Bernie Sanders endorsed Hillary Clinton for president Tuesday morning during a joint campaign event in Portsmouth, New Hampshire, as well as in an e-mail blast and a Facebook note.

Some enthusiastic Sanders fans, including his captain in the precinct next door to mine, have made their own pitches to their fellow Berners today. I enclose below an e-mail that former State Senator Daryl Beall sent to friends and acquaintances. Johnson County Supervisor Mike Carberry shared the Sanders Facebook post calling on progressives to continue the political revolution. More power to them, and to those who are expressing their newfound support for Clinton in a humorous way.

I still see too many arguments on social media between Clinton backers and #BernieOrBust holdouts. Please stop. Give people time to grieve. Most Democrats who backed Sanders in the primaries will eventually support Clinton this fall. Some small percentage won’t. It’s not productive for those who were “with her” from the beginning to engage with them, especially not now. No amount of arguing on Facebook or Twitter will convince diehard Hillary-haters to support the Democratic nominee. It can only antagonize people.

Some in the #HillYes crowd get upset seeing fellow Democrats bash a woman they admire. My best advice: you don’t have to make it your mission to get them to see what you see. Either try to find common ground with them by talking about down-ballot races, or back off and focus your energy on mobilizing other voters.

Iowa families hoping for guaranteed insurance coverage of autism services will have to wait at least one more year. Despite Democratic efforts to add an autism coverage mandate to the health and human services budget for fiscal year 2017, the compromise approved on the final day of this year’s legislative session excluded such language. Instead, lawmakers increased state funding for various autism-related grants and programs.

According to the lead Republican negotiator on the human services budget, families affected by autism will have insurance coverage by January 2017 without a mandate, thanks to Wellmark Blue Cross/Blue Shield’s decision to sell policies through Iowa’s public insurance exchange. But those policies will not be available to Iowans living in dozens of counties, nor will they cover applied behavior analysis (ABA) interventions, which are effective but prohibitively expensive for many people with spectrum disorders.

The 800-pound gorilla of Iowa’s health insurance market, Wellmark Blue Cross/Blue Shield, released new details today about its plans to sell policies for 2017 on the health insurance exchange created as part of the 2010 Affordable Care Act. More than half of Iowans are insured by Wellmark, mostly through employer-provided policies. The company controls about three-quarters of the state’s market for individual health insurance, but up to now, those policy-holders have not been eligible for federal subsidies. Wellmark announced last October that it would participate in Iowa’s exchange for 2017 and confirmed those plans last month, when UnitedHealthcare disclosed that it would exit “Obamacare marketplaces” across the country, including Iowa’s.

Wellmark’s Chairman and CEO John Forsyth said last year that the company decided to join the public exchange so members “can access subsidies that are critical to help reduce the cost of health insurance premiums for themselves and their families.” Many thousands of people will need those subsidies, because today Wellmark revealed that roughly 30,000 Iowans who hold individual policies compliant with the Affordable Care Act will likely see massive premiums increases of 38 to 43 percent next year.

Unfortunately, as Tony Leys reported for the Des Moines Register, Wellmark policies will be available on the public exchange only for residents of 47 Iowa counties–not statewide.

Five states along the east coast held primaries today. Donald Trump had a clean sweep on the Republican side of the so-called Acela primary, named for the Amtrak express train that connects Boston to Washington, DC. As of 8 pm central time, Trump had won more than 50 percent of the votes counted in Pennsylvania, Maryland, Delaware, Connecticut, and Rhode Island.

Dark days lie ahead for the #NeverTrump crowd. Even if Ted Cruz manages to win the Indiana primary next week and John Kasich wins Oregon and New Mexico, stopping Trump from reaching 1,237 delegates before the Republican National Convention will be a tall order. Dave Wasserman published a good analysis of Trump’s success at FiveThirtyEight.com. I’ve posted excerpts after the jump.

Networks called Maryland for Hillary Clinton immediately after polls closed. At this writing, she has also been projected to win Pennsylvania and Delaware, while Bernie Sanders is set to win Rhode Island, and Connecticut is still too close to call. Clinton’s remarks to her supporters in Philadelphia tonight sounded very much like a general-election stump speech.

Dave Weigel noted Clinton has won eleven states she lost to Barack Obama in 2008: Iowa, Maryland, Illinois, Missouri, Louisiana, Alabama, Mississippi, Georgia, South Carolina, North Carolina, and Virginia. Even more striking, Weigel pointed out, “After tonight, Donald Trump will have won 12 of the 13 original colonies. He’s also favored to win in the 13th, New Jersey.”

Any comments about the presidential race are welcome in this thread. Today the admin for U.S. Senate candidate Tom Fiegen’s social media blocked me on Twitter after I challenged one of Fiegen’s many tweets suggesting the Democratic superdelegates should switch from Clinton to Sanders. So touchy! Fiegen proceeded to block several people who had re-tweeted me or commented negatively about the blocking.

UPDATE: Added below the full text of Clinton’s speech tonight and a statement released by Sanders. Although he did not concede the nomination, he appears to be shifting to a fight about the Democratic Party platform, rather than trying to beat Clinton.

SECOND UPDATE: Clinton ended up winning Connecticut by about 5 points. Trump’s margins of victory were enormous in all five states: 29 points ahead of Kasich in Connecticut, 35 points in Pennsylvania, 31 points in Maryland, 39 points in Rhode Island, and 40 points in Delaware.

For six years running, the Democratic-controlled Iowa Senate has confirmed almost all of Republican Governor Terry Branstad’s nominees unanimously or nearly so. But every year, one or two Branstad nominees don’t get through. On Thursday Dr. Mariannette Miller-Meeks became the first (and probably the only) nominee to fail an Iowa Senate confirmation vote this year.

Polls just closed in South Carolina, where Hillary Clinton is favored to defeat Bernie Sanders easily, possibly by as large a margin as Sanders’ big win in New Hampshire. Any comments about the Democratic race for the presidency are welcome in this thread. Here are a few links to get the conversation started.

African-American voters are critically important for Clinton and will make a large share of the electorate not only in South Carolina but also in at least six of the states that vote on “Super Tuesday” (Alabama, Georgia, Tennessee, Texas and Virginia). This chart shows data from the 2008 primaries on the non-white percentages of electorates in the states that will vote on March 1.

Toni Monkovic argued recently, “We’re living in an era when blacks have essentially played kingmaker in the most important elections in the nation.” Sanders did extremely well among white working-class voters in the first three states, but “he does not really have a path to victory unless he can significantly narrow or even erase Mrs. Clinton’s edge among nonwhite voters,” Nate Cohn argued earlier this month. The prevalence of moderate Democratic voters in several of the Super Tuesday states should also work to Clinton’s advantage.

Tim Murphy wrote an interesting piece for Mother Jones on “Clinton’s Most Valuable Allies in South Carolina: the Moms of Black Lives Matter.”

Terrell Jermaine Staff profiled Marcus Ferrell in Fusion. Ferrell’s job with the Sanders campaign is “convincing black folks to ‘feel the Bern.’”

David Sirota took a close look at what economists say about whether Sanders’ plans on single-payer health care and free education at public universities “add up.”

Nate Silver of FiveThirtyEight.com laid out which states Sanders needs to win on Super Tuesday and beyond to win the Democratic nomination.

Excerpts from all of those articles are after the jump.

For comic relief, I recommend Steve Deace’s latest column for the Conservative Review on how 2016 is shaping up to be “the devil’s favorite presidential election.” He takes some ridiculous shots at Clinton and Sanders but the real venom comes out when he writes about Donald Trump. Deace is furious the strong anti-establishment sentiment in the Republican electorate is working mostly in Trump’s favor, rather than pushing Ted Cruz ahead.

UPDATE: Clinton is on track to outperform her lead in South Carolina polling. She gave her victory speech less than an hour after polls closed, and sounded like she was running against Donald Trump, not Sanders. I’ve added excerpts from her speech below. She recognized by name all of the “Black Lives Matter” moms, as well as their children who were killed.

SECOND UPDATE: Wow. A crushing victory for Clinton by nearly a 3 to 1 margin. I don’t remember seeing anyone predict she would even win 2 to 1. Harry Enten speculates that South Carolina “may be the beginning of the end for Sanders.” Added excerpts at the end of this post.

I enjoy learning how thoughtful Iowa Democrats have approached this decision. -promoted by desmoinesdem

Relevant experience IS very important. I want to be clear on that point. But I think the discussion could use a little historical perspective (skip down a few paragraphs if you want to skip the preliminaries). But when looking at the leading Democratic presidential candidates I see two people who meet and exceed any reasonable resume requirements, and therefore I didn’t find experience as a terribly useful metric for deciding between Sanders and Clinton. More important to me is how a candidate stands on issues which are important to me, how consistent they have been in those stances, what they have done about them historically, and what I can infer about the way they approach and solve problems based on what they’ve said and done.

Just to be up front, I’ve decided to caucus for Senator Bernie Sanders on February first.

Bleeding Heartland welcomes guest posts on issues or candidates. -promoted by desmoinesdem

For the past several months, both online and out in the real world, I have advocated for the candidacy of Senator Bernie Sanders. I believed then as I believe now that he is an honest, principled advocate for the concerns of working people who are seeing their livelihoods imperiled on a daily basis by political process that is rigged against them and an economic system that favors massive, inherited wealth and fosters inequality. I believed then as I believe now that the vast and growing gap between the wealthy elite and the struggling masses threatens the very foundation of our collective society and that the only way to prevent a new-fangled aristocracy from permanently seizing the reins of power would be for immediate and drastic actions to not only stop but reverse this devastating growth of inequality. I believed then as I believe now that, even though Secretary Hillary Clinton is an eminently qualified candidate to lead our nation, it was necessary for someone like Senator Sanders to challenge her to confront these issues and speak to and up for the losers of our economic system.

Bleeding Heartland welcomes guest posts on topics of statewide, local, or national importance. -promoted by desmoinesdem

My name is Aaron Camp. I’m not an Iowan, in fact, I’m a lifelong resident of Vermilion County, Illinois who has never been to Iowa. I’m a staunch supporter of the Bernie Sanders presidential campaign, although I am not officially affiliated with the Sanders campaign in any way. With the first-in-the-nation Iowa caucuses just days away, I’ll take this opportunity to encourage Iowans to participate in the Democratic caucus and caucus for Bernie Sanders.

Expanded from a short take for CNN

Hillary Clinton was solid and Bernie Sanders turned in his best debate performance yet in Charleston last night. Can anyone deny that Democratic National Committee leaders should have allowed more debates and scheduled them on nights when more voters would watch? The sometimes sharp exchanges between the front-runners probably didn’t change many Democratic minds, but Clinton and Sanders both delivered plenty of lines that should reinforce the inclinations of voters who are supporting them or leaning in that direction.

I suspect the following moments will particularly resonate with Iowa caucus-goers, based on my conversations with hundreds of Iowa Democrats and on how I’ve seen multiple crowds react to the candidates.

Hillary Clinton’s campaign has wisely avoided attacking Bernie Sanders these past nine months. But the front-runner’s tactics are changing as multiple Iowa polls show Sanders within striking distance or a little ahead in Iowa only a few weeks before the February 1 caucuses. Clinton would do better making the case that she is a stronger and more battle-tested general election candidate. Attacking Sanders on gun control and especially on health care reform could backfire with Democrats who are undecided or not firmly committed.

For months, Ted Cruz deliberately did not engage with Donald Trump, positioning himself well to inherit the support of voters who might lean toward the Republican front-runner. But since Cruz emerged as the primary threat to him in Iowa, Trump has hammered the Texas senator during his media appearances and at his campaign rallies. Trump has attacked on policy grounds (“Ted was in favor of amnesty”) and repeatedly raised doubts about whether Cruz, born in Canada to a U.S. citizen, is eligible to become president.

Over the last few days, Cruz finally started hitting back at Trump during public events and media availabilities. A poll in the field this week is testing numerous anti-Trump talking points with Iowa voters, and signs point to the Cruz campaign or an aligned group commissioning that survey. I enclose below Simpson College Professor Kedron Bardwell’s notes on the message-testing poll; look for Cruz to employ some of those lines during Thursday night’s presidential debate.

The Iowa Republican caucus polling average shows a tight race between the top two contenders here, with all other candidates well behind. But a closer look at the Iowa findings, particularly the latest from Selzer & Co for the Des Moines Register and Bloomberg News, suggests that Cruz could easily exceed his topline numbers on caucus night. Meanwhile, Trump seems more likely to underperform his polling numbers, hampered by a much less competent ground game.

Happy new year, Bleeding Heartland readers! Here’s an open thread: all topics welcome.

I am grateful to everyone who contributed guest posts during 2015: Dave Swenson, Jon Muller, fladem, 2laneIA, ahawby, Julie Stauch, Susan Staed, Mike Owen, natewithglasses, sarased, frankly, Jane Kersch, aleand67, Matt Hauge, ModerateIADem, Leland Searles, Eileen Miller, Tracy Leone, Pari Kasotia, Roger Pedactor, Stacey Walker, Mike Draper, cocinero, AbramsMom, mrtyryn, desmoinesiowa15, moderatepachy, Joe Stutler, Zach Wahls, and State Representative Chuck Isenhart.

Guest authors can write about any political topic of state, local, or national importance. Pieces can be short or long, funny or serious. You do not need to contact me ahead of time with your story idea. Just register for a user account, log in, write a post, edit as needed, and hit publish when you are ready. The piece will be “pending” until I approve it for publication, to prevent spammers from using the site to sell their wares.

I also want to thank everyone who participates here by commenting on posts. If you’ve never done so, feel free to register for a user account and share your views. If you used to comment occasionally but have not done so since this blog relaunched on a different software platform in October, you will need to reset your password. E-mail me with any problems registering for an account, logging in, or changing a password; my address is near the lower right-hand corner of this page.

I wish everyone success in sticking to your new year’s resolutions. Keep in mind that new habits typically take a few months to establish. I’m still working on my list of Iowa politics predictions for 2016, but now seems like the right time to hold myself accountable for last year’s effort. Follow me after the jump to see how I did.

The good news is, the federal government won’t shut down before the end of the current fiscal year on September 30, 2016. The bad news is, members of Congress snuck some awful provisions in the “omnibus” budget bill and package of tax cut or tax credit extensions that just cleared the U.S. House and Senate. You know leaders aren’t proud when they bury news about a deal during another event occupying the political world’s attention, in this case Tuesday night’s Republican presidential debate. I enclose below background on key provisions in the bills, as well as statements from the Iowans in Congress. I will update this post as needed.

The House held separate votes on the “tax extenders” and the omnibus. Republicans were nearly united in support of the tax bill (confusingly named “On Concurring in Senate Amdt with Amdt Specified in Section 3(b) of H.Res. 566”), which passed yesterday by 318 votes to 109 (roll call). The Democratic caucus was split; Naomi Jagoda and Cristina Marcos reported for The Hill that House Democratic leaders “opposed the tax package” but “did not whip their members against it.” Republicans Rod Blum (IA-01), David Young (IA-03), and Steve King (IA-04) all voted for the tax extenders; so did Democratic Representative Dave Loebsack (IA-02), one of 77 House Democrats to do so.

Loebsack was the only Iowan to vote for the omnibus bill, which easily passed this morning by 316 votes to 113 (roll call). Most of the Democratic caucus supported the bill that keeps the federal government open for at least nine more months; just 18 Democrats voted against it.

Although House Speaker Paul Ryan and his team persuaded 150 Republicans to vote for the budget measure, 95 Republicans opposed it, including all three Iowans. Blum and Young appear to have concluded that the bill was simply too expensive. King’s main objection was that none of his nine amendments were included in the final deal. Click through to read the texts of those amendments, which would have barred the use of appropriated funds for: enforcing the 2010 Affordable Care Act (health care reform law); implementing President Barack Obama’s executive orders to provide temporary protection against deportation for some immigrants who entered the country without permission; enforcing the U.S. Supreme Court decision that legalized same-sex marriage nationwide; supporting any activities of Planned Parenthood Federation of America or any of its clinics, affiliates, or successors; implementing or enforcing any change to the U.S. EPA’s Waters of the United States rule; resettling refugees; implementing the multilateral deal struck earlier this year to prevent Iran from obtaining nuclear weapons; implementing any regulation that stemmed from the recent international agreement to combat climate change; or expanding the use of H-2B visas.

The Senate combined the tax extenders and budget bills into one package, which passed this morning by 65 votes to 33 (roll call). Iowa’s Senators Chuck Grassley and Joni Ernst both voted no; in the statements I’ve enclosed below, Grassley went into greater detail about his reasons for opposing the package. However, earlier this week he released a separate statement bragging about some of the provisions he helped to insert in the tax legislation. Members of Congress from both parties use that sleight of hand.

Among the presidential candidates, Bernie Sanders, Ted Cruz, and Rand Paul voted against the omnibus, Lindsey Graham voted for it, and unbelievably, Marco Rubio missed the vote. What is wrong with this guy? He “has missed more than half of the Senate’s votes since October,” Jordain Carney reported for The Hill. I think not showing up for Senate work will hurt Rubio in Iowa, though not having a strong field operation will hurt him more.

The Senate is now adjourned until January 11 and the House until January 5. During the winter recess, Bleeding Heartland will catch up on some of the Iowa Congressional voting not covered here during the late summer and fall.

Although I put up another thread for discussing the key findings from Selzer & Co.’s latest survey for the Des Moines Register and Bloomberg News, I want to focus on one surprising data point that some liberals were passing around social media on Saturday night: supposedly 49 percent of Iowans likely to attend the Republican caucuses support a single-payer health care plan.

Ann Selzer is a polling genius, no doubt about that. But this is a rare example of poor question wording in one of her surveys.

I’m going to mention some stands on issues some candidates have taken. For each, please tell me if you agree or disagree with this position. (Rotate list.) […]

Supports a single-payer health care plan instead of the current law

I would bet the farm that most of the Republican respondents who said they agree with that position heard “instead of the current law” and thought the caller was referring to a GOP candidate who wants to repeal and replace the dreaded Obamacare–not to Bernie Sanders, who supports “Medicare for All.”

I would also bet that most of the respondents had no idea that a single-payer health care plan means “socialized medicine,” as it’s often described in conservative circles.

Representative Steve King endorsed Senator Ted Cruz for president a few minutes ago, calling the senator from Texas “the answer to my prayers, a candidate God will use to restore the soul of America.” After going through several key issues, including the need to stop President Barack Obama’s executive actions on immigration and to repeal “root and branch” the 2010 Affordable Care Act, King said his candidate would need to be committed to those policies. In addition, King said a successful candidate needs to be able to appeal not only to establishment Republicans, but also to “constitutional Christian conservatives” and libertarians. The candidate must be able to raise enough money to run a strong campaign, and must be able to inspire Christian conservatives for a large turnout. In King’s view, one reason Republicans lost the 2012 presidential race was millions of Christian conservatives staying home.

King argued that Cruz is “unmatched in his tenacity to take on the Washington cartels” and has “consistently stood on principle” against the D.C. elites. He “does listen, and he does think.” Asked how much he will do to support Cruz before the Iowa caucuses, King joked that “if they’ll let me,” he is prepared to hit the campaign trail, adding, “I’m in with both feet, I’m in all the way.” Asked to sum up his reasoning in one sentence, King said, “Ted Cruz is the full package, the constitutional conservative that can restore the soul of America.”

King didn’t endorse a candidate before the 2012 Iowa caucuses, and didn’t take a stand the previous cycle until shortly before the 2008 caucuses, when he endorsed Fred Thompson. I suspect that coming out so early for Cruz reflects King’s concern about Donald Trump’s and Ben Carson’s long ride at the top of the Iowa and national polls. During the Q & A, King said he hopes his endorsement will add “clarity” to Cruz’s position on immigration, and asserted that some others are trying to distort Cruz’s stance on that issue. When a reporter asked King why he doesn’t see Carson as a candidate who can restore the soul of America, King praised Carson’s intellect but suggested that Washington, DC is not “a zone that he is familiar with.” Later in the Q & A, King made a similar point about Trump–he doesn’t know enough about how Washington works. He made clear that he would support Trump if he became the GOP nominee and said he appreciated that Trump has raised some of the issues King has worked on for a long time.

UPDATE: Added below some reaction to today’s news and the official video of King endorsing Cruz, which the senator’s campaign sent out a few minutes before King made the big reveal at his press conference. One of the pro-Cruz super-PACs also announced King’s endorsement before the congressman did.

Former Maryland Governor Martin O’Malley’s presidential campaign is pushing a new line of attack against Senator Bernie Sanders: in 2011, Sanders said President Barack Obama was “weak” and perhaps should face a challenger in the 2012 Democratic primary. O’Malley’s communications staff have also pushed out reports suggesting Sanders himself was considering a primary challenge to Obama and failed to campaign vigorously for the president’s re-election later in 2012 (not that Vermont was ever in play for Mitt Romney).

Those talking points may fire up Democrats who already resent the fact that the self-proclaimed democratic socialist Sanders has always campaigned as an independent. But I doubt they are a promising line of attack for moving caucus-goers and primary voters away from Sanders and toward O’Malley. The inconvenient truth is that Obama’s record hasn’t always lined up with progressive principles or with his own campaign promises. I suspect those who “feel the Bern” are more likely to agree with than be offended by Sanders’ critique of the president.

I don’t know yet for whom I will caucus, the first time I’ve ever been undecided so late in the election cycle. But I count myself among those “millions of Americans” Sanders described as “deeply disappointed in the president” during the interview O’Malley’s campaign portrays as harmful. I caucused uncommitted in 2012 to send the message that the president “hasn’t stood up for core principles of the Democratic Party.” Moreover, O’Malley’s own stump speech hints at some valid reasons for Democrats to be disaffected by Obama’s rightward drift.

A new poll is in the field testing numerous statements designed to convince Iowa Democrats to caucus for Bernie Sanders rather than for Hillary Clinton. I received the call last night and enclose my notes below. If you were a respondent for the same survey and can provide additional details, please post a comment in this thread or contact me via e-mail (the address is near the lower right corner of this page).

My best guess is that an outside group wanting to boost Sanders commissioned the poll. The questionnaire did not include any negative statements about the senator from Vermont. If the Sanders campaign were designing a poll like this, I think they would have tested a few arguments against supporting the candidate, to identify his possible weak points. An outside group planning to produce direct mail or paid advertising to influence Iowa Democrats wouldn’t need that information. They would only be interested in the best way to discourage people from caucusing for Clinton and/or encourage them to caucus for Sanders.

Although Sanders doesn’t have a super-PAC promoting his campaign, progressive advocacy groups that want him to become president may make independent expenditures supporting him. Note that the survey asked respondents whether they had a favorable or unfavorable opinion of the environmental group Friends of the Earth; no other non-profit organizations were mentioned in the questionnaire. Friends of the Earth endorsed Sanders this summer and would presumably be interested in knowing how well they are known/liked among early state Democrats.

It’s also possible that a conservative organization would commission a poll like this, hoping to hurt Clinton in the early nominating states.

Anyone who listened to what Blum told journalists and Republican audiences when he was seeking the GOP nomination for Congress in 2012 and 2014.

But apparently not the Cedar Rapids Gazette editors, who engaged in some wishful thinking before endorsing Blum for Iowa’s first Congressional district last year.

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

Congratulations to Hawkeyes and commiserations to Cyclones over the outcome of yesterday’s big game. Not being a football fan, I can’t remember how many years it’s been since I watched Iowa play Iowa State. The last time I focused on the Cy-Hawk game was in 2013, when Iowa running back Mark Weisman’s decision to play on Yom Kippur (the most important Jewish holiday) was a big topic of conversation for central Iowa Jews.

The hoopla surrounding yesterday’s game reminded me of a good commentary by “Civic Skinny” in the Des Moines-based weekly Cityview last month. Skinny called attention to how rapidly athletic budgets have grown at Iowa and Iowa State in recent years, and how the athletic departments “continue to find ways to spend” the extra money, “without shipping any to the libraries or the English departments or any other academic endeavors at the two big universities.” I would bet few Iowans know that for many years, Iowa and Iowa State “regularly subsidized the athletic departments with money from the general fund.” I recommend clicking through for all the data in the original piece; excerpts are after the jump.

For two days, the Des Moines Register reported the Des Moines School Board District 1 race as “too close to call,” but Shane Schulte finally conceded to Heather Anderson on Friday. Schulte had earlier indicated plans to seek a recount, but truthfully, the race was never too close to call. When all the precincts reported on election night, Anderson led by 36 votes out of a little more than 2,500 ballots cast. The next day, her lead in unofficial returns grew to 46 votes. That’s a close election, but not close enough for a recount to have a realistic prospect of changing the outcome. Recounts of two Iowa Senate races in 2010 did not overturn Mark Chelgren’s twelve-vote lead out of more than 19,000 ballots cast or Tod Bowman’s 70-vote lead out of nearly 20,000 ballots cast. Two years later, Republican leads of fewer than two dozen votes in Chris Hagenow’s Iowa House race and Mike Breitbach’s Iowa Senate race both held up after recounts of roughly 17,500 ballots and 30,000 ballots, respectively.

Ever since the Affordable Care Act became law in 2010, conservative pundits and Republican politicians have predicted that “Obamacare” would force many businesses to drop health insurance coverage for their employees. This week, the Des Moines Register’s Tony Leys covered the latest data on employer-provided insurance in Iowa. The Clive-based David P. Lind Benchmark research firm surveyed 1,001 employers and found that only 1 percent (mostly “companies with fewer than 10 employees”) stopped offering health insurance coverage this year. The cost of insuring employees in 2015 increased by an average of 7.7 percent, up from the 6.8 percent increase in 2014 but “significantly lower” than typical price hikes “Iowa employers faced a decade or more ago.” Michael Ralston, who leads the Iowa Association of Business and Industry, told Leys “he heard more complaints about insurance costs years ago, when employers’ health insurance prices were rising at more than double the current clip. He still hears grumbling about the complex requirements of the Affordable Care Act, but not as often as in the years after it passed in 2010.” Scroll to the end of this post for more excerpts from Leys’s report.  

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.

Hillary Clinton’s presidential campaign started running two 60-second television commercials today in Iowa and New Hampshire. An August 2 press release noted,

These ads are part of an initial five-week, approximately $1 million ad buy in each state plus additional digital advertising. In New Hampshire, the ads will run statewide – in the Boston/Manchester market and in the Burlington market. In Iowa, the ads will air in the state’s two largest media markets – Des Moines and Cedar Rapids. As of today, Republican candidates and their SuperPACS have spent or reserved $34 million in air time in the four early primary states.

I enclose below the videos for “Dorothy” and “Family Strong,” with my annotated transcripts.

The commercials are strong, but I have to say: if you can afford to spend $2 million on tv ads in August (and Clinton can, having raised $47,549,799.64 for her campaign between April 1 and June 30), then you should have paid your full-time summer interns–sorry, “fellows.”

While Congress is on recess until after July 4, it’s time to catch up on an unusually busy few weeks in June for U.S. House members. Bleeding Heartland previously covered how Iowa’s representatives voted on the failed and successful attempts to pass trade promotion authority, repeal of country-of-origin labeling requirements for meat, a bill to eliminate a tax on medical devices, and the Intelligence Authorization Act.

Follow me after the jump to find out how Democrat Dave Loebsack (IA-02) and Republicans Rod Blum (IA-01), David Young (IA-03), and Steve King (IA-04) voted on the latest defense budget bill, more trade-related policies, and legislation dealing with chemical safety, Medicare cost controls, and regulations of greenhouse gas emissions from power plants. Iowa’s representatives also voted last week on a matter relating to the growing national controversy over Confederate symbols.

Something you don’t see often when looking through Congressional roll calls: three of Iowa’s four House members crossed party lines more than once during the floor debate on the defense budget.

Some 40,000 Iowans will continue to receive federal subsidies for purchasing health insurance, thanks to a 6-3 U.S. Supreme Court opinion announced today. Plaintiffs in King v Burwell had argued that Congress intended for subsidies to be available only to Americans who purchased health insurance through state-run exchanges. Chief Justice John Roberts rejected that interpretation in his opinion (pdf), joined by Justices Anthony Kennedy, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, and Elena Kagan. Amy Howe explained the ruling in “plain English” at the SCOTUS blog, where Lyle Denniston wrote a separate analysis of the opinion.

Dissenting Justice Antonin Scalia accused his colleagues of changing “usual rules of statutory interpretation for the sake of the Affordable Care Act,” as the Supreme Court majority did (in his view) when it upheld the individual mandate to purchase health insurance in 2012.

A ruling for the plaintiffs in King v Burwell would not only have threatened health care access for roughly 6.4 million people who receive subsidies for health insurance purchased through the federal website Healthcare.gov. It could have caused cascading effects such as sharp premium increases for millions of Americans who do not qualify for subsidies but would nevertheless have been priced out of the health insurance market. In theory, Congress could have fixed the problem with a one-paragraph bill clarifying that people who buy insurance through the federal exchange qualified for subsidies, but most House and Senate Republicans appeared unwilling to go that route.

Today’s Supreme Court decision removes the only remaining threat to federal health insurance subsidies for eligible Iowans. Last month, several insurance companies applied to offer policies for 2016 to Iowans through the exchange. Only one provider did so for 2015, and if that company had pulled out of Iowa, health insurance subsidies would not have been available to anyone in our state for next year.

UPDATE: Added Iowa political reaction below. Note that several of the Republican statements renew a vow to repeal and replace “Obamacare.” Though destroying the system created by the 2010 health care reform law was transparently the goal of the King v Burwell plaintiffs, their lawyers maintained the charade that the lawsuit was only about getting the Obama administration to follow the Affordable Care Act.

Late last week, the U.S. House voted yet again to repeal a 2.3 percent tax on medical devices, which was part of the 2010 Affordable Care Act. Effective lobbying by medical device manufacturers has repeatedly put this legislation on the GOP Congressional agenda, even though those manufacturers profited from other provisions in the health care reform law.

Representative Dave Loebsack (IA-02) was among the 46 House Democrats who joined all the Republicans present to pass the “Protect Medical Innovation Act” by 280 votes to 140 (roll call). Loebsack voted for a similar bill in 2012 but not for repealing the same tax in September 2013, when Republicans were trying to defund Obamacare as a condition for approving further federal government spending. In recent years, Loebsack has voted against most of the several dozen House bills to repeal all or part of health care reform, with a few notable exceptions.

Representatives Rod Blum (IA-01) and David Young (IA-03) supported the latest medical device tax repeal bill. Fellow Republican Steve King (IA-04) missed the June 18 vote, but we know where he stands. He has supported any and all efforts to scrap Obamacare, including rescinding this very tax in 2012 and 2013.

Next time the Iowans in the U.S. House claim to care about the deficit, remember that this bill would reduce federal revenues by nearly $25 billion over ten years without any spending cuts to offset the lost revenue.

The White House has warned that President Barack Obama would veto this bill, since it grants “a large tax break to profitable corporations” that are gaining new customers, thanks to health care reform. Bleeding Heartland user Jon Muller explained the economics here and exposed the “pure rent-seeking behavior” of an industry that “wants the fruits of ACA, but does not wish to put anything back on the table to make it happen.”

Another must-read on this issue is Matt Gardner’s post for the Tax Justice blog from earlier this year: “Big Medical Device Makers Decry Device Tax While Dodging Billions by Offshoring Profits.” I’ve enclosed excerpts below but encourage you to click through to read Gardner’s whole piece.

UPDATE: Added below David Young’s press release about this vote.

The Iowa Insurance Division announced today that “seven companies have applied to offer Iowans health insurance through the federal health insurance marketplace” for 2016. This year, Coventry was the sole provider selling through the exchange, following the collapse of CoOportunity Health. Although Iowa’s dominant insurance provider, Wellmark Blue Cross/Blue Shield, is staying off the exchange for another year, Coventry and Minnesota-based Medica want to sell individual plans statewide, and United Healthcare wants to sell in 76 of Iowa’s 99 counties. The Iowa Insurance Division’s full news release is after the jump. Click here (pdf) for a list of counties where each company has applied to offer coverage through the exchange.

Increased competition will not only give roughly 45,000 Iowans more options for health insurance coverage, possibly at lower cost, but will also remove the threat that Iowans could lose access to federal subsidies for lack of a provider willing to sell through our state’s partnership exchange.

Iowans could still lose access to the subsidies many need to make health insurance affordable, depending on how the U.S. Supreme Court rules in the King v Burwell case. An act of Congress could easily address a ruling that invalidated subsidies for Americans who purchase insurance through the federal website, and lawmakers have floated several ideas. But key Republicans don’t want to pass any “fix” to the hated 2010 health care reform law.

Catching up on Congressional news, last week the U.S. House approved a joint Republican framework setting top-line numbers for the federal budget as well as the first two spending bills for the 2016 fiscal year, which begins on October 1. Along the way, House members considered amendments covering a wide range of issues, from regulations on incandescent light bulbs to “prevailing wage” rules for federal construction projects to medical marijuana advice for Americans who receive their health care through the Veterans Administration.

Follow me after the jump for details on the latest votes by Iowa Democrat Dave Loebsack (IA-02) and Republicans Rod Blum (IA-01), David Young (IA-03), and Steve King (IA-04).

Changes to entitlement programs rarely attract strong bipartisan support, but on Tuesday the U.S. Senate approved a bill to change how Medicare sets reimbursement rates for doctors by 92 votes to 8 (roll call). All of the no votes came from Republicans, but Iowa Senators Chuck Grassley and Joni Ernst both supported the bill. Follow me after the jump for background and details.

The U.S. House approved a draft budget yesterday with some drama along the way. Details on the important budget provisions and how the Iowans voted are after the jump.

U.S. Senator Ted Cruz of Texas officially launched his presidential campaign this morning. Click here to watch his speech at Jerry Falwell’s Liberty University or here to read the transcript.

As an outsider candidate, Cruz will need a strong showing in the Iowa caucuses to have any hope of becoming the last man standing against the establishment favorite for the GOP nomination. I don’t see that happening.  

At least 40,000 Iowans are in danger of losing their health insurance later this year, and not only because of the King v Burwell case before the U.S. Supreme Court. Regardless of how justices decide that case, Iowans could lose access to federal subsidies they need to buy insurance policies.

State legislators and Governor Terry Branstad could eliminate the risk by working together to establish a fully state-run health insurance exchange this year. But for reasons I can’t comprehend, I see no sense of urgency to prevent a potentially devastating outcome for thousands of families.  

Yesterday the U.S. House approved a bill to repeal the Affordable Care Act by 239 votes to 186 (roll call). No Democrats supported the bill, and only three Republicans broke ranks with their party to oppose it. By some counts, it was the 56th time the Republican-led House has voted to repeal all or part of the 2010 health care reform law. Still, many newly-elected GOP lawmakers wanted a chance to weigh in after campaigning against Obamacare.

Iowa’s four representatives split along the usual party lines, with Rod Blum (IA-01), David Young (IA-03), and Steve King (IA-04) voting yes and Dave Loebsack (IA-02) opposed. Loebsack has occasionally voted for Republican bills that reverse specific provisions of the Affordable Care Act, but he has never supported any of the broad repeal bills.

I enclose below statements released by King and Young on yesterday’s vote.  During last year’s campaign, Young suggested that Obamacare was “here to stay” and said he would be “at the table trying to fix” the law if elected to Congress. In yesterday’s press release, Young advocated several GOP proposals on health insurance but added that Republicans “must continue to ensure coverage is provided to individuals even if they have preexisting conditions and that young people still struggling in the job market are able to continue to receive coverage under a parent’s plan.” King’s official comments said nothing about preserving any aspects of the current law. He emphasized that he filed the very first Obamacare repeal measure on the day after House members approved the bill in March 2010.

I highly recommend Dana Milbank’s entertaining account of the House debate on the latest bill. Excerpts are after the jump, but you should click through to read the whole Washington Post column.

UPDATE: According to Sahil Kapur,

The [Republican] party is divided on whether it should even attempt to craft a contingency health care plan of its own. Illustrating the dispute, Reps. Steve King (R-IA) and Jeff Duncan (R-SC) tried to propose an amendment that strips out the language calling for “replacement legislation.”

What has seemed likely since Christmas Eve was confirmed on Friday: Iowa’s non-profit health insurance coop is liquidating. At the end of this post, I’ve enclosed the e-mail CoOportunity Health members received on January 23. Members are strongly encouraged to enroll in other health insurance before February 15, the end of 2015 Open Enrollment under the federal health care reform law. In Iowa, only Coventry now sells policies through the exchange, allowing eligible people to receive federal tax subsidies to help cover the cost of insurance.

CoOportunity Health was created to sell individual, family, and small-business health insurance policies in Iowa and Nebraska. Its membership greatly exceeded projections, but so did the costs of insuring a population that had largely been uninsured before the 2010 Affordable Care Act went into effect in 2014.

Some politicians, like Senator Joni Ernst, have nothing to say about CoOportunity’s collapse beyond empty talking points about Obamacare. Others, like Senator Chuck Grassley and Representative Dave Loebsack (IA-02), are digging for answers on why federal officials didn’t do more to help the health insurance coop survive. Those are important questions.

As far as I can tell, no one in a position of power is examining how decisions by Iowa officials stacked the deck against CoOportunity ever becoming solvent. Did Iowa’s insurance commissioner Nick Gerhart seal the coop’s fate by bending over backwards to suit the 800-pound gorilla in Iowa’s health insurance market (Wellmark Blue Cross/Blue Shield)? Now that CoOportunity’s failure leaves only one company selling policies on Iowa’s health insurance exchange, what is Gerhart’s “plan B” if Coventry decides later this year against continuing to participate on the exchange for 2016?

Happy new year to everyone in the Bleeding Heartland community! Undeterred by my failure (yet again) to win, place, or show in my own blog’s election contest, I offer fifteen Iowa politics predictions for this calendar year.

Your own predictions or any other relevant comments are welcome in this thread. At the end of this year I’ll look back to see what we got right or wrong.

Tony Leys didn’t bring glad tidings today to the 120,000 members of CoOportunity Health in Iowa and Nebraska. In a front-page story for the Des Moines Register, Leys reported that state regulators have taken over the non-profit health insurance co-op, one of only two companies selling policies on Iowa’s exchange. It sounds like the co-op will be liquidated in the coming months.  

U.S. Senator Tom Harkin’s been giving a lot of interviews lately as he wraps up a 40-year career in Congress this month. I’ve posted some of the newsworthy excerpts after the jump, along with the full text of Senator Chuck Grassley’s widely-praised tribute to his colleague on the Senate floor.

Any relevant comments are welcome in this thread. UPDATE: James Q. Lynch’s feature for the Cedar Rapids Gazette on “The Harkin Legacy” is a good read.  

On Friday the U.S. House of Representatives filed a federal lawsuit challenging several aspects of how the Obama administration has implemented the 2010 Affordable Care Act. You can read the plaintiffs’ full case here (pdf) against two cabinet secretaries and the agencies they lead. The main arguments are that the Obama administration broke the law by delaying the employer mandate to provide health insurance, and also by providing certain payments to health insurance companies without having Congress appropriate those funds. The first point was expected, but the second argument surprised even those who have closely followed the political battle over Obamacare. Sarah Kliff explained the challenged payments and how they fit into the law. Ashley Parker reported for the New York Times, “If the lawsuit is successful, poor people would not lose their health care, because the insurance companies would still be required to provide coverage – but without the help of the government subsidy, the companies might be forced to raise costs elsewhere.”

In contrast, the legal challenge to delaying the employer mandate is more “symbolic,” as that provision of the Affordable Care Act will have gone into effect by the time this lawsuit works its way through federal courts.

House Republicans voted to authorize this lawsuit shortly before going on a long summer recess. Iowa’s four representatives split on party lines, with Republicans Tom Latham (IA-03) and Steve King (IA-04) supporting the measure and Bruce Braley (IA-01) and Dave Loebsack (IA-02) opposed, along with every other House Democrat present. At the time, the lawsuit was perceived as House Speaker John Boehner’s way of deflecting conservative sentiment toward drafting articles of impeachment. At times this fall, Congress-watchers wondered whether the lawsuit would go forward, as two major law firms worked on the case for a while before declining to participate in litigation. A conservative legal scholar eventually took the case.

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

The enrollment period for 2015 health insurance coverage began today and runs through February 15. Approximately “23,000 people nationwide successfully submitted applications to enroll or re-enroll in health insurance plans” today at Healthcare.gov. The Obama administration has set a target of 9.1 million enrollees for 2015. As of this past April, approximately 29,000 Iowans had selected a health insurance plan through the federal marketplace. But roughly double that number are eligible to enroll in a marketplace plan.

Democrats in the Iowa Senate advocated for creating a state portal where Iowans could buy health insurance under the 2010 Affordable Care Act. However, Governor Terry Branstad and Iowa House Republicans refused to go along, perhaps hoping that the health care reform law would be overturned in court or soon after the 2012 presidential election. So, Iowa formed a “partnership” exchange, whereby the state regulates insurance plans, but citizens purchase those plans on the website created and maintained by the federal government. That political decision may prove costly for tens of thousands of Iowans and millions of people in more than 30 other states.

On November 7, the U.S. Supreme Court agreed to hear an appeal that could end tax credit subsidies for all Americans who purchase health insurance plans through the federal website. The SCOTUS blog has compiled links on the King v Burwell case here. Jonathan Cohn provides a concise explanation of how the lawsuit could “wreck Obamacare” if a Supreme Court majority finds in favor of plaintiffs, who argue that subsidies should be available only to people who purchase insurance on state exchanges.

Brianne Gorod argues here that the Supreme Court should “recognize what the statutory text makes clear, and the structure, purpose, and history of the statute all confirm: tax credits and subsidies should be available on all exchanges, state-run and federally facilitated.”

Michael Cannon argues the opposite side here: namely, that the Affordable Care Act “makes no provision for subsidies in federally established exchanges.”

Chief Justice John Roberts is a highly political, results-oriented judge rather than a consistent legal theorist. Will he seize this chance to destroy Obamacare, or will he allow the current system to survive, as he did in the Supreme Court ruling that left most of the Affordable Care Act intact?

The outcome of King v. Burwell should not affect roughly 105,000 Iowans who have received health insurance coverage under the Iowa Health and Wellness Plan, the compromise alternative to simple Medicaid expansion in this state. According to a report by the Iowa Policy Project, those people “previously were not eligible for Medicaid or who were enrolled only in the IowaCare program.” (IowaCare benefits were inferior to Medicaid in various ways.) Iowa hospitals have benefited from these policy changes, as they provided much less uncompensated care to uninsured Iowans during the first half of this year compared to the previous year.

UPDATE: Added after the jump excerpts from the Des Moines Register’s unsigned editorial published on November 17. The editors note the irony of conservatives who oppose the Affordable Care Act hoping that “activist judges” will help unravel it.

The Iowa Hospital Association was one of many health care organizations that advocated strongly for Medicaid expansion. A new analysis of care provided by Iowa hospitals shows why.

Scott McIntyre highlighted the key findings on the Iowa Hospital Association’s blog yesterday.

During the first six months of this year, the number of people hospitalized in Iowa without insurance fell by 45.7 percent compared with the same period last year, an IHA analysis has found.  The analysis is based on data collected from 101 Iowa hospitals from January through June.

According to the study, out of about 159,000 hospital discharges from January to June in 2014 and 2013, 4,445 patients were uninsured this year compared with 8,181 in 2013.

[…] Because of Medicaid expansion, in a six-month span, Iowa hospitals cared for fewer uninsured patients in all settings, including patients admitted for inpatient care as well as those seeking care at hospital emergency rooms and at outpatient clinics.  Similar results are being seen in other states that expanded Medicaid under the Affordable Care Act. […]

For the period January 1-June 30, overall inpatient admissions at Iowa hospitals declined 4.4 percent compared with the same period in 2013.  Within that decline, the number of uninsured hospitalized patients with no source of payment for their health care fell by 45.7 percent in 2014.

Additionally, fears that expanding coverage would make care so easily accessible that use of hospital emergency rooms would rise to unprecedented levels have not materialized, the IHA analysis found.  Total visits to emergency rooms increased less than 1 percent when comparing the six-month spans in 2013 and 2014, despite approximately 30,000 patients with new policies purchased through the Health Insurance Marketplace.

With more Iowans now insured, hospitals’ charity care losses fell 18.5 percent, yielding a total six-month improvement of $32.5 million.

During the state legislature’s 2013 session, Iowa House Republicans and Governor Terry Branstad refused to expand Medicaid, but agreed to create an “Iowa Health and Wellness Plan” as a compromise. The arrangement was more complicated and more expensive than simply expanding Medicaid as foreseen under the 2010 federal health care reform law. Nevertheless, the deal was well worth it and is benefiting tens of thousands of Iowans.  

In a few minutes, Bruce Braley and Joni Ernst will hold their third and final debate. KCAU in Sioux City and ABC-5 in Des Moines are televising the debate locally, and C-SPAN is showing it nationwide. I’ll be liveblogging after the jump.

Before the first debate, I was concerned that Braley might lose his cool, but he did well both that night as well as in last Saturday’s debate.

UPDATE: C-SPAN has the debate video archived here, for those who missed it.