Who's who in the Iowa Senate for 2016

The Iowa legislature’s 2016 session began on Monday. For the sixth year in a row, the 50 state senators include 26 Democrats and 24 Republicans. Just seven senators are women (six Democrats and a Republican), down from a high of ten women serving in the chamber during 2013 and 2014. 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 House or Senate; Nathan Blake fell 18 votes short of becoming the first in 2014. No Asian-American has served in the state Senate since Swati Dandekar resigned in 2011.

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. Little has changed since last year, in contrast to the Iowa House, which saw some big changes in the majority Republican caucus since the legislature adjourned in June.

Term limits are a terrible idea generally but would be especially awful if applied to the Iowa Senate, as the longest-serving current senator bizarrely advocated last year. The experience gap between Democrats and Republicans is striking. As detailed below, only four of the 24 Senate Republicans have ten or more years of experience in the Iowa legislature, compared to seventeen of the 26 Democrats. No current Iowa Senate Republican has more than 20 years legislative experience, whereas six Democrats do.

Some non-political trivia: the 50 Iowa Senate members include three Marks, three Bills, three Richards (who go by Rich, Rick, and Dick), two Mikes, two Toms, two Joes, and two men named Charles (one goes by Chaz).

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Feds say Iowa not ready, must delay Medicaid privatization until March 1

For months, Governor Terry Branstad has dismissed warnings from patients, advocates, doctors, hospitals, editorial boards, and lawmakers that the state’s rush to privatize Medicaid would disrupt health care for some 560,000 Iowans. Today the governor finally got the message in a form he can’t ignore. Director Vikki Wachino of the federal government’s Centers for Medicare and Medicaid Services wrote to Iowa Medicaid Director Mikki Stier,

Based on our review last week of Iowa’s progress, as well as the information you have provided, CMS expects that we will ultimately be able to approve Iowa’s managed care waivers. However, we do not believe that Iowa is ready to make this transition Jan. 1. CMS previously outlined the requirements to provide high quality, accessible care to Medicaid beneficiaries, and Iowa has not yet met those requirements, meaning that a transition on January 1 would risk serious disruptions in care for Medicaid beneficiaries. While you have made progress in some areas of readiness, our review also identified significant gaps that need to be addressed before CMS can authorize your waiver requests. For that reason, CMS will work with you toward approval of your request effective March 1, 2016, provided that the state demonstrates progress toward readiness consistent with the actions in the attachment to this letter.

Click through to read the full four-page letter and four-page attachment from Wachino to Stier, which the Des Moines Register posted online. CMS officials found that "significant areas of the state did not have many provider types within a reasonable distance," and that "Relying too heavily on out-of-network providers is likely to create confusion among beneficiaries and providers, result in access issues for beneficiaries, and disrupt continuity of care for beneficiaries." Many of the points raised echo concerns three Democratic state senators expressed during meetings with CMS officials in Washington last month.

The CMS readiness review also showed that nearly half of Medicaid recipients who tried to call the state’s call centers earlier this month could not get through. Many Iowans who did reach a staffer on the phone were not able to find out whether any of their current doctors had signed contracts with the four managed care providers approved to run Medicaid. The CMS findings are consistent with what I’ve been hearing from acquaintances: the enrollment packets sent to Medicaid recipients did not include basic details they would need to make an informed choice of managed care provider (such as where their family’s current doctors will be in-network).

I enclose below reaction to today’s news from Branstad, who struck an upbeat tone, and key Democratic lawmakers, who vowed to keep fighting to improve legislative oversight of the Medicaid privatization. The Democratic-controlled Iowa Senate approved such a bill during the 2015 session, but the Republican-controlled Iowa House declined to take it up. Oversight is the very least state lawmakers could do to prevent the transition to managed care from becoming a pretext for denying services to vulnerable Iowans.

David Pitt noted in his report for the Associated Press,

Two legal challenges continue including one from the Iowa Hospital Association, a trade group for the state’s hospitals. It sued the state claiming the privatization plan is illegal because it takes millions of dollars from a dedicated hospital trust fund and gives it to the four managed care companies.

Any relevant comments are welcome in this thread. I am grateful that so many Iowans took the time to contact federal officials about Branstad’s disastrous policy. Bleeding Heartland reader Rhonda Shouse has been one of the superstar organizers in that fight.

UPDATE: Added below reaction from Representative Dave Loebsack (D, IA-02). I expect that during next year’s re-election campaign, Loebsack will highlight his efforts to shield constituents from the negative consequences of shifting Medicaid to managed care. His only declared Republican opponent is State Senator Mark Chelgren, who like his GOP colleagues in the upper chamber has done nothing to slow down the privatization or strengthen legislative oversight of the process.

SECOND UPDATE: Added more news and commentary related to this issue.

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Republicans not giving up efforts to defund Planned Parenthood in Iowa

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Iowa’s social conservatives have suffered several setbacks lately in their crusade against Planned Parenthood. The Iowa Supreme Court unanimously struck down an administrative rule that would have banned the use of telemedicine for medical abortions in several Planned Parenthood clinics. Iowa Attorney General Tom Miller informed a large group of Republican lawmakers that his office has neither "jurisdiction over transfers of fetal tissue" nor the "authority to investigate or demand information about the transfer of fetal tissue." (Not that it mattered, since Planned Parenthood clinics in Iowa have never participated in fetal tissue donation programs.)

Governor Terry Branstad, who has always opposed abortion rights, acknowledged two weeks ago that "we cannot defund Planned Parenthood," because a review of Planned Parenthood’s contracts with the state revealed that the health care provider has not "violated their responsibilities under the grants that they have received" for family planning services. An official review also confirmed no taxpayer money goes toward abortion services at Planned Parenthood clinics in Iowa.

During this year’s legislative session, Republicans successfully pushed for ultrasound requirements for women seeking abortions, but the final adopted language on ultrasounds did not add any new roadblocks or delays to the process of getting an abortion in Iowa.

Advocacy groups like Bob Vander Plaats’ FAMiLY Leader organization continue to pressure Branstad to keep his 2010 campaign promise to end Planned Parenthood’s state funding. Last week, Iowa House Republicans indicated that they plan to continue their "deliberate and unwavering battle" for the "pro-life" agenda.

Here’s how efforts to defund Planned Parenthood are likely to play out during next year’s Iowa legislative session. What happens after that depends mostly on whether the 2016 general election changes the balance of power at the statehouse.

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Weekend open thread: Iowa Wing Ding edition

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

More than twenty Iowa Democratic county committees put on a great “Wing Ding” in Clear Lake Friday night. The Surf Ballroom was packed to capacity, thanks to appearances by four of the five Democratic presidential hopefuls. Despite a fairly long list of speakers including candidates for U.S. House and Senate and State Senator Amanda Ragan, who was receiving an award, the Wing Ding amazingly finished ahead of schedule. I enclose below my take on all the speeches.

For those following the saga of three former Ron Paul campaign operatives, recently indicted for their role in making illegal payments to then State Senator Kent Sorenson: Russ Choma covered the prosecutors’ latest court filing for Mother Jones. Prosecutors allege the operatives “were prepared to leak documents to harm Sorenson in 2012 if they couldn’t obtain his endorsement for Ron Paul.” An attorney for Jesse Benton acknowledged that in late 2011, his client “threatened to expose Mr. Sorenson, believing that Mr. Sorenson was trying to blackmail the 2012 RP Campaign, if Mr. Sorenson did not make up his mind on whether to commit to the Ron Paul Campaign.” But the lawyer said Benton did not follow through on what he described as “a knee-jerk, emotional reaction.” Of course, there would have been no reason to carry out the threat after Sorenson agreed to take the money in exchange for switching his allegiance to Paul.

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A close look at the status of abortion regulations in Iowa

Anti-abortion activists suffered a setback last month when the Iowa Supreme Court unanimously ruled unconstitutional the state ban on using telemedicine for medical abortions. But the health and human services budget for the fiscal year that began on July 1 contained two provisions sought by those who want to reduce the number of abortions performed in Iowa.

The first part of this post examines new language in the Iowa Code related to ultrasounds for women seeking abortions. Who was closer to the mark: Iowa Right to Life, which hailed the “HUGE life-saving victory” as the anti-choice movement’s biggest legislative success in two decades? Or Planned Parenthood of the Heartland, which countered that the ultrasound language would neither change the standard of care at their clinics nor “directly impact a woman’s access to abortion”?

Next, the post addresses language lawmakers first adopted in 2013 and renewed in the just-passed human services budget, which allows the Iowa governor to determine whether Medicaid should reimburse for abortion services. No other state has a similar provision.

Finally, I offer some thoughts on an odd feature of anti-abortion activism in the Iowa legislature. State Senate Republicans advocate more for restrictions on abortion rights and access than do GOP representatives in the House, even though “pro-choice” Democrats control the upper chamber, while all 57 members of the House majority caucus are nominally “pro-life.” Iowa House leaders have not been eager to put abortion bills on the agenda. This year, rank-and-file House Republicans didn’t even introduce, let alone make a serious attempt to pass, companion bills to most of the abortion-related legislation their counterparts filed in the state Senate.

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