returned to the governor’s office, the overwhelming majority of Iowa Senate votes on contentious political issues have fallen along strict party lines: 26 Democrats one way and 24 Republicans the opposite. However, the Branstad administration’s rush to privatize Medicaid has created space for bipartisanship, as a growing number of Republicans acknowledge the dangers of shifting to managed care for a program through which one in six Iowans access health services.

Last month, three GOP senators joined their Democratic colleagues to vote for a bill that would have halted Iowa’s Medicaid privatization. That legislation is going nowhere in the Republican-controlled state House, and federal officials recently approved waivers to allow the Iowa Department of Human Services to implement the managed care policy as of April 1.

Yesterday a quarter of the GOP state senators voted with all 26 Democrats for a Medicaid oversight bill that had cleared the Senate Human Resources Committee unanimously. In her remarks to open floor debate on Senate File 2213, Human Resources Committee Chair Amanda Ragan said the bill was designed “to safeguard the interests of Medicaid members, encourage the participation of Medicaid providers, and protect Iowa taxpayers.” She told colleagues, “we must require DHS and the managed care companies to protect consumers, preserve provider networks, address the unique needs of children and assure accountability.”

I enclose below highlights from the debate on SF 2213, the roll call on final passage, and Ragan’s full remarks, along with a Democratic staff analysis summarizing the bill’s key points.

Iowa’s Medicaid program will shift to managed care for some 560,000 recipients on April 1, in accordance with waivers granted by the federal Centers for Medicare and Medicaid Services. CMS had previously denied the request from Governor Terry Branstad’s administration to privatize Medicaid by January 1, citing numerous signs that the state was not ready. In a letter the Branstad administration released today, Vikki Wachino of CMS noted “significant improvement” in several areas: the provider networks of three insurance companies picked to manage care for Medicaid recipients; plans for reimbursing out-of-network providers for services; better communication between state officials and Medicaid providers and recipients; and training of case managers to assist Medicaid beneficiaries during the transition.

I enclose below reaction to today’s news from the governor, key state lawmakers, and other stakeholders, as well as the full five-page letter from CMS to Mikki Stier, director for Medicaid in the Iowa Department of Human Services. Federal officials set several conditions on their approval of Iowa’s plans, such as monitoring the actions of the three managed-care organizations, making sure call centers are running their helplines competently, and preserving some “continuity of care” for Medicaid recipients.

Although the delay until April 1 will allow more time to prepare for the transition, the policy’s likely impact remains the same: more money for insurance company overhead and profit and less for health care services; a deterioration in care for disabled people, as seen in Kansas and other states; and less access to health care providers (a key issue for the three Iowa Senate Republicans who recently voted with Democrats to terminate Medicaid privatization).

Senate Democrats continue to push for “tough, bipartisan oversight and accountability protections.” Chelsea Keenan reported for the Cedar Rapids Gazette that the Senate Human Resources Committee will consider that bill (Senate File 2213) on February 24. I don’t expect that legislation to go anywhere. All I’ve heard from Iowa House Republicans is happy talk, backed up by no evidence, that privatizing Medicaid will save the state money and improve patient care.

Bleeding Heartland welcomes guest posts on state legislative races. Great to see a candidate stepping up in this district. Democrats failed to field a challenger against Heaton in 2012 or 2014. By the way, some Iowa politics junkies have Heaton on retirement watch. -promoted by desmoinesdem

Carrie Duncan is running for State Representative in House District 84 against eleven-term incumbent Dave Heaton (R-Mount Pleasant), as a Democrat. With the controversy surrounding the potential closure of a mental health facility in Mount Pleasant. Carrie felt the need to run against Representative Heaton, feeling that he was not a strong enough of a voice against the Branstad Administration’s plans to close the facility.

Carrie’s support for organized labor is fierce and deep. She is a proud member of the International Association of Machinists and Aerospace Workers (IAMAW), Chief Steward, Local 1010 She works at the American Ordinance LLC in Middletown. Carrie’s son, Zach also works at American Ordinance LLC. Zach lives with his wife Randee, in Mount Pleasant. Carrie has also worked at Pioneer Corn and Pinnacle Foods. She resides in New London.

Carrie got into this race as a voice for the middle class and the poor in the state of Iowa. She believes that the state government is simply giving too much away, using tax breaks to procure agreements with big corporations while not doing enough to educate our children. The unemployment rate is too high in District 84; this means that we need leaders in Des Moines that are regularly communicating with small businesses instead of constantly trying to lure extremely large companies, many times hiring out of state labor to fill the positions.

Carrie has worked in the New London School District as well; she has gained knowledge about the issues that our educators face daily. She has worked in some different industries, always fighting for fair wages and equal treatment for all in the workplace. She currently serves as the Vice President of the North Lee County Labor Council.

She is also hoping to see an end to the Governor’s plan to privatize Medicaid, and wants to see a more transparent process when large economic development agreements come to the area.

District 84 encompasses portions of Northern Lee County, Henry County, and Jefferson/Washington townships. [note from desmoinesdem: A map is after the jump, along with the latest voter registration numbers.]

Carrie is originally from Chillicothe, Illinois and she grew up on a family farm. She has a lifetime appreciation for our state’s local ag producers. Carrie is involved in a number of terrific charitable organizations in Southeast Iowa, as well.

For more information go here:

http://kilj.com/2016/01/news/carrie-duncan-announces-run-for-state-representative-in-washington-henry-jefferson-and-lee-counties/

One of the four companies the Iowa Department of Human Services initially selected to manage care for Medicaid recipients has given up the fight to keep a contract that would have been worth hundreds of millions of dollars. Follow me after the jump for details on the final stages of WellCare’s unsuccessful effort to overturn state officials’ decision to terminate that contract.

Who watched the six remaining Republican presidential candidates debate in Greenville, South Carolina last night? It was such a free-for-all that the Washington Post’s Alexandra Petri had trouble satirizing some of the exchanges: “nothing I can say is actually more ridiculous than what the candidates in fact said.”

The New York Times posted the full transcript here. I’ve enclosed some excerpts below.

What struck me most about the debate was how Donald Trump kept playing to the nationwide audience, ignoring the crowd that booed many of his comments. In contrast, Ted Cruz seemed to do better with the house, but I’m not convinced he came across as well on television. Jeb Bush continues to gain confidence on the debate stage, but where he can start winning states remains a mystery. Marco Rubio seemed relieved to have most of the attention on others and neither reverted to “robot mode” nor lost his cool in a heated exchange with Cruz over immigration policy. Carson and Kasich failed to make any case for their candidacies. The Ohio governor’s whining about negative campaigning won’t win any votes, nor will his defense of expanding Medicaid–though I agree with him on that issue. Carson’s only memorable comment was a Joseph Stalin quote that turned out to be fake.

As has so often occurred since last summer, pundits quickly concluded that Trump “went too far” and would be hurt by some of his attacks, especially denigrating President George W. Bush’s leadership. I’m not so sure. A sizable number of Republicans may share Trump’s views: Bush didn’t “keep us safe” on 9/11, the Iraq War was a disaster, and the Bush administration lied about weapons of mass destruction. The only comment likely to do significant harm to Trump with the GOP base is his admission that Planned Parenthood does “wonderful things” for women outside of its abortion services.

This is an open thread: all topics welcome.

This morning the Iowa Senate passed Senate File 2125, which would terminate contracts the state has signed with insurance companies picked to manage care for Iowans on Medicaid. Governor Terry Branstad announced his administration’s “modernization” plans early last year and selected four managed care providers in August, with a view to fully privatizing Medicaid by January 1, 2016. The state later terminated a contract with one of those four companies, and the federal government refused to grant the necessary waivers, saying Iowa would not be ready to shift to managed care until March 1 at the earliest.

Iowa Senate leaders made clear on day one of this year’s legislative session that Medicaid privatization would be a pressing concern. Senate President Pam Jochum has been sounding the alarm since last year, worried about how privatization would affect her developmentally disabled adult daughter and other Iowans with special needs. Jochum gave the opening and closing remarks in support of Senate File 2125 today. She repeatedly warned that the Branstad administration has tried to do too much, too fast, without input from state lawmakers or other stakeholders with expertise in the area. Fellow Democrats Chris Brase, Liz Mathis, Mary Jo Wilhelm, Rich Taylor, and Amanda Ragan echoed many of those concerns in their speeches.

During the floor debate, Republican State Senator David Johnson explained why he would vote for the bill. He read e-mails from numerous constituents expressing concern about access to health services for their loved ones on Medicaid. He pointed out that Minnesota took 20 years to transition to managed care, while Iowa is trying to implement the same changes over just one year. “It’s moving too fast. That’s the issue here. We need to put a dagger in this.”

Last week Johnson became the first GOP lawmaker to come out in favor of terminating the privatization program; I enclose below excerpts from Jason Clayworth’s report for the Des Moines Register. Johnson’s fears about “children at risk of losing services” stem from the failure of the managed care companies to sign contracts with thousands of providers who have been treating Iowans on Medicaid, including children on HAWK-I (Iowa’s version of the State Children’s Health Insurance Program). Scroll to the end of this post for more details on that access problem, based on data from the Iowa Department of Human Services.

Republicans who spoke against the bill today included Senators Jason Schultz and Mark Chelgren. Schultz claimed Democrats took “ownership” of managed care by putting assumptions about Medicaid savings into the health and human services budget for the current fiscal year. During her concluding remarks, Jochum pushed back hard against the idea that a vote for last year’s health and human services budget was a vote for managed care. Rarely do I ever agree with Schultz, but I think Senate Democrats walked into a trap there. The Branstad administration’s estimates on reduced Medicaid costs after privatization were never grounded in reality, but Democrats accepted those assumptions in the budget they passed–not because they supported the Branstad effort, but likely because doing so gave them an extra $51 million to spend on other health-related priorities.

Chelgren argued that lawmakers should keep their word after voting for a budget that assumed Medicaid would shift to managed care. He likened the situation to Congressional Republicans voting to repeal the 2010 Affordable Care Act without having a plan ready to replace “Obamacare.” The analogy fails because terminating Medicaid privatization that hasn’t been fully implemented would not be like repealing Obamacare after several years of operation. The status quo is an available and less disruptive alternative to serving the 560,000 Iowans on Medicaid. Chelgren claimed that halting Medicaid privatization and starting the process over would “betray” those who signed up as providers under the new system. That argument made no sense; public comments from Iowans on Medicaid and health care stakeholders have overwhelmingly opposed the Branstad policy.

During her concluding remarks, Jochum refuted claims that 39 other states have put Medicaid in managed care. In reality, only four states have fully privatized the system, as the governor is doing.

Shortly after the floor debate, senators voted 29 to 19 to approve SF 2125. Republicans Jake Chapman and Tom Shipley joined Johnson and all 26 Senate Democrats. Notably, those three Republicans all represent strongly GOP districts, not marginal seats.

The bill now goes to the Iowa House, where Speaker Linda Upmeyer has indicated she does not plan to bring the measure up for debate. For a nurse practitioner by training, Upmeyer is remarkably insensitive to ordinary people’s health care needs–not only those on Medicaid, but also chronically ill Iowans who could benefit from medical cannabis. A post in progress will catch up on the state of play for medical marijuana in the Iowa legislature.

UPDATE: Added more links and comments on the Medicaid debate below. According to Erin Murphy, Upmeyer confirmed today that the House will not take up SF 2125, because the governor would certainly veto it. Given how unpopular Medicaid privatization is, the public would likely support a legislative override of that veto. But at least five more Republican senators would have to change their stands to override a veto in the upper chamber. In the House, at least 24 GOP state representatives would need to support an override, assuming all 43 House Democrats voted in favor.

Governor Terry Branstad delivered his annual Condition of the State address to members of the Iowa House and Senate and the Iowa Supreme Court justices yesterday. If you missed the speech, the full prepared text is here. Iowa Public Television posted the video and transcript here. The early part of the 30-minute address included one false or misleading assertion after another.

· “Sound budgeting practices and fiscal discipline now have us ranked as the 3rd best managed state in the nation.” Contrary to the idea that Branstad markedly improved Iowa’s operation, a major investors group also ranked Iowa the third best-managed state in 2010 under Governor Chet Culver, recognizing Iowa’s good fiscal position, high credit ratings from leading agencies, and low debt per capita compared to most other states.

· “The Iowa Economy has created 214,000 new jobs; surpassing our 2010 goal.” Sorry, no. That’s a fake statistic no economist would accept. It’s a shame the governor has instructed Iowa Workforce Development to keep cooking the books on employment.

· “If the state fails to implement managed care, the growth of Medicaid spending will consume virtually all of our revenue growth.” The Branstad administration has not been able to demonstrate that managed care will save the state money. Florida’s Medicaid privatization turned out to be more costly without improving patient care.

I was also disappointed not to hear more specifics about how Branstad envisions spending funds he would like to divert from school infrastructure to water programs. What kind of water quality programs would be prioritized, and who would administer them? Then again, details about this plan may be irrelevant, because Iowa House and Senate leaders don’t sound open to the idea.

For now, I want to focus on a much more promising part of Branstad’s address. To my surprise, the governor devoted a major section–roughly eight minutes of speaking time–to advocating for criminal justice reforms proposed by a working group he appointed in August. The group was charged with developing ideas to increase fairness and reduce racial disparities in Iowa’s criminal justice system. Click here to read the full recommendations released in November. Bleeding Heartland will discuss some of the proposals in more detail in future posts. Advocates for defendants’ rights and racial justice have generally welcomed the proposals.

Although some policies do not go far enough, and other important reforms are missing from the document, I’m encouraged to see the governor apply some political capital toward reducing systemic racism and inequities in the justice system. I enclose below the relevant portion of Branstad’s speech, with some annotations.

UPDATE: I can’t believe I forgot to mention one thing Branstad could do immediately to address a massive racial disparity in Iowa. His executive order making it extremely difficult for felons to regain their voting rights disenfranchises Iowans of all ethnic backgrounds but disproportionately affects racial minorities.

Governor Terry Branstad wore a pink tie and many colleagues remarked on history made yesterday at the Capitol, as Linda Upmeyer became the first woman to preside over the Iowa House as speaker, as well as the first child of an Iowa legislative leader to rise to the same position. Erin Murphy’s take on the milestone is worth a read.

As in recent years, social issues were almost entirely absent from the leaders’ opening remarks to their Iowa House and Senate colleagues. State budget priorities dominated the comments relating to public policy, with Republicans emphasizing the importance of not spending too much and Democrats emphasizing the need to spend enough on education and other vital services. No one mentioned Branstad’s call to extend the penny sales tax for school infrastructure and divert part of the revenue stream to water programs.

One of the best pickup opportunities for Democrats in the Iowa House got better on Thursday, as three-term Republican State Representative Brian Moore told KMAQ Radio in Maquoketa that he will not run for re-election in House district 58. After an unsuccessful bid for the Democratic nomination in an Iowa Senate district, Moore switched parties, filed in a House seat where there was no Republican challenger, and pulled off one of the most shocking Iowa state legislative upsets in 2010. He won a re-match against Tom Schueller in the next election cycle and defeated challenger Kim Huckstadt by a comfortable margin in 2014.

House district 58 is among the most Democratic-leaning legislative seats currently held by a Republican. In 2012, Barack Obama received 55.6 percent of the vote here; only residents of House district 91 in the Muscatine area gave a higher percentage of their votes to the president while electing a Republican to the Iowa House. According to the latest figures from the Iowa Secretary of State’s office, House district 58 contains 6,968 active registered Democrats, 4,726 Republicans, and 9,151 no-party voters.

Moore has not always fallen in line with House Republican leaders. In late December, he told William Garbe of the Dubuque Telegraph-Herald that he may break with his caucus during this year’s session to support a larger funding increase for K-12 schools. Fellow GOP State Representatives Quentin Stanerson and Ron Jorgensen are also retiring this year and are known to have been dissatisfied with the final compromise on education funding last year. Moore’s announcement will increase speculation that State Representative Josh Byrnes may not seek a fourth term in House district 51. He challenged Linda Upmeyer for the speaker’s chair last summer. After losing that contest, Byrnes criticized excessive partisanship and the failure to meet deadlines for approving school funding. In 2013, Byrnes and Moore were the only two House Republicans to vote with Democrats to expand Medicaid as foreseen under the Affordable Care Act.

Democrat Peter Hird launched his campaign in House district 58 in October. I enclose below some background on Hird and a map of the district, which covers all of Jackson County, a large area in Jones County and two rural Dubuque County townships. Pat Rynard profiled Hird at Iowa Starting Line last month. I would not be surprised to see another Democrat file to run for this seat, since the winner of the primary will have a good chance of being elected in November.

No matter how closely you follow current events, some days the news will shock you. I enclose below the biggest Iowa political stories I never saw coming last year.

Please share your own thoughts on this subject in the comments.

As I mentioned on Tuesday, writing is a labor of love for me. Some posts are much more labor-intensive than others.

All of the pieces linked below took at least a couple of days to put together. Some were in progress for weeks before I was ready to hit the publish button. (No editor, deadlines, or word limits can be a dangerous combination.) A few of the particularly time-consuming posts required additional research or interviews. More often, the challenge was figuring out the best way to present the material.

Several pieces that would have qualified for this list are not included, because they are still unfinished. Assuming I can get those posts where they need to be, I plan to publish them during the first quarter of 2016.

While working on another piece about Iowa politics highlights from the year, I decided to start a new Bleeding Heartland tradition. Writing is a labor of love for me, as for many bloggers, but let’s face it: not all posts are equally lovable.

The most important political events can be frustrating or maddening to write up, especially when there is so much ground to cover.

Any blogger will confirm that posts attracting the most readers are not necessarily the author’s favorites. The highest-traffic Bleeding Heartland post of 2015–in fact, the highest-traffic post in this blog’s history–was just another detailed account of a message-testing opinion poll, like many that came before. Word to the wise: if you want a link from the Drudge Report, it helps to type up a bunch of negative statements about Hillary Clinton.

Sometimes, committing to a topic leads to a long, hard slog. I spent more time on this critique of political coverage at the Des Moines Register than on any other piece of writing I’ve done in the last decade. But honestly, the task was more depressing than enjoyable.

Other pieces were pure pleasure. Follow me after the jump for my top fifteen from 2015.

They were so close. Florida-based WellCare played the game almost perfectly to win a contract for its Iowa subsidiary to manage care for Medicaid recipients, which could have been worth hundreds of millions of dollars over the next three years.

The first sign that WellCare’s ambitions might come to nothing attracted little notice, appearing just before the long Thanksgiving weekend. More bad tidings for WellCare arrived yesterday in a late Friday afternoon dump, the classic way for government officials to bury news. Reading Jason Clayworth’s report for the Des Moines Register, it’s easy to see why the Branstad administration sought minimal attention for fixing an embarrassing oversight.

For months, Governor Terry Branstad has dismissed warnings from patients, advocates, doctors, hospitals, editorial boards, and lawmakers that the state’s rush to privatize Medicaid would disrupt health care for some 560,000 Iowans. Today the governor finally got the message in a form he can’t ignore. Director Vikki Wachino of the federal government’s Centers for Medicare and Medicaid Services wrote to Iowa Medicaid Director Mikki Stier,

Based on our review last week of Iowa’s progress, as well as the information you have provided, CMS expects that we will ultimately be able to approve Iowa’s managed care waivers. However, we do not believe that Iowa is ready to make this transition Jan. 1. CMS previously outlined the requirements to provide high quality, accessible care to Medicaid beneficiaries, and Iowa has not yet met those requirements, meaning that a transition on January 1 would risk serious disruptions in care for Medicaid beneficiaries. While you have made progress in some areas of readiness, our review also identified significant gaps that need to be addressed before CMS can authorize your waiver requests. For that reason, CMS will work with you toward approval of your request effective March 1, 2016, provided that the state demonstrates progress toward readiness consistent with the actions in the attachment to this letter.

Click through to read the full four-page letter and four-page attachment from Wachino to Stier, which the Des Moines Register posted online. CMS officials found that “significant areas of the state did not have many provider types within a reasonable distance,” and that “Relying too heavily on out-of-network providers is likely to create confusion among beneficiaries and providers, result in access issues for beneficiaries, and disrupt continuity of care for beneficiaries.” Many of the points raised echo concerns three Democratic state senators expressed during meetings with CMS officials in Washington last month.

The CMS readiness review also showed that nearly half of Medicaid recipients who tried to call the state’s call centers earlier this month could not get through. Many Iowans who did reach a staffer on the phone were not able to find out whether any of their current doctors had signed contracts with the four managed care providers approved to run Medicaid. The CMS findings are consistent with what I’ve been hearing from acquaintances: the enrollment packets sent to Medicaid recipients did not include basic details they would need to make an informed choice of managed care provider (such as where their family’s current doctors will be in-network).

I enclose below reaction to today’s news from Branstad, who struck an upbeat tone, and key Democratic lawmakers, who vowed to keep fighting to improve legislative oversight of the Medicaid privatization. The Democratic-controlled Iowa Senate approved such a bill during the 2015 session, but the Republican-controlled Iowa House declined to take it up. Oversight is the very least state lawmakers could do to prevent the transition to managed care from becoming a pretext for denying services to vulnerable Iowans.

David Pitt noted in his report for the Associated Press,

Two legal challenges continue including one from the Iowa Hospital Association, a trade group for the state’s hospitals. It sued the state claiming the privatization plan is illegal because it takes millions of dollars from a dedicated hospital trust fund and gives it to the four managed care companies.

Any relevant comments are welcome in this thread. I am grateful that so many Iowans took the time to contact federal officials about Branstad’s disastrous policy. Bleeding Heartland reader Rhonda Shouse has been one of the superstar organizers in that fight.

UPDATE: Added below reaction from Representative Dave Loebsack (D, IA-02). I expect that during next year’s re-election campaign, Loebsack will highlight his efforts to shield constituents from the negative consequences of shifting Medicaid to managed care. His only declared Republican opponent is State Senator Mark Chelgren, who like his GOP colleagues in the upper chamber has done nothing to slow down the privatization or strengthen legislative oversight of the process.

SECOND UPDATE: Added more news and commentary related to this issue.

December 14 marked 7,642 days that Terry Branstad has been governor of Iowa, making him the longest-serving governor in U.S. history, according to Eric Ostermeier of the Smart Politics website. Because most states have term limits for governors, “The odds of anyone passing [Branstad] in the 21st Century are next to none,” Ostermeier told Catherine Lucey of the Associated Press.

Speaking about his legacy, Branstad has emphasized the diversification of Iowa’s economy, even though a governor has far less influence over such trends than Branstad seems to believe. Some have cited “fiscal conservatism” as a hallmark of Branstad’s leadership. I strongly disagree. The man who has been governor for nearly half of my lifetime is stingy about spending money on education and some other critical public services. He opposes bonding initiatives commonly used in other states to fund infrastructure projects (“you don’t borrow your way to prosperity”). But he is happy to provide tens of millions or hundreds of millions of dollars in tax breaks to corporations that don’t need the help, without any regard for the future impact of those tax expenditures on the state budget. Many of Iowa’s “giveaways” in the name of economic development will never pay for themselves.

Branstad’s governing style has changed Iowa in important ways. He has altered Iowans’ expectations for their governor. He has expanded executive power at the expense of both the legislative branch and local governments. And particularly during the last five years, he has given corporate interests and business leaders more control over state policy. More thoughts on those points are after the jump, along with excerpts from some of the many profiles and interviews published as today’s landmark approached.

P.S.- Speaking of Branstad doing what business elites want him to do, Iowa Public Television’s “Governor Branstad: Behind the Scenes” program, which aired on December 11, included a telling snippet that I’ve transcribed below. During a brief chat at the Iowa State Fair, Iowa Board of Regents President Bruce Rastetter asked Branstad to call Bruce Harreld, at that time one of the candidates to be president of the University of Iowa. That Rastetter asked Branstad to reassure Harreld was first reported right after the Board of Regents hired the new president, but I didn’t know they had the conversation in public near a television camera.

P.P.S.-Now that Branstad has made the history books, I remain convinced that he will not serve out his sixth term. Sometime between November 2016 and July 2017, he will resign in order to allow Lieutenant Governor Kim Reynolds to run for governor in 2018 as the incumbent. Although Branstad clearly loves his job, he is highly motivated to make Reynolds the next governor. She lacks a strong base of support in the Republican Party, because she was relatively inexperienced and largely unknown when tapped to be Branstad’s running mate in 2010. Even assuming she is the incumbent, Reynolds strikes me as more likely to lose than to win a statewide gubernatorial primary. Remaining in Branstad’s shadow would give Reynolds little chance of topping a field that will probably include Cedar Rapids Mayor Ron Corbett and Iowa Secretary of Agriculture Bill Northey.

P.P.S.S.-I will always believe Branstad could have been beaten in 1990, if Democrats had nominated a stronger candidate than Don Avenson. Attorney General Tom Miller lost that three-way primary for one reason only: he was against abortion rights. Miller later changed that stance but never again ran for higher office.

A Republican challenger to three-term State Senator Jeff Danielson in Iowa Senate district 30 emerged last week. Bonnie Sadler is on Facebook here and on Twitter here. Danielson has a campaign website as well as a Facebook page and Twitter feed.

Danielson was the Iowa legislative incumbent re-elected by the narrowest margin in 2008, beating Walt Rogers by just 22 votes out of more than 32,000 cast. Although Danielson won his third term by a somewhat larger margin in 2012, Republicans are still likely to target this race as one of their top two or three pickup opportunities. The Republican State Leadership Committee has committed to play for the Iowa Senate majority in 2016. Democrats currently control the chamber by 26 votes to 24.

I enclose below a map of Senate district 30, a review of its voter registration numbers and recent voting history, background on both candidates, and first thoughts on what should be a central issue during next year’s campaign.

Democrat Dave Grussing announced earlier this month that he will challenge two-term Republican State Representative Tedd Gassman again in Iowa House district 7, which covers Emmet and Winnebago counties plus half of Kossuth County on Iowa’s northern border. A detailed district map is below, along with background on both candidates. Grussing’s campaign is on the web at Grussing for Iowa House and on Facebook here. His key campaign issues include job creation for rural Iowa, more funding for K-12 schools and community colleges, “encouraging veterans and military retirees to locate in Iowa,” and raising the minimum wage. Grussing has also expressed concern about Governor Terry Branstad’s unilateral decision to close two in-patient mental health institutions and privatize Medicaid.

House district 7 has been one of the most competitive state legislative districts in recent election cycles. Democrat John Wittneben defeated Republican Lannie Miller in an open-seat race by just 32 votes in 2010. That campaign likely would have ended differently if Iowa Republican leaders and key GOP-leaning interest groups such as the Iowa Farm Bureau Federation and the Iowa Association of Business and Industry had not left Miller behind. Redistricting following the 2010 census made House district less friendly territory for a Democrat, and Wittneben lost his 2012 re-election bid to Gassman by just 44 votes.

House district 7 leans Republican, with 5,269 active registered Democrats, 6,323 Republicans, and 8,307 no-party voters, according to the latest figures from the Iowa Secretary of State’s office. Voters living in the district supported Mitt Romney over Barack Obama by 51.82 percent to 46.97 percent in 2012 and favored Joni Ernst over Bruce Braley in last year’s U.S. Senate race by 55.71 percent to 38.56 percent, nearly double Ernst’s statewide margin of victory. Grussing’s challenge to Gassman was one of seven Iowa House races the progressive group Democracy for America targeted last cycle, probably because of Gassman’s narrow win in 2012. But Gassman easily won by more than 1,700 votes.

Even in a presidential election year, when more Democrats turn out to vote, Grussing will need to outperform the incumbent substantially among independents and win some crossover Republican votes. That’s not an insurmountable task for a hard-working candidate, though. Especially since Gassman promised during the 2014 campaign to “support education at all levels,” saying “his first priority would be to approve a supplemental state aid bill for K-12 education.” Although Gassman served as vice chair of the House Education Committee during the 2015 legislative session, to my knowledge he did not speak out for investing more in education as Republican House leaders refused for months to compromise on school funding. Nor did I hear of him criticizing Branstad’s decision to strike nearly $65 million in K-12, community college, and state university funding from the supplemental spending bill lawmakers approved. Gassman certainly didn’t try to override Branstad’s vetoes. Grussing should remind voters frequently that their elected representative stood by while the governor blew a hole in the budgets of K-12 school districts and Iowa Lakes Community College in Emmetsburg.

In addition, for lack of a more tactful way to say this, Gassman is kind of weird. He has often put himself way outside the mainstream, even in his own party. For instance, during an Iowa House subcommittee hearing to consider his 2013 bill to end no-fault divorce for couples with children under age 18, Gassman speculated that his daughter and son-in-law’s divorce put his 16-year-old granddaughter at risk of becoming “more promiscuous.” Only six of his fellow Iowa House Republicans co-sponsored that no-fault divorce bill. The same year, Gassman was among just ten GOP state representatives to co-sponsor a bill that would have banned county recorders from issuing marriage licenses to same-sex couples “until such time as an amendment to the Constitution of the State of Iowa defining marriage as the legal union of one man and one woman is submitted to the electorate for ratification.” The bill was clearly unconstitutional and would have created a circus like what Kentucky experienced this summer, thanks to rogue county clerk Kim Davis.

Gassman’s not a strong fundraiser, although his campaign disclosure reports for 2013 and 2014 (see here, here, and here) show that he receives a fair amount of “free money” from political action committees that give the same amount to dozens of state lawmakers. During the 2014 campaign, Grussing benefited from a number of labor union PAC donations, which will likely come through again if he can demonstrate he is running an active campaign.

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

In what the Des Moines Register’s editors described as a “new low in the out-of-control race to keep or attract employers,” a state board unanimously approved $4.75 million in financial assistance to Kraft Heinz, which plans to replace a large factory in Davenport with a new facility on the northwest side of town. Although at least 900 people are expected to lose their jobs in the downsizing, the city of Davenport will put up $10 million in tax-increment financing to support the project. The Iowa Department of Transportation and the city are expected to commit $5.8 million for road work around the new factory site too. Never one to shy away from handing state funds to large corporations, Iowa Economic Development Authority Director Debi Durham has let all downsizing companies know that the state of Iowa’s wallet is open: “‘Will I take this deal any day? You bet,’ Durham said Thursday morning. ‘This is a future play.’” Durham also told reporters she “expects the state to do more of these kinds of deals in the future, as more massive companies merge.”

Iowa State University economist Dave Swenson characterized the Kraft Heinz incentive package as “bizarre,” adding, “The idea of providing public assistance for a company that has billions of dollars of annual sales cannot make sense to anybody.” The Register’s editors noted, “the company could get $20.75 million in state and local assistance,” which “works out to nearly $43,700 for every job Kraft Heinz agrees to keep”–and roughly 200 of the jobs the company promised to save will pay less than $37,000 a year.”

Speaking of lousy deals, Iowa’s plan to privatize Medicaid looks worse and worse. A post in progress will discuss this policy in more detail; for now I enclose below excerpts from several stories by Jason Clayworth for the Des Moines Register. In recent weeks, Clayworth has exposed damning facts, including:

• Some claims made in bidding documents from the four private insurers chosen to manage Medicaid in Iowa “contain unverifiable data, misleading statements or half-truths.”

• No data support the government’s estimate that privatizing Medicaid would save $51 million from the state budget during the first six months of the program.

• The insurers selected to manage Medicaid “have each been held accountable in other states for serious service and administrative errors, including some that wrongly delayed or denied medical services to poor residents […].”

• Iowa’s Medicaid director Mikki Stier “had improper communications with an insurance company consultant and former lawmaker during a critical review period that ended with the for-profit company being selected” as a managed care provider for Medicaid.

A November 6 letter from the Centers for Medicare and Medicaid Services to Stier enumerated “significant concerns” about the transition to managed care; excerpts from that letter are at the end of this post. Federal officials and Iowa Senate Democrats have scheduled “listening sessions” around the state to focus on Medicaid privatization. Click through for meeting details, as well as a list of state and federal officials to contact with concerns. Only the feds can stop this train by denying the necessary waivers. Branstad administration officials have been unmoved by any of the Register’s revelations or by the risks to vulnerable Iowans, which many speakers raised during Legislative Oversight Committee hearings on November 3.

Governor Terry Branstad didn’t run for re-election last year on a plan to let private insurance companies manage health care for some 560,000 Iowans on Medicaid. He didn’t work with key state legislators to draw up his administration’s “Medicaid Modernization” plans. The governor’s draft budget, submitted in January, projected some $51 million in savings on Medicaid for the 2016 fiscal year. But key lawmakers like the chair of the Iowa Senate Health and Human Resources Appropriations subcommittee didn’t learn that four private companies would be selected to handle almost all Medicaid services until the Iowa Department of Human Services made its request for proposals public in February.

Recent accusations of bias and conflicts of interest, as well as allegedly inaccurate scoring of insurers’ proposals, have raised many questions about how the Iowa DHS selected the four companies now negotiating contracts to manage Medicaid for one-sixth of Iowans. Reports of campaign contributions by lobbyists and political action committees representing firms that sought Iowa’s Medicaid business prompted one watchdog to decry “pay to play” politics.

Those news stories point to a conclusion that isn’t getting enough attention: various insurance companies and their paid representatives knew what was coming down the pike long before the Branstad administration disclosed its plans to privatize Medicaid.

The Branstad administration has justified its “Medicaid Modernization Initiative” with optimistic projections about more “efficient, coordinated and high quality healthcare” and greater “accountability in health care coordination,” delivered at a savings to taxpayers.

Jason Clayworth shared a less encouraging perspective in the August 21 Des Moines Register: all four private insurance companies now negotiating contracts to manage Medicaid in Iowa have “faced serious charges of fraud or mismanagement” related to serving Medicaid recipients in other states. Some of those violations led to “hundreds of millions of dollars in fines” against the insurers.  

On Monday, the Iowa Department of Human Services announced the four private insurance companies selected to manage care for almost all of the 560,000 Iowans on Medicaid. Pending successful contract negotiations, Amerigroup Iowa, AmeriHealth Caritas Iowa, UnitedHealthcare Plan of the River Valley, and WellCare of Iowa will start managing care for Iowans on January 1, 2016. It’s too early to say how the change will affect medical services. Speaking to the Des Moines Register, Democratic State Senator Amanda Ragan expressed concern “that people will fall through the cracks” and said she hopes Iowans will contact state lawmakers “if problems develop” under the new system.

Some losers have emerged from the process already: namely, two companies now managing care for some Iowans on Medicaid, which were not selected to continue in that role next year. Follow me after the jump for background on the Medicaid privatization plan and the fallout from the Iowa DHS not choosing Magellan Health Inc and Meridian Health Plan as managed care organizations for 2016.  

While the four presidential hopefuls attracted the most attention at last night’s “Wing Ding” in Clear Lake, some big Iowa political news preceded their pitches. Kim Weaver delivered her first major speech as a Congressional candidate in the fourth district. Given the smooth delivery, I would never have guessed she hasn’t run for office before.

After telling the audience a little about her background, Weaver talked about some of her key issues: protecting Social Security, Medicare, and Medicaid; supporting the middle class; raising the minimum wage; fighting to change a “predatory” student loan system; supporting women’s access to health care; immigration reform including a pathway to citizenship; clean water and environmental protections. The packed house frequently applauded, especially loudly when Weaver said, “These are some of the things I stand for. What I stand against is Steve King.” Iowa Democrats love to hate King. Weaver argued the seven-term incumbent “doesn’t represent Iowa values,” citing his offensive comments about immigrants and votes against Katrina aid and even a Farm Bill (because he thought it contained too much hunger assistance).

Weaver’s campaign is online at WeaverforCongress.com, as well as on Facebook and Twitter. Her website contains brief statements on most of the issues her stump speech covered. After the jump I’ve posted her announcement video and excerpts from her official bio.

Taking on King is a daunting task for any Democrat. The 39 counties in IA-04 contain 119,020 active registered Democrats, 176,515 Republicans, and 174,355 no-party voters, according to the latest figures from the Iowa Secretary of State’s office.

Iowa House Speaker Kraig Paulsen announced yesterday that he will not seek re-election in 2016 and will step down from leadership before next year’s legislative session. His surprise move kicks off what will be the most competitive leadership election within the House Republican caucus since colleagues elected Paulsen minority leader shortly after the 2008 general election.

Linda Upmeyer, a seven-term incumbent who has served as majority leader since 2011, immediately confirmed that she will run for speaker. She would be the first woman to lead the Iowa House, and to my knowledge, the first child of an Iowa legislative leader to follow a parent in that role. Upmeyer’s father Del Stromer was House speaker for part of the 1980s.

She won’t get Paulsen’s job without a fight, though.  

Anti-abortion activists suffered a setback last month when the Iowa Supreme Court unanimously ruled unconstitutional the state ban on using telemedicine for medical abortions. But the health and human services budget for the fiscal year that began on July 1 contained two provisions sought by those who want to reduce the number of abortions performed in Iowa.

The first part of this post examines new language in the Iowa Code related to ultrasounds for women seeking abortions. Who was closer to the mark: Iowa Right to Life, which hailed the “HUGE life-saving victory” as the anti-choice movement’s biggest legislative success in two decades? Or Planned Parenthood of the Heartland, which countered that the ultrasound language would neither change the standard of care at their clinics nor “directly impact a woman’s access to abortion”?

Next, the post addresses language lawmakers first adopted in 2013 and renewed in the just-passed human services budget, which allows the Iowa governor to determine whether Medicaid should reimburse for abortion services. No other state has a similar provision.

Finally, I offer some thoughts on an odd feature of anti-abortion activism in the Iowa legislature. State Senate Republicans advocate more for restrictions on abortion rights and access than do GOP representatives in the House, even though “pro-choice” Democrats control the upper chamber, while all 57 members of the House majority caucus are nominally “pro-life.” Iowa House leaders have not been eager to put abortion bills on the agenda. This year, rank-and-file House Republicans didn’t even introduce, let alone make a serious attempt to pass, companion bills to most of the abortion-related legislation their counterparts filed in the state Senate.

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).

Governor Terry Branstad is forging ahead with some major policies he didn’t campaign on last year, oblivious to concerns about the impact on Iowa’s Medicaid recipients and people served by two mental health institutions the governor wants to close.

According to Public Policy Polling’s latest Iowa survey, the governor’s plans are deeply unpopular.

Iowans who advocate for people with disabilities have deep concerns about Governor Terry Branstad’s plan to privatize Medicaid, shifting most recipients into managed care. Iowa Senate President Pam Jochum, who has been caregiver to a daughter with developmental disabilities, has been warning for weeks that the reorganization of Medicaid is too hasty and needs oversight from state lawmakers. Last week she discussed potential problems in more detail, citing the Kansas experience with Medicaid privatization as a cautionary tale. After the jump I’ve posted the transcript from that press conference. Supporting documents are available here on how managed care has affected Kansans with disabilities.

Meanwhile, Disability Rights Iowa Executive Director Jane Hudson shared her take on the “empty promises” in Branstad’s plan for Medicaid. You can read the full text of her April 20 guest column for the Des Moines Register at the newspaper’s website or at Disability Rights Iowa. I’ve enclosed a few passages after the jump, but you should click through to read the whole piece. Nearly 20 advocacy groups for Iowans with disabilities or mental health challenges signed on to Hudson’s editorial; the full list is below.

Governor Terry Branstad made a remarkable claim at his latest press conference: because “the people of Iowa elected me to reduce the size and cost of government,” he has the authority to “make tough decisions” on closing state-run mental health facilities and reorganizing Medicaid services for more than half a million Iowans.

To justify his position, Branstad channeled President Harry Truman: “The buck stops with me.” But his view of governance reminds me more of Mel Brooks in the movie “History of the World, Part 1”: “It’s good to be the king.”

Governor Terry Branstad will expand the number of Medicaid recipients who are covered under private managed-care companies, Tony Leys reported for the January 21 Des Moines Register.

Details are scarce on how the plan would work, but Branstad projects it would save $51.3 million from January through June 2016, its first six months. […]

“Through better coordinated care in Medicaid, focused on improving outcomes, Iowa can better serve Medicaid patients and provide more predictability for Iowa taxpayers,” [Branstad spokesman Jimmy Centers] wrote in an email to the Register. “The growth of Medicaid spending in Iowa is unsustainable over the long-term and it limits Iowa’s ability to provide high-quality and stable health services to our most vulnerable residents as well as our ability to invest state taxpayer dollars in other key programs aimed at growing our state.” […]

Rep. Linda Miller, a Bettendorf Republican who serves on the [Human Resources] committee, said most of the savings would come from improved care, so Medicaid members wouldn’t need hospitalization or other expensive services as often. She said legislators want to make sure the shift won’t lead to cuts in services or in payment rates to medical providers.

Amy McCoy, a spokeswoman for the Iowa Department of Human Services, said the state and federal governments spend about $4.2 billion annually – including $1.5 billion of state money – on Iowa’s Medicaid program. That’s up 73 percent since 2003, she said.

If Branstad’s plan really would save $51.3 million each year (I am skeptical), that figure represents a little more than 1 percent of Medicaid’s total annual costs in Iowa, or about 3.4 percent of the state’s share of Medicaid costs.

Approximately 564,000 Iowans are now covered under the Medicaid program. It’s not clear how many of them would be shifted to private companies; the Department of Human Services is expected to release a plan in March. Magellan of Iowa has offered “a broad range of mental health and substance abuse services” to most Iowans on Medicaid since 1995. Meridian Health Plan has been providing coverage to some Medicaid recipients since 2012 “through a contract with the Iowa Department of Human Services.” Currently about 17,000 beneficiaries are covered through Meridian.

Leys quoted Iowa House Republican Dave Heaton as saying the governor can implement this change without legislative approval.

Any relevant comments are welcome in this thread.

P.S. – Who is old enough to remember when Republicans demonized the idea of “managed care” as evil interference between doctors and their patients?

Governor Terry Branstad will deliver his annual Condition of the State address to members of the Iowa House and Senate this morning at 10 am. You can watch the speech live on Iowa Public Television’s website or on IPTV World (channel 119 on Mediacom in central Iowa). The full text as prepared will be available on the governor’s official website.

Judging by yesterday’s opening remarks from state legislative leaders, Iowa House Republicans most want to see new tax reform proposals from the governor. Iowa Senate Democrats are most closely watching to see whether Branstad will propose adequate funding for education at all levels, from pre-school to K-12 to community colleges and state universities. I’ll update this post later with highlights from the day. Any comments about the governor’s speech (content or delivery) or the upcoming legislative session are welcome in this thread.

UPDATE: Added highlights and some reaction to the “Together We Can” speech below. James Q. Lynch created a graphic showing the words Branstad used most.

Chutzpah alert: Branstad is urging lawmakers to “bring together state agencies that have a shared interest in quality of life initiatives and invest in our parks, trails, lakes and museums.” Maybe he’s forgotten that the state legislature did that last year, before he vetoed millions of dollars that would have gone toward parks, trails, water quality programs and other amenities.

It’s also disappointing that the governor can’t quit lying about how many jobs have been created since he returned to public office.

It’s encouraging to hear the governor call for stronger efforts to protect victims of domestic violence and end bullying in schools. The devil will be in the details of those proposals. Speaking to Radio Iowa, Iowa Senate President Pam Jochum said “the anti-bullying proposal as well as the anti-domestic violence proposal will get a very good response from the Iowa Senate.” But she said the governor’s proposed education funding is “less than what we know we need in order to bring Iowa’s per pupil spending investment up to at least close the national average.” Meanwhile, House Speaker Kraig Paulsen told Radio Iowa that his caucus will continue to look for tax cuts (“a way to for Iowans to leave more of their own money in their pockets”).

SECOND UPDATE: As he did last year, the governor called for expanding access to broadband statewide. But strangely, Branstad does not plan to attend President Barack Obama’s scheduled January 14 event in Cedar Falls, where the president will “propose plans to increase affordable access to high-speed broadband internet.”

LATE UPDATE: Nate Monson, executive director for Iowa Safe Schools, characterized the governor’s anti-bullying bill as a “giant leap forward for gay youth” in Iowa. I’ve enclosed excerpts from his Des Moines Register guest editorial at the end of this post.