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.