Iowa Democrats face incredibly difficult path back to legislative majorities (part 1)

Many Iowa Democrats expect to have the wind at their backs for the 2018 elections, due to surging progressive activism, an unpopular Republican president, and backlash against GOP lawmakers who used their power this year to take rights away from hundreds of thousands of workers, lower wages for tens of thousands more, and undermine protections for those who suffer workplace injuries.

It’s too early to predict the political climate next fall, but Democrats need to hope for favorable external conditions as well as strong recruits and well-run campaigns. New calculations of last year’s presidential election results by state legislative district point to a very steep climb back to 51 seats in the Iowa House and 26 seats in the Senate. This post will survey the terrain in the upper chamber.

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Branstad/Reynolds claims on Medicaid "not matching reality"

Real-world data don’t match figures Governor Terry Branstad and Lieutenant Governor Kim Reynolds released yesterday in order to demonstrated the alleged “continued success of modernizing our state’s Medicaid program.”

April 1 marked a year since Iowa allowed three private insurance companies to manage care for more than half a million Medicaid recipients. The shift was disruptive for thousands of Iowans as well as for caseworkers and service providers, some of which went out of business. Reimbursement problems and cutbacks to care are still affecting many people, Chelsea Keenan reported in this retrospective on the first year of the policy.

Although privatization was supposedly designed to save money and bring predictability to the state budget, the Branstad administration agreed last fall and again in February to hand over millions more state dollars to the managed-care organizations (MCOs), unlocking some $225 million in extra federal funding for the corporations, which have much higher administrative costs than Iowa’s state-run Medicaid program did.

I enclose below the latest deceptive official statements about the “modernization,” along with a demolition fact-checking job by Democratic State Senator Liz Mathis. I’ve also included independent State Senator David Johnson’s reaction to what he called a “lousy, lousy” press release. While still a member of the Republican caucus during the 2016 legislative session, Johnson worked with Democrats trying to halt Medicaid privatization or at least provide stronger legislative oversight of the program.

The Iowa Hospital Association can’t substantiate the Branstad/Reynolds claims on hospitalization rates, Tony Leys reported yesterday for the Des Moines Register. Excerpts from that story are at the end of this post.

On a related note: thousands of Iowans who follow this issue closely are mourning Rhonda Shouse, who died unexpectedly in late March. I never met Rhonda in person, but we communicated through social media, and I admired her relentless advocacy on behalf of those adversely affected by Medicaid privatization. Keenan marked her passing in the Cedar Rapids Gazette, and Leys did so in the Des Moines Register. May her memory always be for a blessing.

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Who's who in the Iowa Senate for 2017

The Iowa legislature’s 2017 session begins today with minor adjustments to business in the state House but massive changes in the Senate. After ten years of Democratic control, the last six with a one-seat majority, the upper chamber now contains 29 Republicans, 20 Democrats, and one independent (former Republican David Johnson).

I enclose below details on the Iowa Senate majority and minority leadership teams, along with all chairs, vice chairs, and members of standing Senate committees. Click here to find the same information from the 2016 legislative session.

Just six senators are women (five Democrats and a Republican), down from ten women serving in the chamber in 2013 and 2014 and seven during the past two years. All current senators are white. To my knowledge, the only African-American ever to serve in the Iowa Senate was Tom Mann, elected to two terms during the 1980s. No Latino has ever served in the Iowa legislature; in 2014, Nathan Blake fell 18 votes short of becoming the first to join the Senate. No Asian-American has served in the state Senate since Swati Dandekar resigned in 2011.

As a group, the members of the new majority caucus have much less legislative experience than do their Democratic counterparts. As detailed below, only three of the 29 Senate Republicans have served ten or more years in the Iowa legislature, compared to thirteen of the 20 Democrats.

Some non-political trivia: the 50 Iowa senators include two with the surname Johnson, four Marks, three Bills, and two men each named Richard (Rich and Rick), Robert (a Rob and a Bob), Dan, Tim, Tom, Jeff, and Charles (one goes by Chaz).

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Rob Hogg, Amanda Ragan to lead Iowa Senate Democrats

Iowa Senate Democrats unanimously chose Rob Hogg today to serve as Senate minority leader during the upcoming legislative session. Amanda Ragan will be the new minority whip, and the incoming assistant leaders will be Bill Dotzler, Liz Mathis, Rita Hart, Joe Bolkcom, Matt McCoy, and Herman Quirmbach.

Six Democratic senators lost their re-election bids this month, including Mike Gronstal, who had served as either minority or majority leader of the caucus since 1997. Pam Jochum, who was Senate president for the past four years, will not be on the new leadership team. Ragan, Dotzler, and McCoy were among last year’s assistant majority leaders, while Bolkcom served as majority whip.

Erin Murphy reported for the Quad-City Times,

Hogg said Senate Democrats will speak on behalf of Iowans “who need state government to work” and attempt to prevent Republicans from implementing policies that could damage the state’s economy or adversely affect its residents.

“I’m hopeful we can stop Republicans from going down a knee-jerk, partisan pathway,” Hogg said.

I see no realistic chance to stop Republicans from using their large majorities in both chambers to head down that partisan pathway. Among their likely top priorities: cutting taxes so that most of the benefits go to corporations and higher-income individuals, gutting Iowa’s 42-year-old collective bargaining law, restricting abortion rights, ending state funds for Planned Parenthood’s non-abortion services, adopting the gun lobby’s wish list (“stand your ground,” “constitutional carry,” and/or open carry), and making it harder for Iowans to vote. Republicans will almost certainly need to reduce funding for education and a variety of social net programs, such as Medicaid and child care assistance, to pay for those tax cuts.

All Democrats can accomplish these next two years is to warn ahead of time how such policies will hurt the majority of Iowans, and to “document the atrocities” after Governor Terry Branstad signs the various harmful bills into law.

I enclose below a news release with more comments from Hogg. O.Kay Henderson’s profile of Gronstal for Radio Iowa is worth reading.

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Fewer women will serve in the new Iowa Senate and House (updated)

The non-partisan organization 50/50 in 2020 has set a goal of electing 25 women to the Iowa Senate and 50 women to the Iowa House by 2020. Yesterday’s elections will bring a lot of new voices to the state capital. However, chambers that were already less diverse than most other state legislatures will become even less representative of the state’s population.

LATE UPDATE: The new Iowa House will in fact have one more female member than the chamber did in 2015 and 2016, following Monica Kurth’s victory in the special election to represent House district 89.

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Branstad will transfer more money to for-profit Medicaid managed care providers

During his long tenure, Governor Terry Branstad has typically been attentive to the concerns of for-profit corporations. So when the insurance companies picked to manage Medicaid for more than half a million Iowans reported in August that they were losing money on the deal, they got a favorable hearing.

A senior analyst from Iowa’s non-partisan Legislative Services Agency confirmed on Friday that the Branstad administration has agreed to pay an extra $33.2 million to the three Medicaid managed care providers for the contract period beginning on April 1 and continuing through June 2017. I enclose that e-mail below, along with reaction from several Democratic state senators.

Hardly a week goes by without my hearing yet another story about an Iowan hurt by Medicaid privatization. Thousands of people have been forced to change doctors or have lost access to therapy for loved ones. This summer, a survey of care providers for Iowans on Medicaid found that:

90% say their administrative costs have increased;
80% say more health care claims are being denied;
79% of providers say they are not getting paid on time;
66% say they are being reimbursed at rates lower than their contracted rates;
61% say the quality of services they can provide has been reduced;
46% have or plan to cut their services; and
28% have taken out loans while waiting to be paid.

Branstad refuses to adjust his Medicaid policy to help patients who are suffering or care providers struggling to keep the doors open. On the contrary, he keeps spinning tales (backed up by no evidence) about “protecting the interests of the taxpayers” and “stopping significant fraud and abuse.” His administration hasn’t followed up on supposed new benefits for patients and puts out impossible-to-verify accounts of “success stories.”

Critics warned that any money saved by privatizing Medicaid would come at the expense of health care for vulnerable patients. They warned that those apparent savings would evaporate once for-profit insurers demanded more money from the state, as had happened in Florida following that state’s rapid privatization of Medicaid.

Iowa enjoyed low administrative costs under the old Medicaid system. Thanks to our governor and his Republican enablers in the state legislature, taxpayers will now experience the “nightmare” scenario that has already unfolded for Medicaid patients and care providers. Connecticut saved money by moving away from managed care, back to the state-run, fee-for-service model.

Don’t expect anything that sensible from Branstad, who happily spends other people’s money when corporations come calling.

UPDATE: Branstad claimed at an October 31 press conference that the state budget will still save money thanks to efficiencies in the new Medicaid system. If those savings materialize (they didn’t in Connecticut), it will happen through companies denying health care services to Iowans.

SECOND UPDATE: Added below excerpts from an excellent post by Iowa Policy Project Executive Director Mike Owen.

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