What’s on your mind this long weekend, Bleeding Heartland readers? This is an open thread. I posted some links below to get a conversation going.

UPDATE: Scroll down for excerpts from the inaugural speech and some reaction from Iowa political figures.

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

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

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

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

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

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

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

Medicaid coverage of abortion has been a contentious issue in the Iowa legislature since 2011 and will be on lawmakers’ agenda during next year’s session. I was surprised to learn that Iowa is already more restrictive than most other states when it comes to Medicaid coverage of abortion in cases of rape.

Medicare and alleged “job-killing” policies are the focus of the latest television commercials from Representative Dave Loebsack and his GOP challenger John Archer. Meanwhile, the National Republican Congressional Committee is taking cheap shots over a committee hearing Loebsack attended three and a half years ago.

Videos and transcripts of the latest television commercials in Iowa’s second Congressional district are after the jump. Bleeding Heartland covered previous ads from this race here, here, and here.

U.S. Health and Human Services Secretary Kathleen Sebelius, a former governor of Kansas, made clear last week that the Obama administration will work with governors who are reluctant to expand Medicaid eligibility in their states.

A bidding war between Iowa and Illinois ended yesterday, as an Egyptian company’s representative stood with Governor Terry Branstad to announce plans for a $1.4 billion fertilizer plant in Lee County. A package of state, federal, and local tax incentives worth hundreds of millions of dollars will support the project, costing taxpayers more than $1 million for each of the 165 permanent jobs created.

Voting for the so-called “failed stimulus” has become a stock phrase in Republican attack ads against Congressional Democrats. But as Bleeding Heartland has discussed many times before, the “Great Recession” would have been more devastating without the 2009 American Recovery and Reinvestment Act.

State budget cuts are a huge drag on the economy. Follow me after the jump for a picture that’s worth a thousand words on how a favorite conservative punching bag helped soften the recession’s impact in Iowa.

The Iowa Hospital Association’s board has “unanimously agreed that expanding Medicaid in Iowa is the appropriate public health policy for Iowa.” After the jump I’ve posted the full text of the association’s policy brief explaining why Medicaid expansion would be good for Iowa individuals, businesses, and the state as a whole.

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

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

Governor Terry Branstad confirmed yesterday that his administration will not take steps to limit Medicaid funding of abortions without further action by the Iowa legislature.

Republican presidential candidate Mitt Romney announced his running mate this morning: Representative Paul Ryan of Wisconsin, the chair of the U.S. House Budget Committee. The two men are launching a four-day bus tour today. I don’t know what surprises me more: Romney not choosing Senator Marco Rubio of Florida, or Ryan’s willingness to give up his committee chairmanship for a shot at the vice presidency.

Democratic House incumbents and challengers have already been running against the Ryan budget. Iowa’s representatives split on party lines when the House approved this plan in April 2011, and Representative Leonard Boswell was eager to draw this contrast between himself and IA-03 opponent Representative Tom Latham. Having Ryan on the Republican ticket ensures that tax and budget issues will be at the center of the presidential campaign discourse this fall. Ryan’s approach to solving the long-term deficit problem asks virtually nothing of wealthy people but would devastate Medicaid, not to mention the Medicare program for future retirees. After the jump I’ve posted excerpts from a new report on the Ryan plan’s impact on state budgets, along the Iowa Policy Project’s comment on how the Ryan budget would affect Iowa in particular.

Any relevant comments are welcome in this thread. I will update this post with Iowa reaction and more news and links after the jump. Representative Steve King was enthusiastic about the pick.

Opposing all government funding for abortion is settled dogma among Iowa Republican activists and elected officials. For two years in a row, Senate Democrats have blocked attempts to write new restrictions on Medicaid abortion coverage into the budget for the state Department of Human Services. Now DHS Director Chuck Palmer has signaled that taking control of the upper chamber may not give Republicans the power to restrict the choices of low-income women.

Palmer’s action puts Governor Terry Branstad in an awkward position, and a legislature completely under GOP control could create a political nightmare for Branstad, a proud “pro-lifer” throughout his career.

Roughly 150,000 people, or about 5 percent of Iowa’s population, will not receive Medicaid coverage under the 2010 federal health insurance law if Governor Terry Branstad gets his way. The governor repeated yesterday that he does not intend to go along with the Medicaid expansion, because he doesn’t believe the federal government should or will provide the promised funding to cover the cost.

Congressional Republicans including Representative Steve King are urging governors to reject other aspects of the Affordable Care Act, such as the state-based health insurance exchanges. Branstad has not yet decided whether to take that route. More details on these stories and other fallout from last Thursday’s U.S. Supreme Court ruling are after the jump.  

The U.S. Supreme Court today upheld the constitutionality of the 2010 Affordable Care and Patient Protection Act, better known as health care reform. I am shocked not only by the decision, but by the 5-4 breakdown with Chief Justice John Roberts (not Justice Anthony Kennedy) being the swing vote in favor of upholding the law. Most commentators and the betting site Intrade thought the court would strike down at least the individual mandate to purchase health insurance, if not the whole law. To her credit, Linda Greenhouse of the New York Times consistently predicted that Roberts would vote to uphold the law.

Any comments related to health care reform are welcome in this thread. I will update this post frequently during the day as Iowa elected officials, candidates, and activist groups weigh in on the decision.  

Cedar Rapids resident Katie Beckett passed away last week, prompting many tributes to the woman whose fluke childhood illness helped change federal policy on caring for the disabled.  

Yesterday the U.S. House approved a bill to require additional Congressional Budget Office analysis on legislation with a large price tag. The concept is intended to reduce the apparent cost of tax cuts to the federal budget. Iowa’s representatives split on party lines over this bill and proposed amendments, including one offered by Democrat Leonard Boswell (IA-03).

Iowa’s current fiscal year ends on June 30, which gives Governor Terry Branstad, Republican leaders in the Iowa House and Democratic leaders in the Iowa Senate just ten days to approve a 2012 budget without disrupting state government operations. Although the parties have settled on a total spending target for the next fiscal year, they are still at odds over funding for key programs. They appear to have made no progress toward a compromise on commercial property tax reform, which Branstad demands as part of any final budget deal.

Lots of links on spending priorities, rival tax proposals and government shutdown scenarios are after the jump.

UPDATE: Scroll to the end for further details Senate Democrats released on June 20 regarding a budget compromise.

The U.S. Senate rejected motions to proceed with considering four draft budgets for the 2012 fiscal year yesterday. Democratic leaders scheduled the vote primarily to get Republicans on the record supporting the budget that passed the Republican-controlled House of Representatives last month. That blueprint, also known as Paul Ryan’s budget, foresees big changes to the Medicare program and became a central issue in Tuesday’s special election in New York’s 26th Congressional district.

Senator Chuck Grassley voted for two out of the three Republican proposals on the table, including the Ryan budget, while Senator Tom Harkin voted against all three GOP budgets as well as President Barack Obama’s budget blueprint.

Details on the votes and proposals are after the jump.

Governor-elect Terry Branstad announced today that ophthalmologist Dr. Mariannette Miller-Meeks will run the Iowa Department of Public Health in his administration. A press release noted that Miller-Meeks “has served as the first woman President of the Iowa Medical Society and was the first [woman] on the faculty in the Department of Ophthalmology at the University of Iowa and councilor for Iowa to the American Academy of Ophthalmology.” Miller-Meeks was the Republican nominee in Iowa’s second Congressional district in 2008 and 2010. She worked hard during both campaigns but lost to Dave Loebsack in Iowa’s most Democratic-leaning Congressional district.

Also on December 9, Branstad announced that he will tap Chuck Palmer to head the Department of Human Services in his administration. Palmer did that job during Branstad’s previous time as governor from 1989 to 1999. Most recently he has been president of Iowans for Social and Economic Development, “an asset development organization with the mission of creating opportunities for low and moderate income Iowans to increase income and achieve financial stability.”

Branstad has pledged to reduce the size of state government by 15 percent, and keeping that promise would likely require significant cuts in the departments Miller-Meeks and Palmer will be running. The current budget (fiscal year 2011) allocated $935.5 million from the general fund to health and human services. That’s 17.7 percent of the general fund budget alone, or 15.9 percent of total state expenditures, including federal stimulus money and reserve funds as well as general fund spending. More than $200 million in federal stimulus money supported Iowa’s Medicaid budget in the current budget year, but similar support won’t be forthcoming in future years now that Republicans have a majority in the U.S. House of Representatives.

Branstad administration press releases on Miller-Meeks and Palmer are after the jump.

When Congress passed $26 billion in fiscal aid to the states, including $96.5 million in education funding and $128 million in Medicaid assistance for Iowa, Republican gubernatorial candidate Terry Branstad avoided commenting on the issue. Scott Keyes of Think Progress was in Iowa recently and got Branstad to speak on the record about the issue. Click the link for the audio and the full transcript. Excerpt:

[Think Progress]: They just passed that big state aid bill out in Washington. I was curious how you felt about that.

BRANSTAD: I have real concerns because there’s strings attached to that. And it’s one-time money, so it doesn’t solve the problem, it just puts it off a year. And it increases the federal debt. I don’t think they should have done it. I’m not sure, we’ve got to see what the strings are and whether or not we should even accept it or not.

Branstad added that he was against the 2009 stimulus bill and wasn’t sure whether he would accept or reject stimulus funding for Iowa.

Perhaps Branstad has never heard of economic cycles. Congress approved the stimulus bill when the U.S. was in the middle of the worst recession since World War II, and state revenues were dropping at the sharpest rate seen in 60 years. Although the recession is technically over, and state revenues are increasing in Iowa, shortfalls are still projected in key social services.

Branstad says federal assistance “doesn’t solve the problem, it just puts it off a year.” But if the economy continues to improve, state budgets will be under less strain in the 2012 fiscal year. Branstad would rather give up an additional $96.5 million for Iowa schools during the current fiscal year, which would cost approximately 1,800 teachers’ jobs. He would rather do without an extra $128 million for Medicaid, and I doubt he’ll offer an alternative budget showing how he would meet the need for those services. Branstad can’t explain how he would have balanced the current-year budget without stimulus funds, just like he can’t explain how he would pay for his new spending promises.

Branstad is wrong about the $26 billion fiscal aid bill adding to the federal deficit, by the way. The Congressional Budget Office confirmed that the bill’s costs are fully offset by closing tax loopholes and various spending cuts.

Yesterday the House of Representatives approved and President Barack Obama signed a $26.1 billion package to support state education and Medicaid budgets in the current fiscal year. The bill passed the House by a 247 to 161 vote. Iowa’s House delegation split on party lines, as with the 2009 federal stimulus bill and previous legislation designed to support public sector jobs in the states. Iowa will receive about $96.5 million of the $10 billion in education funding, enough to save an estimated 1,800 teachers’ jobs.

The bill also contains $16.1 billion in Federal Medical Assistance Percentage or FMAP funding, including about $128 million to support Iowa’s Medicaid budget in the 2011 fiscal year. Last week I read conflicting reports about how much Medicaid assistance Iowa would receive, but staffers for Representatives Bruce Braley and Dave Loebsack confirmed yesterday that $128 million is the correct figure. That’s a bit more than Iowa legislators were counting on for FMAP funding in the 2011 budget. Extra federal spending on Medicaid also “has an economic benefit for the state of Iowa far greater than the federal government’s initial investment,” according to Iowa State University economist Dave Swenson.

For the last several days, I have been searching for some comment on this legislation from Republican gubernatorial candidate Terry Branstad. I’ve found nothing in news clips, and his campaign has not issued a press release on the federal fiscal aid since the Senate approved the bill on August 4.

Branstad rails against “one-time sources” of funding to support the state budget, but he has nothing to say about $96.5 million for Iowa schools and $128 million for Iowans dependent on Medicaid services.

Branstad is happy to run false advertising about the number of teachers’ jobs supposedly lost in Iowa, but he has nothing to say when federal action saves a significant number of teachers’ jobs. The issue is a bit awkward for Branstad, because Republicans Tom Latham and Steve King voted against the fiscal aid bill in the House, just as Republican Chuck Grassley voted no in the Senate.

Perhaps Branstad lacks the courage to go beyond vague campaign rhetoric about excessive government spending. It’s easy to talk abstractly about “one-time” funding, but risky to slam government support for education and Medicaid. CNN’s latest nationwide poll, which was in the field from August 6 through August 10, asked respondents, “Do you favor or oppose a bill in which the federal government would provide 26 billion dollars to state governments to pay for Medicaid benefits and the salaries of public school teachers or other government workers?” 60 percent of respondents favored such a bill, while only 38 percent opposed it.

Speaking of conspicuous silence from Branstad, when will he tell us how he plans to keep his contradictory promises to cut state spending by 15 percent while having the state pay a larger share of mental health and school funding?

Share any relevant thoughts in this thread.

Good news: the U.S. Senate overcame an attempt to filibuster a bill containing $26.1 billion in fiscal aid to state governments today. About $10 billion will support state education budgets in order to save teaching jobs. The other $16.1 billion will support state Medicaid budgets according to the Federal Medical Assistance Percentage or FMAP formula, which was originally part of the 2009 stimulus package. The Senate’s final vote on this bill is set for August 5, and it will easily gain more than the 50 votes needed for passage. Speaker Nancy Pelosi plans to call the House of Representatives back from August recess in order to approve this bill next week.

Iowa’s Senator Tom Harkin was a co-sponsor of this bill. Senator Chuck Grassley joined Republicans who tried to block it from getting an up-or-down floor vote. I haven’t seen a statement from his office explaining why. The bill does not add to the deficit, because expenses are offset by revenue-raising measures:

Senate Democrats said the $26 billion bill would be paid in part by revenue raising changes in tax law. Senate Democrats said the modifications would curtail abuses of the U.S. foreign tax credit system. The bill would also end the Advanced Earned Income Tax Credit and would return in 2014 food stamp benefits to levels set before last year’s federal stimulus plan.

I’m not happy about cutting future food stamp benefits, but there may be opportunities to restore that funding in other bills. This federal fiscal aid is urgently needed to prevent teacher layoffs in the school year that’s about to begin.  

Republican gubernatorial nominee Terry Branstad has been touring Iowa this summer with a contradictory campaign message. On the one hand, he blasts education cuts that have eliminated some teaching positions (he exaggerates the number of teacher layoffs, but that’s a topic for another post). On the other hand, Branstad criticizes the use of “one-time money” from the federal government to support the state budget. He promises to veto any budget that would spend more than 99 percent of projected state revenues. Branstad has never explained what he would have cut to make up for the federal stimulus money, but other questions are on my mind today, namely:

1. Does Branstad think Grassley did the right thing in trying to stop this fiscal aid package from reaching Iowa and other states?

2. Iowa’s budget for fiscal year 2011 assumes about $120 million in additional Medicaid funding under the FMAP program. If elected governor, would Branstad try to return that money to the federal government?

3. Would Branstad reject federal education funding that is targeted for saving teachers’ jobs in the upcoming academic year?

Share any relevant thoughts in this thread.

UPDATE: A statement from Senator Harkin’s office says this bill would provide “at least $128 million in additional Medicaid funding” to Iowa in the current fiscal year. Harkin also said,

“This vote came down to one thing: priorities.  Today, a majority of Senators proved that our priority is helping those who are the backbone of this country, America’s teachers and our families, to weather the continuing effects of the great recession.  And we provide this funding without adding one dime to the deficit.

“This is a crisis of the first order.  Not since the Great Depression have our public schools faced the prospect of such massive layoffs.  With this fund, we will preserve tens of thousands of education jobs that states can use for retaining or hiring employees at the pre-K and K-12 levels.

“Also with the funding, we provide critical assistance to states, whose budgets are already stretched to the limit, to protect Medicaid.  This six month extension of federally-matched funding will allow states to continue health benefits for some of the nation’s most needy.”

SECOND UPDATE: Jennifer Jacobs reported somewhat different numbers for the Des Moines Register:

A federal spending plan that advanced in Congress Wednesday would route $83.1 million in extra money to help Iowa pay for children’s services and payments to hospitals and nursing homes.

But the Iowa Legislature banked on getting an $116 million in extra federal Medicaid money in the first six months of next year.

That means the state budget will be short $32.9 million – or short $116 million if the bill fails to pass Congress altogether, according to the non-partisan Legislative Services Agency. Medicaid is the government health insurance plan for the poor. […]

The measure would give states $16 billion to help cover their Medicaid budgets, and $10 billion to extend programs enacted in last year’s stimulus law to help preserve the jobs of teachers, police officers, firefighters and other public employees.

Iowa would get about $96.5 million in the jobs piece, which would protect about 1,500 jobs, said U.S. Sen. Tom Harkin, a Democrat.

Keep in mind that Iowa’s budget for fiscal year 2011 has an ending balance of $182.6 million, providing a cushion in case some expected revenue doesn’t materialize. Also, state revenues for the first month of the current fiscal year exceeded projections. Falling short $32.9 million in federal Medicaid assistance isn’t ideal, but it is manageable and far better than falling $116 million short, as would happen if Grassley and other Republicans got their way.

THIRD UPDATE: The Senate gave final approval to this bill on August 5 by a 61-39 vote. Grassley voted no along with most of the Republican caucus.

Governor Chet Culver’s campaign released a second television commercial spotlighting Terry Branstad’s record. Like the Culver tv ad that debuted last week, the new commercial mentions Branstad’s dismal record on fiscal issues. It also mentions eight pay raises that Branstad signed for himself, some of them during very tight budget years:

Transcript:

As Governor, Terry Branstad admitted “his books were never balanced.” According to the State Auditor, Terry “cooked the books.” And when state unemployment hit a record high, Branstad asked for a raise. When Terry cut foster care, Branstad took another raise. When the state couldn’t pay its bills, Branstad raised our taxes and raised his pay once again. Terry Branstad: Cooked books, Raised Taxes, Eight pay raises. A past we can’t repeat.

A Culver campaign press release with supporting facts and citations from news reports is after the jump.

We all know Branstad wasn’t a good manager of state finances, but I like the way this ad touches on his deeply flawed priorities as well. Branstad started seeking a pay raise during his very first year in office, when unemployment peaked at 8.5 percent. A few years later, this guy wasn’t ashamed to take home more money even as he was cutting foster care programs.

I hope future Culver ads will underscore how cutting state assistance to vulnerable Iowans has long been Branstad’s knee-jerk preference, rather than his last resort. The foster care cuts highlighted in Culver’s new commercial occurred in 1987. When Iowa faced a budget crisis in 1992, Branstad brought two money-saving ideas to a meeting with state lawmakers in advance of a special legislative session: first, cut spending on foster care, and second, cut Medicaid programs that helped children buy eyeglasses and keep senior citizens out of nursing homes. During this year’s campaign, when asked an open-ended question about how he would cut state government, Branstad

said he’s still looking for ideas but did mention reforming the state’s mental health system and rolling back Medicaid, which has been expanded to cover more people, including children. He said state employees should pay for their health insurance like private sector employees.

That’s classic Branstad. Gee, I haven’t figured out yet how to make the budget numbers add up, but why not change Medicaid so that fewer people qualify? While we’re at it, let’s stop helping tens of thousands of families send their four-year-olds to preschool.

Branstad’s record of incompetence should be at the center of the gubernatorial campaign, but let’s not forget about his skewed priorities.

UPDATE: Conservative blogger Gary Barrett claims the Culver ad distorts the facts on Branstad’s pay hikes. The Culver campaign released a response to Barrett’s post, which you’ll find after the jump.

The Branstad campaign cited a Des Moines Register report from 1982 on how Branstad didn’t want a pay raise and might veto such a bill. Culver’s campaign leaped on that as evidence Branstad “said one thing and did another on pay raises.”

The Senate version of a bill designed to create jobs, support state budgets and extend various tax credits and benefit programs failed to overcome a Republican filibuster yesterday. Tom Harkin was among 56 members of the Democratic caucus who voted for the cloture motion (which would end debate on the bill), but Ben Nelson of Nebraska and Joe Lieberman of Connecticut voted with all the Republicans present, including Chuck Grassley, to kill the bill (roll call here). Joan McCarter observed that Senate Majority Leader Harry Reid

voted yes, without changing his vote, signaling that this iteration of the bill is indeed dead.

Reid followed the vote by attempting to pass the emergency provisions of the bill, the “doc fix,” unemployment benefits extension, and FMAP as well as the homebuyer tax credit, as separate bills under unanimous consent. McConnell objected to each, so we’re stuck in further limbo.

Extending unemployment benefits should be a no-brainer when the percentage of unemployed Americans who have been out of work for more than six months is higher “than at any time since the government began keeping track in 1948.” Without the “doc fix,” medical providers’ reimbursements for Medicare patients stand to drop about 20 percent. FMAP stands for Federal Medical Assistance Percentage funding, relating to federal government reimbursements for part of each state’s Medicaid spending. The 2009 stimulus bill temporarily raised FMAP payments for states during the recession, with larger increases going to states with higher unemployment rates. Failing to extend this provision will put state budgets under further strain for the 2011 and 2012 fiscal years.

Republicans who blocked this bill claim we should not be adding to the federal deficit. A spokesman for GOP enabler Ben Nelson laid out his views here. Ezra Klein pointed out a few glaring problems with the analysis: the federal budget can’t start approaching balance with unemployment at 9 percent, polls show Americans are much more concerned about jobs than the deficit, and the current rate of economic recovery is “far, far too slow to really dent unemployment.” Meanwhile, the same senators who claim to oppose adding to the deficit also oppose rolling back tax cuts or tax loopholes for the wealthy in order to pay for extending unemployed benefits, state fiscal aid and tax credits.

I share John Aravosis’ view that it was a terrible mistake for President Barack Obama to talk tough about reducing the deficit earlier this year. As Aravosis writes,

[T]he President didn’t want to blame Bush and the GOP for the deficit, and he didn’t want to sufficiently defend the stimulus and explain to people that they had a choice between a Great Depression and a bigger deficit. […] If the public understood that the deficit was a) mostly caused by Bush, and b) not nearly as important as staving off a Depression and creating jobs, the GOP would be facing far more pressure not to launch these filibusters at all.

Perhaps no jobs bill passed this week would alter the economy enough to affect the November elections, but if we accept current unemployment levels and don’t pass additional fiscal aid to the states, the economy may still be very weak leading up to the 2012 election.

Share any relevant thoughts in this thread. From where I’m sitting, the case for Harkin’s filibuster reform proposal has never looked stronger.

Anyone following the Iowa governor’s race must read Todd Dorman’s recent interview with Republican front-runner Terry Branstad. The Branstad so many Iowans remember from his four terms as governor shines through.

Branstad is at his most incoherent when speaking about gay marriage, but his answer to an open-ended question about the state budget was also revealing. The whole interview is worth your time. I discuss a few of my favorite excerpts after the jump.

Following up on my review of news from the first half of last year, I’ve posted links to Bleeding Heartland’s coverage of Iowa politics from July through December 2009 after the jump.

Hot topics on this blog during the second half of the year included the governor’s race, the special election in Iowa House district 90, candidates announcing plans to run for the state legislature next year, the growing number of Republicans ready to challenge Representative Leonard Boswell, state budget constraints, and a scandal involving the tax credit for film-making.

Last night the U.S. Senate voted 60 to 40 to move forward with debate on the health insurance reform bill. All senators who caucus with Democrats voted for cloture, and all Republicans voted against. The breakthrough came on Saturday, when Senate Majority Leader Harry Reid secured Senator Ben Nelson’s support with extra money for Medicaid in Nebraska and new language on abortion.

At Daily Kos mcjoan published a good summary of what’s in the latest version of the bill.

Reid reportedly promised Nelson a “limited conference” on this bill, meaning that very few changes will be made to the Senate version. However, it’s far from clear that the House of Representatives will approve the Senate’s compromise. About two dozen House Democrats plan to vote against health care reform no matter what, meaning that it will only take 15-20 more no votes to prevent supporters from reaching 218 in the House.

Bart Stupak, lead sponsor of the amendment restricting abortion coverage in the House bill, has been working with Republicans against the Senate’s abortion language. Meanwhile, the leaders of the House pro-choice caucus have suggested the Senate language may be unconstitutional.

Even before Reid struck the final deal with Nelson, Representative Bruce Braley told the Des Moines Register, “I think the real test is going to be at the conference committee and if it doesn’t improve significantly, I think health care reform is very remote based on what I’m hearing in the House.”

Senator Tom Harkin has done several media appearances in recent days defending the Senate compromise. He seems especially pleased with the Medicaid deal for Nebraska:

The federal government is paying for the entire Medicaid expansion through 2017 for every state.

“In 2017, as you know, when we have to start phasing back from 100 percent, and going down to 98 percent, they are going to say, ‘Wait, there is one state that stays at 100?’ And every governor in the country is going to say, ‘Why doesn’t our state stay there?’” Harkin said. “When you look at it, I thought well, god, good, it is going to be the impetus for all the states to stay at 100 percent. So he might have done all of us a favor.”

Ezra Klein has posted some amazing spin this morning about how the Senate bill is “not very close to the health-care bill most liberals want. But it is very close to the health-care bill that Barack Obama promised.” Sorry, no. Obama campaigned on a health care plan that would control costs and include a public insurance option, drug re-importation, and letting Medicare negotiate for lower drug prices. Obama campaigned against an individual mandate to purchase insurance and an excise tax on insurance benefits.

Those of you still making excuses for Obama should listen to what Senator Russ Feingold said yesterday:

“I’ve been fighting all year for a strong public option to compete with the insurance industry and bring health care spending down,” Feingold said Sunday in a statement. “Unfortunately, the lack of support from the administration made keeping the public option in the bill an uphill struggle.”

Republican Senator Olympia Snowe was about as unprincipled and two-faced during this process as White House officials were. She voted for the Senate Finance Committee’s bill in October and had suggested her main objection to Reid’s compromise was the inclusion of a public health insurance option. Yet Snowe remained opposed to the bill even after the public option was removed last week. Because of her stance, Reid cut the deal with Nelson. The supposedly pro-choice Snowe could have prevented the restrictions on abortion coverage from getting into the bill if she had signed on instead.

Speaking of Republicans, the Iowa Republican posted this rant by TEApublican: “Nebraska And Huckabee Respond To Ben ‘Benedict’ Nelson’s Christmas Senate Sellout.” If you click over, be prepared to encounter mixed metaphors and misunderstandings about what this “reform” does. Still, the rant is a good reminder of how Republicans will still scream about government takeovers even though corporate interests got everything they wanted out of the bill.

Like Spinal Tap’s amp that goes up to 11, Bob Vander Plaats can ratchet up the demagoguery that little bit more than the competition. While other conservatives warn against compromising the Republican Party’s core principles, Vander Plaats says Republican moderates make voters want to throw up, like Jesus when confronted with “lukewarm” followers.

While other conservatives back a constitutional amendment to ban same-sex marriage (which would take years to adopt), Vander Plaats promises to stop gays and lesbians from getting married on his first day as governor of Iowa.

While other conservatives warn against a “government takeover” of health care, Vander Plaats isn’t just against a new public health insurance plan, he wants to protect Iowans from the tyranny of federal-run Medicare and Medicaid.  

I was intrigued by an article in today's Des Moines Register about Dr. David Nash, who advocates training “oral health therapists” to handle simple procedures for children's teeth.

My cousins who are dentists probably wouldn't like this idea, but Nash made a compelling case:

Nash, who spoke at a conference in Johnston, framed the problem as an issue of justice and fairness. He criticized fellow dentists for concentrating on profitable treatments, including cosmetic procedures. He said they should spend more time on public-health needs, including care for poor children insured under Medicaid.

Dentists often say they limit their Medicaid work because the program pays them too little. But Nash said states that have dramatically raised reimbursements have not seen corresponding increases in dentists willing to accept more Medicaid patients. “Many dentists just do not want to see these people in their offices,” he said.

[…]

The professor has made waves nationally with a proposal to create a new class of “oral health therapists,” who would receive two years of training in the treatment of children. They could perform typical dental-hygienist duties, plus simple fillings, crowns and extraction of baby teeth. They could be posted in schools, pediatricians' clinics or mobile clinics, he said. Such therapists provide safe, economical treatment in 53 countries, including New Zealand, Britain and Canada, he said.

I have a friend whose family is on Medicaid, and I know she has struggled to find a dentist to fill her daughters' cavities. The family dentists or pediatric dentists recommended by me and other friends do not take Medicaid patients. She wants to avoid getting mercury amalgam fillings, and the only dentists in the Des Moines area she can find who take Medicaid patients use mercury in the fillings.

I'm sure there are arguments to be made against Nash's idea, but it seems to merit serious consideration. 

While most of us are focused on insurance or universal care, the Bush Administration has been incrementally shredding Iowa’s existing public health safety net in ways that have yet to become apparent.  The most recent assault on our public health care infrastructure is escaping the notice of mainstream media and citizen journalists alike, probably because it is not easily explained. I am referring to a proposed set of arcane regulation changes by the Center for Medicaid and Medicare Services (CMS) which, if enacted, will result in $15 billion dollars in cuts over five years to service providers, closing or scaling back emergency rooms, medical education and school based services in Iowa communities.