I doubt many presidential appointees have indirectly saved more lives or done more to change American culture for the better than C. Everett Koop, U.S. surgeon general under Ronald Reagan. Koop died today at the age of 96, a legend in the field of public health.

Iowa Department of Public Health Director Mariannette Miller-Meeks on Friday reversed plans to eliminate the top administrator’s position at the Division of Tobacco Use Prevention and Control. Her comments came several hours after Democratic State Senator Jack Hatch predicted “legal action” to challenge the way IDPH downsized its smoking prevention programs.

Iowa Department of Public Health Director Mariannette Miller-Meeks insisted on August 1 that state efforts to reduce and prevent smoking will continue deep despite budget cuts, which just cost a senior department staffer her job.

The Des Moines Register continues to release results from its latest statewide poll. Selzer and Co surveyed 800 Iowa adults between February 13 and 16. Bleeding Heartland discussed the Register’s poll numbers on Governor Terry Branstad here.

Follow me after the jump to discuss President Barack Obama’s approval inching up in Iowa, slight growth in support for same-sex marriage rights, views on ways to close the state budget gap, and more.

House File 45 heads to Governor Terry Branstad’s desk today after the Iowa House approved the “deappropriations” bill by a 95 to zero vote. The bill was the top legislative priority for House Republican leaders, but the Democratic-controlled Iowa Senate eliminated many of its controversial provisions last week. The full text of House File 45 is here, and the complete bill history is here. The Senate Journal for February 17 contains roll calls for votes on House File 45 and various amendments (pdf file). The final Senate version of House File 45 passed with 48 yes votes. First-term Republican Senator Mark Chelgren voted against the bill, and Republican Senator Sandy Greiner was absent.

Thanks to the Senate amendment, state funding for preschool, family planning, passenger rail, smoking cessation programs, and the core curriculum live to fight another day in the Iowa legislature. So do the Power Fund, the Office of Energy Independence, and the Grow Iowa Values Fund, all economic development programs long targeted by statehouse Republicans.

In addition, the Senate removed language from House File 45 that would have reduced funding for state universities, area education agencies, land acquisitions by the Department of Natural Resources and the Resource Enhancement and Protection fund.

The Senate’s version of House File 45 also did not include language creating a “tax relief fund” that would have collected surplus revenues after state reserve funds were filled.

After the jump I’ve posted an overview compiled by the Iowa House Democratic research staff on “major items eliminated” by the Senate amendment to House File 45. I’ve also listed some other significant points of divergence between the Senate and House versions of this bill, as well as key points on which the Senate left House File 45’s language intact.

Finally, I’ve posted the House Democratic research staff’s explanation of language that would create searchable databases on the state budget and tax rates.  

Until this morning, I would have considered myself the blogger least likely to defend the right to smoke. Because of the many health risks associated with secondhand smoke, I strongly supported the Iowa Smokefree Air Act adopted in 2008, as well as the Iowa Department of Public Health’s decision to enforce that ban in all restaurants. I had no sympathy for smokers who whined about “Big Brother Democrats and Turncoat Republicans” and called the public smoking ban “Soviet” or “fascist.” I knew restaurant and bar owners who challenged the smoking ban in court were wasting their time and money.

However, Wellmark Blue Cross Blue Shield is going too far with its new personnel policy on tobacco use. Beginning on June 1,

The insurer will “require applicants to assert that they are tobacco-free in order to be considered for a position,” said Rob Schweers, spokesman for Wellmark, which employs approximately 1,600 people in Des Moines and another 200 throughout the rest of the state.

Wellmark is asking existing employees to stop using tobacco by Oct. 1. The new policy also prohibits any smoking during work hours, including scheduled breaks and during lunch.

The Des Moines Register quotes Schweers as saying the company wants to provide “incentive for people to quit [smoking], which will result in a healthier, more productive work force.” If Wellmark wants to pay for counseling or nicotine patches or other support for smokers trying to quit, I’m all for it. Nicotine is highly addictive, and many people need extra support to stop using it. But smoking is still legal in private homes and many outdoor spaces, and employers should not try to control how employees live when they’re not at work. Yes, smokers cost employers more in health care costs, but so do people who eat unhealthy diets or engage in other risky (but legal) behavior.

According to the Register, several other large employers in central Iowa ban smoking during working hours, including lunch breaks, but don’t prohibit their employees from smoking during private time. Wellmark has not yet threatened to fire employees who don’t quit smoking by October 1, but apparently, they would have the legal right to do so. Peggy Huppert of the American Cancer Society said violating that organization’s policy on tobacco use is grounds for termination.  

I’ve heard some strange arguments against marriage equality, but the latest from Iowa Family Policy Center President Chuck Hurley is a doozy. Reacting to a new report on HIV and syphilis rates among gay and bisexual men, Hurley asserted,

“The Iowa Legislature outlawed smoking [in some public places] in an effort to improve health and reduce the medical costs that are often passed on to the state,” Hurley said. “The secondhand impacts of certain homosexual acts are arguably more destructive, and potentially more costly to society than smoking.” […]

“Iowa lawmakers need to pay attention to hard facts and not be persuaded by emotion laden half-truths,” he said. “Because of their unwillingness to correct the error of last April’s Iowa Supreme Court opinion, the Iowa Legislature is responsible for sanctioning activities that will lead to dramatically higher rates of HIV and syphilis in Iowa.”

Where to begin? Smoking increases the risk of heart disease, cancer, stroke, and various respiratory ailments, causing an estimated 438,000 preventable deaths every year nationwide. In Iowa, smoking directly causes an estimated 4,400 deaths each year, and secondhand smoke claims another 440 lives. Smoking causes about $1 billion in health care costs every year in Iowa, of which about $301 million is covered by Medicaid.

AIDS is a serious health threat in the U.S., but not on the same scale as smoking. AIDS has caused fewer than 20,000 deaths nationwide per year in the past decade. The total number of AIDS deaths in this country since the epidemic began is estimated at just under 600,000. I was unable to find statistics showing how many Iowans have died of AIDS, but according to this report for the Iowa Department of Public Health, 114 Iowans were diagnosed with HIV in 2005, and 79 Iowans were diagnosed with AIDS the same year. The numbers may have increased somewhat since then, but AIDS is nowhere near as “destructive” and “costly” to Iowans as smoking. Iowa’s syphilis rate is far below the national average, and none of the states with the highest syphilis rates permit same-sex marriages. If Iowa legislators want to influence the syphilis rate, they should focus on providing adequate funding levels for STD testing and ensuring that young people have access to medically accurate sex education.

Hurley’s argument is not only fact-free, but also illogical on several levels. He seems to think that allowing same-gender couples to get married is going to encourage many more Iowans to experiment with gay sex. Do you know anyone who decided to become gay because they knew they’d be able to get married? Has homosexual activity diminished in New York and New Jersey since those states’ legislatures declined to legalize same-sex marriage? Did California’s Proposition 8 reduce the number of gays and lesbians having sex there?

If Hurley is worried about promiscuity and sexually-transmitted diseases, he should be happy to see gay couples settle down and get married.

Contrary to the strange fantasies of the Iowa Family Policy Center crowd, the Iowa Supreme Court didn’t make the sky fall last April. Fortunately, most Iowans understand that our state legislators have more important things to do than overturn same-sex marriage rights. They also sense that giving legal recognition to the relationships of committed same-sex couples does no harm to other people. More than 90 percent of respondents in a statewide poll conducted last September said gay marriage had caused “no real change” in their lives.

Hurley’s position on gay marriage is more coherent than, say, Terry Branstad’s, but it’s also more detached from reality. Maybe his latest comments aren’t the worst argument ever against gay marriage, but they are certainly a contender.

Yesterday the Iowa House State Government Committee voted down a Republican plan to cut state spending by $290 million in the coming year. State Representative and gubernatorial candidate Chris Rants offered the plan as an amendment to the government reorganization bill. He said his party was trying to “work in a bipartisan way” and make “tough decisions” to balance the budget for the coming year. All twelve Democrats on the House State Government Committee voted against the GOP amendment, while the nine Republicans voted for it. Later the same day, the committee approved the reorganization bill on a 20-1 vote, with only Rants opposed.

We are sure to hear more from Rants and other Republicans about how big, bad Democrats rejected their good ideas for spending cuts. A closer look reveals funny math in the Republican “plan.”

The biggest line item is “$92.3 million, end all state benefits to adult illegal immigrants.” The Iowa House Republican caucus claims this number comes from the nonpartisan Legislative Services Agency. The implication is that the state of Iowa hands out $92.3 million in cash to illegal immigrants.

But that’s not the case. From a report by the Legislative Services Agency on “Undocumented Immigrants’ Cost to the State” (pdf file):

The only government services that illegal immigrants are eligible for are elementary and secondary public education and emergency health care.1 Most citizens do not gain direct benefits from a majority of government spending. Instead, government programs are intended to benefit society as a whole through maintenance of a healthy economy, satisfying public health and safety concerns, providing basic infrastructure, etc. Although undocumented immigrants do not receive most direct benefits, the total benefit of State spending is assumed to accrue to undocumented immigrants at the same rate as legal residents.

The LSA divides total spending from the state general fund by the state’s total population to calculate roughly how much in “benefits” each Iowa resident receives annually. This isn’t a cash payment from the state to residents; it represents each individual’s share of benefit from the state paying for schools, roads, and so on.

Iowa House Republicans arrived at the $92.3 million figure by dividing total general fund expenditures by the number of undocumented immigrants currently estimated to be living in Iowa. They call the remainder “benefits” that illegal immigrants receive. But there’s no magic wand we can wave to make immigrants stop benefiting indirectly from what state government does. The same LSA report noted:

Undocumented immigrants qualify for few services at the State level, and those for which they do qualify are largely mandated by federal law or the Courts. Therefore, decreasing undocumented immigrant eligibility for State spending does not appear to be a viable policy option. Additionally, if the assumption that undocumented immigrants accrue benefits even without receiving direct services is considered valid, attempting to reduce direct State expenditures on undocumented immigrants would have a minimal effect.

By the way, proof of citizenship and identification are already required for Iowans participating in Medicaid and HAWK-I (the children’s health insurance program).

Scoring points against undocumented immigrants may be good for Rants politically, but that won’t help the state of Iowa save $92.3 million in the coming year. That one item represents nearly a third of the Republican-proposed spending cuts.

I’ve posted the full list of cuts after the jump. Some ideas may have merit, but most of them reflect skewed Republican priorities for state government. GOP legislators want to save $45 million by reducing access to pre-school for four-year-olds. They also want to invest less in renewable energy production and energy efficiency measures by eliminating the Power Fund and the Office of Energy Independence, which would $25 million. Many Republicans never liked the core curriculum, so it’s no surprise they’d like to save some money by delaying its implications. The Des Moines Register’s Iowa poll in November indicated that Iowans support higher spending on renewable energy research and development and are divided over whether to cut funds for expanded free pre-school.

Some of the smaller Republican-backed cuts would please conservative interests. The religious right would love to eliminate the family planning waiver. Rants has always been a good friend to tobacco companies, who would love to see the state scrap the “Just Eliminate Lies” anti-smoking campaign. There’s also $4 million saved by cutting “taxpayer-funded lobbyists,” which sounds great until you realize that would leave corporate groups unchallenged as they lobby for bills that might counter the public interest. Anyway, last year taxpayer money for lobbying totaled about $1.8 million, and a lot of that didn’t come from the state general fund. Municipalities, county agencies and associations like the League of Cities hire lobbyists too.

Hope everyone had an enjoyable and safe New Year’s Eve.

Share any thoughts, hopes or resolutions for the new year in this thread.

My boring resolutions are to exercise more, lose 10-15 pounds and make soup once a week (at least through the winter months).

If you want to quit smoking this year, try the Quitline Iowa website:

http://www.quitlineiowa.org/

There’s a toll-free number (1-800-QUIT NOW, 1-800-784-8669), and if you call during the month of January you can get four weeks of free nicotine patches or gum.

Asthma has been on my mind lately, because a child in my extended family was recently diagnosed with it after going to the hospital for respiratory problems. The chronic disease is one of the leading causes of hospitalization in children.

In addition, at least 20 million American adults are estimated to have asthma.

Today is World Asthma Day, in connection with Asthma Awareness Month.

Join me after the jump to read about five policies our society should implement, as well as five steps individuals can take, to reduce the incidence and severity of asthma in our households and across the country.

Alright, It seems to be buzzing everywhere on the blogs. Honestly I am tired of it. The smoking ban is one of the greatest steps forward I have seen Iowa take in a while and here are my reasons why…