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.

Exciting times for Iowa politics watchers: the state legislature’s 2015 session began in Des Moines today. A tentative schedule for this year’s work is available here (pdf). The last day lawmakers will receive per diem expenses is on May 1, but for the past four years of divided control between a Republican House and a Democratic Senate, the session has always gone into overtime–sometimes by a little and sometimes by a lot. Bleeding Heartland previously posted details on the each chamber’s majority and minority leadership teams, along with all chairs, vice chairs, and members of standing committees. Click here for who’s who in the Iowa House, and here for who’s who in the Iowa Senate.

Today legislative leaders from both parties pledged to work together. After the jump I’ve enclosed the full texts of opening day remarks. Iowa Senate Majority Leader Mike Gronstal called for making Iowa’s middle class the “focus of the 2015 session” by ensuring adequate education spending, fighting wage theft, and expanding worker training while keeping a balanced budget. He praised Governor Terry Branstad for agreeing to go back to setting K-12 school funding a year in advance, as is required by state law, but warned the governor not to make a partisan statement by proposing too little funding for education when he addresses the legislature tomorrow.

Echoing some of the priorities she named last year, Senate President Pam Jochum said building an economy that “works for everyone” means supporting families and especially children: “For too long, the well-being of children has been considered a woman’s issue.’ It is not just a ‘woman’s issue’. It is an American issue. It is an Iowan issue.” Jochum urged lawmakers to expand access to education from pre-K through college, make “quality, affordable childcare” more available across the state, and boost an initiative to “detect and help prevent mental health and developmental problems among young children.”

Iowa House Minority Leader Mark Smith said the top priorities for House Democrats are strengthening the middle class and re-vitalizing rural Iowa. In addition to expanding early childhood education and providing adequate funds for K-12 schools, Smith called for raising the minimum wage, though GOP leaders have shown no willingness to negotiate on that issue.

As has been true in recent years, top Iowa House and Senate Republicans focused on fiscal issues and mostly avoided social issues. Iowa House Speaker Kraig Paulsen challenged his colleagues “to ensure that government do less and do it better” when “others bring forward their laundry list of funding opportunities, spending priorities, or flashy government programs.” He called for more tax cuts along the lines of a 2006 bipartisan agreement to eliminate the state tax on Social Security benefits. (Mike Owen of the Iowa Policy Project explained in a guest column for the Quad-City Times why that tax cut was passed “under false pretenses” and skewed Iowa’s tax code “further to the benefit of the wealthy.”) House Majority Leader Linda Upmeyer emphasized the need to “craft a responsible budget.” She singled out the Medicaid program for criticism, claiming growth in Medicaid spending is “not sustainable” and will threaten lawmakers’ ability to invest in education, job training, infrastructure, and renewable energy. Iowa Senate Minority Leader Bill Dix called on senators to “work together to rein in spending, make cuts and reduce the size of government and lift up all Iowans in the process by reducing their tax burdens.”

None of the Republicans set a goal of undoing marriage equality, and only House Speaker Pro Tem Matt Windschitl made passing reference to other top priorities for social conservatives when he said, “Let us work together to make Iowa the best place to live, where taxes are low, jobs are abundant, education is top of the line, innocent life is protected and Second Amendment rights are fully embraced.”

Any comments about the legislative session are welcome in this thread. By the way, here’s some trivia you may not know about Speaker Paulsen.  

Tony Leys didn’t bring glad tidings today to the 120,000 members of CoOportunity Health in Iowa and Nebraska. In a front-page story for the Des Moines Register, Leys reported that state regulators have taken over the non-profit health insurance co-op, one of only two companies selling policies on Iowa’s exchange. It sounds like the co-op will be liquidated in the coming months.  

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

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

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

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

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

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

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

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

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

A year after Iowa law changed to require the governor to approve all Medicaid reimbursements for abortions, the new policy does not appear to have limited low-income women’s access to abortions in cases of rape, incest, threat to the mother’s life or severe fetal abnormality.

On the other hand, the policy has in effect ended Medicaid coverage of abortion in Iowa, which was already among the most restrictive states in this area.  

Since last summer, many Iowa politics watchers have had Republican State Representative Josh Byrnes on retirement watch. However, he announced this week that he will seek a third term in Iowa House district 51. After the jump I’ve posted a district map and Byrnes’ re-election statement.

Democratic candidate Laura Hubka has been actively campaigning for months. She’s facing a relatively strong incumbent in this district, which covers Howard, Mitchell, Worth, and part of Winneshiek Counties along Iowa’s northern border. Byrnes was comfortably re-elected in 2012 even as President Barack Obama won more than 55 percent of the vote in House district 51. The latest totals from the Secretary of State’s office indicate that the district contains 5,765 registered Democrats, 6,470 Republicans, and 8,643 no-party voters.

Although I have not heard of any Republican planning to challenge Byrnes, three factors make me suspect he will not get a free pass in the GOP primary.

1. Byrnes is the leading Iowa House proponent of raising the gasoline tax, a popular view among some rural constituencies but not in the Republican base. He even taunted the advocacy group Iowans for Tax Relief after this year’s subcommittee hearing, where the gas tax bill advanced.

2. While many Iowa House Republicans are quietly satisfied to see a constitutional amendment on marriage die in the funnel for two years running, to my knowledge Byrnes is still the only person in his caucus who openly supports same-sex marriage rights.

3. Last year Byrnes was one of just two GOP legislators to support the Democratic position on expanding Medicaid in Iowa. (The other one, Brian Moore, represents the most Democratic-leaning Iowa House district Republicans now control.)

It will be a St. Patrick’s Day miracle if no anti-tax zealot, social conservative, or “Liberty” activist steps up to challenge Byrnes by the March 14 filing deadline.  

UPDATE: Amazingly, no other Republican filed papers to seek the GOP nomination in House district 51.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

This week Iowans may have gotten the answer.

Iowa House Republicans failed in 2011 and again last summer to curtail Medicaid coverage of abortions in this state. A compromise passed near the end of this year’s legislative session gave the governor power to determine whether the state should reimburse abortion providers for certain Medicaid cases. However, administrators at the University of Iowa Hospitals in Iowa City have apparently let Governor Terry Branstad off the hook: the hospital no longer bills Medicaid for the handful of abortions that might be eligible for coverage.

Follow me after the jump for background and more details on the current policy.

State Representative Walt Rogers confirmed to the Waterloo/Cedar Falls Courier that he is analyzing a bid for the Republican nomination in Iowa’s first Congressional district now that House Speaker Kraig Paulsen has passed on the race. Rogers hopes to decide later this summer whether to run for Congress. After the jump I’ve enclosed background on Rogers and early thoughts on his strengths and weaknesses as a candidate.

I also included a map of Iowa House district 60 and the latest voter registration numbers for the seat Rogers would have to leave open if he runs for Congress in 2014.

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

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

Iowa House Speaker Kraig Paulsen is thinking seriously about running for Congress in the open first district, covering 20 counties in northeast and central Iowa. He hasn’t given a timeline for making up his mind and has said he’s trying to figure out “what’s the best way to serve Iowans. What meets their needs?”

I would suggest that Paulsen consider this cold, hard reality: he is unlikely to serve Iowans as a member of Congress, because he would lose the GOP primary in IA-01.

UPDATE: Scroll to the end of this post for a sixth reason.

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

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

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

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

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

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

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

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

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

State Senator Kent Sorenson claims to have made some Iowa House Republicans unhappy by helping the advocacy group Iowa Pro-Life Action pressure state representatives over abortion funding. Currently, Iowa’s Medicaid program covers abortions under very limited circumstances. In fact, our state is among the most restrictive in this area. Nevertheless, a compromise worked out on the final day of the 2011 legislative session angered many conservatives. Some Iowa Republicans have pushed for a total ban on Medicaid-funded abortion.

In a Facebook post last night, Sorenson lambasted members of his own party who do not keep their promises on the “pro-life” issue. He claimed that some House Republicans “are considering filing ethics charges against me” because he signed a letter Iowa Pro-Life Action sent to lawmakers. Looking through the Iowa House Code of Ethics, it’s not clear to me which rule Sorenson might have violated. House Republican staffer Josie Albrecht told me by telephone that she was not aware of any pending ethics complaints by legislators against Sorenson.

I enclose the full text of the Facebook post after the jump. At this writing, it has been “shared” by 63 Facebook users, including conservative talk radio hosts Steve Deace and Jan Mickelson.

Sorenson is already facing an ethics investigation related to alleged paid work for Michele Bachmann’s presidential campaign. I have been wondering whether Republicans might be better off with a different nominee in Iowa Senate district 13 next year. However, an uncompromising stand against abortion funding would serve Sorenson well if he faced a GOP primary challenger.

Does anyone still doubt that Governor Terry Branstad plans to run for a sixth term next year? Those not convinced should read Mike Wiser’s report on the full-time staffer just hired by Branstad’s re-election campaign.

Meanwhile, Democratic State Senator Jack Hatch dropped a couple of hints lately about a possible run for governor.

The Iowa legislature’s 2013 session is already in overtime, and the standoff over whether to expand Medicaid is one of the last obstacles to adjournment. A conference committee including five lawmakers from each party has been seeking middle ground between Medicaid expansion, a priority for the 26 Senate Democrats, and the “Healthy Iowa Plan” that barely cleared the Iowa House but failed in the Senate.

This week Senate Democrats offered another gesture toward the Republican desire for low-income Iowans to have more “skin in the game” when they obtain health insurance coverage.

Meanwhile, three major advocacy groups stepped up their efforts to persuade lawmakers that the Healthy Iowa Plan offers inferior access for patients while incurring substantially higher property tax costs.

Finally, a coalition of progressive organizations announced that it will run a television commercial this Sunday targeting GOP State Representative Dave Heaton, the weakest link among House Republicans trying to pass Governor Terry Branstad’s alternative plan. Details on all those developments are after the jump.

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

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

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

Last night the Iowa House approved by 51 votes to 49 a version of Governor Terry Branstad’s alternative to expanding Medicaid. Two Republicans opposed the plan, but State Representative Dave Heaton fell in line despite his major doubts about the bill.

Details on the vote and highlights from the debate are after the jump.

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

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

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

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

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

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

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

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

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

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

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

It’s been a while since I posted about the 2016 Iowa caucus campaign. Wisconsin Governor Scott Walker agreed to headline the Polk County Republican Party’s spring fundraiser in May. According to Kevin Hall’s report for The Iowa Republican blog, Governor Terry Branstad helped make arrangements for Walker’s appearance. Like Branstad and unlike eight other GOP governors around the country, Walker opted against taking federal funding to expand Medicaid in his state.

Hall reports that retired insurance executive Cameron Sutton “played a key role in securing Scott Walker’s appearance” as well. Sutton was one of seven Iowa Republican donors from the business community who flew to New Jersey in May 2011 to urge Governor Chris Christie to run for president. (Christie’s star has fallen in Republican circles since he praised President Barack Obama’s handling of Hurricane Sandy and later agreed to expand Medicaid in New Jersey.) Sutton endorsed Newt Gingrich for president before the Iowa caucuses but wasn’t pleased with the way Gingrich bashed Mitt Romney during the GOP primaries.

Any comments about the next presidential campaign are welcome in this thread.

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

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

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

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

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

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

A Terrace Hill mystery: why doesn’t Governor Terry Branstad have more details to share about his proposed alternative to expanding Medicaid in Iowa?

Answer: Outside consultants are still working up a plan for him. CORRECTION: Branstad rolled out his “Healthy Iowa Plan” on March 4.

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.

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.

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.

Do you want the good news first, or the bad news? President Barack Obama has reportedly settled on a strong candidate to replace Lisa Jackson as Environmental Protection Agency administrator. On the flip side, Steven Chu’s successor at the Department of Energy is likely to be a nuclear physicist with connections to major polluting industries. Details are after the jump. Still no word on the next secretary of transportation.

Florida Governor Rick Scott is the latest Republican governor to decide to expand Medicaid under the 2010 health care reform law. He was one of those leading the charge to have the law declared unconstitutional. Some comments from today’s press conference are after the jump as well. Arizona Governor Jan Brewer, Ohio Governor John Kasich and Michigan Governor Rick Snyder are all Republicans who opposed the Obama administration policy but have agreed to expand Medicaid in their states. I hope that when Iowa Governor Terry Branstad meets with U.S. Health and Human Services officials later this week, he will find some face-saving way to agree to expand Medicaid here. So far he sounds determined to resist the policy, despite the consensus of every major Iowa medical group as well as a wide array of religious and social justice organizations.

This is an open thread: all topics welcome.

Nine days from now, approximately 85 billion in federal spending cuts will go into effect unless Congress and President Barack Obama can agree on an alternative to the so-called “sequester.” After the jump I’ve posted details on how the spending cuts might affect Iowa, as well as recent comments and actions by some of the Iowans in Congress.

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

The Des Moines Register continues to release bits and pieces from the latest Iowa poll conducted by Selzer & Co. After the jump I’ve posted some of the more important findings, other than the IA-Sen numbers, which I discussed in this post. Like the Iowa .Gif-t Shop blog, I found it bizarre that the Register asked respondents whether they’d be “thrilled,” “mildly happy,” or “don’t really care” about the prospect of certain national retailers opening an Iowa store.

Iowans support expanding Medicaid as provided under the 2010 health care reform law by more than a two to one margin, according to a new poll commissioned by the American Cancer Society Cancer Action Network, which supports the policy.