Matt Chapman closely follows Iowa legislative affairs, especially bills like the one discussed here. -promoted by Laura Belin

Iowa Senate Republicans have approved another bill targeting people receiving public assistance, such as Medicaid or Supplemental Nutrition Assistance Program (SNAP) benefits.

Senate File 2272, which passed along party lines February 26, would require the state to contract for extra screening, looking for evidence of Iowans enrolled in more than one state. Labor and Business Relations Committee chair Jason Schultz introduced and floor-managed the bill. He has been attempting to pass versions of this legislation for years and sponsored five bills in a similar vein in 2019.

The vendor that would receive the contract, LexisNexis, does similar work in other states, often flagging 15 percent of beneficiaries as possibly fraudulent. In the five southern states that have adopted this screening, further checks have confirmed dual participation by just 0.1 percent to 0.2 percent of enrollees, on average.

UPDATE: Bruce Bearinger announced in April 2020 that he will not seek re-election. Original post follows:

In a colossal recruiting failure, Republicans did not field a candidate last cycle in Iowa House district 64, which Donald Trump had carried by a 13-point margin in 2016.

The GOP will not give State Representative Bruce Bearinger a pass this year. On the contrary, Chad Ingels should be able to make this race highly competitive.

Matt Chapman closely follows Iowa legislative affairs, including bills targeting people on public assistance programs. -promoted by Laura Belin

Two bills related to oversight of Iowans on public assistance were in subcommittee on January 28 at the state capitol.

Chasing traffic never has been and never will be my primary goal for Bleeding Heartland. If it were, I’d publish weekly posts about puppies or Casey’s pizza instead of Iowa wildflowers.

And anyone who has worked on an online news source can vouch for me: a writer’s favorite projects are often not the ones that get the most clicks.

Still, people do ask me from time what posts tend to do well, and I find it fun at year-end to recap the pieces that were particularly popular with readers. Since I started this exercise a few years ago, I’ve always uncovered some surprises.

More than 125 authors contributed to the 290 guest posts Bleeding Heartland published this calendar year–way up from the 202 pieces by about 100 writers in 2018 and the 164 posts by 83 writers the year before that. I’m immensely grateful for all the hard work that went into these articles and commentaries and have linked to them all below.

You will find scoops grounded in original research, such as John Morrissey’s exclusive reporting on Sedgwick landing a lucrative contract to administer Iowa’s worker’s compensation program for state employee, despite not submitting the high bid.

The most-viewed Bleeding Heartland post this year was Gwen Hope’s exclusive about the the Hy-Vee PAC donating $25,000 to the Iowa GOP, shortly before President Donald Trump headlined a Republican fundraiser at Hy-Vee’s event center in West Des Moines.

Several commentaries about major news events or political trends were also among the most widely read Bleeding Heartland posts of 2019. I’ve noted below pieces by Ed Fallon, Tim Nelson, Bruce Lear, Randy Richardson, J.D. Scholten, Dan Guild, State Senator Claire Celsi, and others that were especially popular. (This site has run more than 630 pieces since January 1.)

Iowa State University economist Dave Swenson: Of three possible approaches to health policy, only Medicare for All “reduces the damage that the existing system causes and remedies the cumulative policy failures of the past 70 years.” -promoted by Laura Belin

Health care delivery in the U.S. is a market failure and a governmental failure.

The private sector cannot adequately supply all that is demanded because many of those seeking health care cannot pay for what they need. Government systems, while attentive to the needs of the elderly, disabled, poor, and many veterans, nonetheless fail to cover all who require health care, because policies and funding are inadequate.

As a consequence, too little health care is delivered. And too little health care is socially destructive.

Bruce Lear suggests a Democratic message resting on “four pillars that sustain small towns.” -promoted by Laura Belin

When I was a kid, my mom always warned, “Keep a screen door between you and the Fuller Brush Man.” Back in the day, Fuller Brush salesmen were mobile carnival barkers. They would literally get a foot in the door and then grow roots on the couch until Mom gave up and bought something.

They were fast talkers.

They weren’t from around here.

I am afraid that too many candidates now treat rural America like the Fuller Brush man of old. They barnstorm a small community without ever stopping to hear what makes the heart of rural America beat.

A rematch is brewing in one of the six Iowa Senate districts Republicans picked up in 2016. Longtime Muscatine firefighter Chris Brase announced on November 12 that he will run for Senate district 46, which he represented for four years before losing to current State Senator Mark Lofgren.

Expanding Medicaid “saved the lives of at least 19,200 adults aged 55 to 64” during the four years after the Affordable Care Act went into effect, including an estimated 272 Iowans, according to a new paper by Matt Broaddus and Aviva Aron-Dine for the Center on Budget and Policy Priorities.

Conversely, 15,600 older adults died prematurely because of state decisions not to expand Medicaid. […] The lifesaving impacts of Medicaid expansion are large: an estimated 39 to 64 percent reduction in annual mortality rates for older adults gaining coverage.

Republicans won six Democratic-held Iowa Senate districts in 2016. All of them were among the eighteen Iowa Senate districts where voters had favored President Barack Obama in 2012 but Donald Trump four years later.*

Some of the largest swings toward Trump occurred in northeast Iowa. Parts of four counties make up Senate district 32, where Democrat Pam Egli recently announced that she will challenge first term State Senator Craig Johnson.

While this race does not currently appear to be among the best 2020 pickup opportunities for Democrats in the upper chamber, it could become competitive. Either way, state legislative elections in this part of Iowa will be important to watch for signs of whether Republicans are able consolidate their 2016 gains.

Two Democrats are now running in Iowa Senate district 20, likely to be one of next year’s most competitive state Senate races.

Information technology professional Charlie Hodges of Urbandale will seek the Democratic nomination in a district covering the northwest suburbs of Des Moines (see map below). Johnston City Council member Rhonda Martin has been campaigning here since May. The winner of the June 2020 primary will face four-term Republican State Senator Brad Zaun.

Upgrade Medicaid is a grassroots group of individuals with disabilities “who are dedicated to building a space for Iowans to tell the stories that need to be seen and heard for Medicaid policy to change.” -promoted by Laura Belin

October 13 through October 19 is National Case Management Week. In recognition of this occasion, the #UpgradeMedicaid team would like to recognize and celebrate what is working in Iowa Medicaid.

Iowa House Republicans meet in Des Moines this morning to elect new leaders for the 2020 legislative session. Linda Upmeyer announced on September 30 that she will step down as House speaker when the legislature reconvenes in January and will not seek re-election next November. She said in a written statement that she wants to spend more time with her husband, children, and grandchildren.

Speaking to WHO Radio’s Jeff Angelo on October 1, Upmeyer said she was also influenced by her predecessor Kraig Paulsen’s decision to leave the post long before an election. A new speaker is “well-served” by having a session under their belt, which helps them with fundraising and recruiting candidates, she explained. “I wanted to make sure that whoever was going to be leading the caucus in the future had those tools at their disposal going into this next election.”

Sources close to the legislature indicate that current House Appropriations Committee chair Pat Grassley is likely to become the next speaker, with Matt Windschitl moving up from House speaker pro-tem to majority leader. Current Majority Leader Chris Hagenow may not be part of the new leadership team, for reasons that remain unclear. UPDATE: The caucus selected Grassley as speaker, Windschitl as majority leader, and State Representative John Wills as speaker pro tem.

I’ve been thinking about Upmeyer’s legacy and how she influenced the chamber.

Forty-three years ago this week, Congress overrode a presidential veto to enact an appropriations bill containing the first ban on federal funding for abortion. Republican U.S. Representative Henry Hyde of Illinois had proposed language prohibiting Medicaid coverage of abortion during House debate on what was then called the Health, Education, and Welfare budget. Ever since, the policy has been known as the “Hyde amendment.”

Four Iowans who served in Congress at the time spoke to Bleeding Heartland this summer about their decisions to oppose the Hyde amendment and the political context surrounding a vote that had long-lasting consequences.

UPDATE: Hanusa announced in March 2020 that she will not seek re-election. Original post follows.

Democrats need a net gain of four seats to take control of the Iowa House after the 2020 elections. One seat that wasn’t on the party’s 2018 target list (but should have been) was House district 16, covering part of Council Bluffs. State Representative Mary Ann Hanusa had a close shave there, defeating Democrat Steve Gorman by only 114 votes, a roughly 1 percent margin.

Gorman is running for the Iowa Senate this cycle, but as of October 1, Democrats have a strong challenger for the House seat: Jen Pellant.

Former State Senator Jack Hatch will run for Des Moines mayor, he announced on WHO-TV on September 19, the last day for local candidates in Iowa to file nominating papers. A few minutes later, his campaign released a statement and a video, both enclosed below, and launched a website at JackHatchforMayor.com.

Key issues for Hatch will include fixing roads and neighborhood infrastructure, addressing “the urgent mental health care crisis that has been ignored,” protecting drinking water, improving area schools, and public safety measures including steps to reduce gun violence. All of those topics were mentioned in a telephone poll Hatch commissioned earlier this month, which Bleeding Heartland summarized here.

Defeating sixteen-year incumbent Mayor Frank Cownie will not be easy, and Hatch will have only six and a half weeks to build his case with voters. However, unlike most challengers, he already has very high name recognition. Hatch represented parts of Des Moines in the Iowa House or Senate for more than 20 years, was the 2014 Democratic nominee for governor, and is a well-known property developer.

Hatch told WHO-TV’s Dave Price he started thinking about running for mayor after Cownie “decided not to protect our drinking water when he had a chance to,” adding that Cownie “was silent” as Republican legislators tried to break up the Des Moines Water Works in 2017. Hatch acknowledged he was starting his campaign late, saying others had considered running against Cownie but backed off. He’s in the race because sees the future of Des Moines “being blurred” without strong leadership.

Turnout on November 5 may be higher than usual for a city election, because Des Moines has multiple competitive city council races, and this is the first year school board elections will be held concurrently with elections for municipal offices. Early voting begins on October 7.

Leslie Carpenter of Iowa City is an advocate for people with serious brain disorders and works to improve the broken treatment system in Iowa and across the country. -promoted by Laura Belin

Here in Iowa, we have heard for several years that we should realize the mental health crisis “isn’t about the beds.”

The argument was couched in a way to say it wasn’t about the beds, but the type of beds. The goal was to divert our attention from the fact that our state has the worst proportion of state bed numbers per capita: just two beds per 100,000 people. The Treatment Advocacy Center ranked Iowa dead last, 51st in the country on this metric. We have only 64 adult beds and 32 child beds at our state-run Mental Health Institutes in Independence and Cherokee.

Industry-funded groups have recently spent more than a million dollars on television and online advertising in Iowa opposing Democratic plans to expand access to health insurance.

Some ads primarily focus on single-payer plans (often known as Medicare for All), which more than half a dozen presidential candidates are supporting. But Partnership for America’s Health Care Future has used its hundreds of thousands of dollars in the Des Moines market targeting more modest proposals to offer a “public option” on exchanges selling private health insurance policies.

Many central Iowa Democratic activists were surprised and upset to see Loretta Sieman, a longtime West Des Moines city council member, in one of the partnership’s commercials. Sieman spoke to Bleeding Heartland on September 11 about why she opposes the public option and why she agreed to appear in the ad, now in heavy rotation on YouTube as well as Des Moines broadcast and cable stations.

Urbandale Mayor Bob Andeweg recently changed his party registration and will manage Democratic State Representative John Forbes’ 2020 campaign in Iowa House district 40.

Speaking at a fundraiser for Forbes in Lions Park on September 7, Andeweg said he’s “been a Republican my whole life.” Because he believes in nonpartisan local government, he has rarely spoken publicly about his party affiliation as mayor since 2005 or on the city council prior to that. Regarding his party switch, Andeweg said, “I truly believe this is where I need to be at this point in time.”

He and Forbes have been friendly since the early 1990s, and Forbes managed Andeweg’s first campaign for city council in 1999. He fell short in that effort but was later appointed to fill a vacancy, then won his next city council race and subsequently four terms as mayor. The two men “worked well together” when Forbes served on the city council, and Andeweg praised Forbes’ ability to get things done in a Republican-controlled chamber.

Service cuts to Iowans with disabilities under privatized Medicaid prompted a 2017 lawsuit, became a central theme of the 2018 governor’s race, and were a featured problem in an annual report from the state ombudsman.

Yet in a meeting with advocates last week, Governor Kim Reynolds’ health policy adviser said she is unaware of major problems for patients trying to obtain essential services.

This commentary was a group effort by Upgrade Medicaid organizers Jenn Wolff, Shelley Jaspering, Kyle Spading, Elaine Gartelos, Tucker Cassidy, and Evan Schultz. -promoted by Laura Belin

Thousands of disabled Iowans rely on Long Term Support Services through Medicaid. Those services were designed to provide daily living assistance for individuals to maintain normal lives in their homes.

Because of Medicaid privatization, some individuals have been forced to consider nursing home placement, which is typically more expensive than community living.

Some sobering facts about the bloodbath that was the 2016 election in Iowa:

Donald Trump carried eighteen state Senate districts that had voted for President Barack Obama in 2012.*

Eleven of those eighteen were even-numbered districts, which are on the Iowa ballot in presidential election years.

The four Republicans who already represented Obama/Trump districts all easily won another term in the Iowa Senate.**

But six of the seven Democratic senators up for re-election in Obama/Trump districts lost: Majority Leader Mike Gronstal (Senate district 8), Mary Jo Wilhelm (Senate district 26), Brian Schoenjahn (Senate district 32), Steve Sodders (Senate district 36), Tom Courtney (Senate district 44), and Chris Brase (Senate district 46).

With Republicans now enjoying a 32-18 majority in the upper chamber, Democrats need to win back at least a few Obama/Trump seats next year to have a realistic chance of regaining Iowa Senate control after the next round of redistricting.

Democrats have been actively campaigning in Senate districts 8 and 44 for some time. Now GOP State Senator Jeff Edler has a strong challenger in Senate district 36.

Former Iowa Department of Human Services director Jerry Foxhoven revealed more details about his wrongful termination claim on August 1. He asserts that he was fired after expressing concern about the DHS continuing to pay a large share of the salary for the governor’s deputy chief of staff, Paige Thorson.

As Bleeding Heartland reported last week, Thorson worked extensively on Medicaid-related issues for some time, but she became less involved with the DHS this spring, as Governor Kim Reynolds brought on a new health policy adviser.

Foxhoven and his attorney Tom Duff released a written statement and answered many follow-up questions during a 45-minute news conference. Radio Iowa posted the full audio. The questions and answers below are not a transcript from the conference, but rather my effort to put information about Foxhoven’s case in context for readers.

Bill Witt represented part of Black Hawk County in the Iowa House for ten years and is a well-known advocate for improving health care services and environmental causes. -promoted by Laura Belin

While the big political noise machines have traded barrages in a host of high-profile battles over border security, student debt, the Affordable Care Act, Afghanistan, and more, U.S. Senator Amy Klobuchar has quietly, and with her customary adroitness, slipped around the flanks of the clanking, clattering behemoths and planted her standard on strategic, long-term high ground: the security and health of America’s seniors.

Editor’s note: Bleeding Heartland’s coverage of this story continues here and here.

Governor Kim Reynolds didn’t want the public to learn why she forced out Jerry Foxhoven as director of the Iowa Department of Human Services. The vague official narrative about Foxhoven’s unexpected departure remained intact for a month.

But the ground shifted last week. As further details emerge, the governor and her top staff will have more explaining to do.

A Polk County District Court has ruled that transgender Iowans must exhaust all administrative remedies before challenging in court a new state law designed to prevent Medicaid from covering gender-affirming surgery.

In a July 18 order dismissing the ACLU of Iowa’s lawsuit on behalf of Mika Covington, Aiden Vasquez, and the LGBTQ advocacy group One Iowa, Judge David Porter wrote that the plaintiffs seeking surgery “have an adequate remedy at law” and that their case “is not ripe for judicial consideration.”

In other words, Covington and Vasquez must jump through hoops that will take many months, possibly years, before any court can consider their claim that denying Medicaid coverage for medically necessary procedures violates their constitutional rights.

Porter’s decision ignored evidence pointing to the law’s discriminatory intent as well as its impact on the plaintiffs.

A third candidate is seeking the Democratic nomination in Senate district 22, which is likely to be among Iowa’s most competitive state legislative races in 2020.

Governor Terry Branstad and then Lieutenant Governor Kim Reynolds promised endlessly that privatizing Medicaid would make the system more “sustainable.” The talking point became a crutch for Governor Reynolds whenever she faced questions about problems privatization has created for patients, caregivers, and health care providers.

The old state-run Medicaid system wasn’t sustainable, Reynolds told reporters again and again. The new system was becoming more sustainable, she claimed during all three debates against her 2018 opponent Fred Hubbell.

The latest reality check arrived on July 10. For the second year in a row, for-profit companies that manage care for hundreds of thousands of Iowans on Medicaid will receive more than an 8 percent increase in government payments.

State Auditor Rob Sand warned the Iowa Department of Human Services on June 26 that service cuts to two quadriplegic Iowans indicate that Amerigroup and UnitedHealthcare “have failed to comply” with their state contracts. Sand said the managed-care organizations (MCOs) have pushed both Medicaid recipients to move into assisted living, rather than meeting their contractual obligations to ensure members have access to covered benefits and adequate health care services.

Elizabeth Matney, who has led the Iowa Medicaid Bureau of Managed Care since the state began privatizing nearly the whole program in 2015, is leaving the Department of Human Services to become Governor Kim Reynolds’ health policy advisor, Matney’s LinkedIn profile shows. Her starting date is unclear; the governor’s office has not announced Matney’s hiring or responded to Bleeding Heartland’s inquiries on the subject. A DHS organizational chart dated June 17 still shows Matney as bureau chief for MCO Oversight & Supports, the state’s leading official for overseeing the private companies picked to manage care for more than 600,000 Iowans on Medicaid.

When the new fiscal year begins on July 1, the governor’s office will receive additional funding for staff, so Matney’s work for Reynolds may formally begin at that time. The governor’s previous health policy advisor, Paige Thorson, appears to be staying on as deputy chief of staff, meaning that new funds would be needed to pay Matney (the governor’s staff have not clarified that point).

A third Democrat hopes to represent Iowa House district 46, where longtime State Representative Lisa Heddens stepped down this week to become a Story County supervisor.

Ross Wilburn confirmed in a June 20 telephone interview that he will seek the nomination at a special convention to be scheduled soon. UPDATE: on June 29.

Jerry Foxhoven has resigned as Iowa Department of Human Services director, effective today, Governor Kim Reynolds’ office announced on June 17. The news release did not give a reason for Foxhoven’s departure. Staff for DHS and the governor did not immediately respond to questions including:

Nineteen presidential candidates had five minutes each to make their case to more than 1,000 activists at the Iowa Democratic Party’s Hall of Fame event in Cedar Rapids on June 9. Most offered at least one really good applause line. Teams of reporters from the Des Moines Register and Iowa Starting Line pulled together some of the memorable parts of each speech here and here.

I decided to focus on how the candidates spoke about health care and women’s ability to access abortion for a couple of reasons. First, while the candidates highlighted a wide range of problems and proposals, almost all of them addressed those topics in some way.

Second, this post represents my gesture toward what media critic Jay Rosen has called the “citizens agenda” approach to covering campaigns. Although I lack survey data to know for sure what Iowa Democrats want the presidential contenders to be talking about, I believe health care and reproductive rights are among the most salient for caucus-goers, because:

Two transgender Iowans and an LGBTQ advocacy group are challenging the new statute intended to deprive transgender people of Medicaid coverage for gender-affirming surgery. The ACLU of Iowa filed suit in Polk County District Court on May 31 on behalf of Aiden Vasquez, Mika Covington, and One Iowa.

Listening to the plaintiffs explain why they took this step, I was struck by the contrast between their heartfelt, compelling words and Governor Kim Reynolds’ heartless, clueless excuses for signing discrimination into law.

One Iowa Action: “We should not be encouraging half-measures and disparate treatment of our fellow Iowans.” -promoted by Laura Belin

Des Moines Register Opinion Editor Kathie Obradovich’s recent column sets out a laudable goal; protecting both religious liberty and the LGBTQ community (What if Iowa could protect both religious freedom and LGBTQ rights?).

Unfortunately, the substance of the piece misses the mark by pulling from erroneous source material that equates Utah and Iowa, two states with very different legal and political landscapes. In doing so Obradovich implies, perhaps unintentionally, that LGBTQ Iowans need to start from a place of compromise when their rights and freedoms are threatened.

Tyler Mills is a Democrat in Keokuk (Lee County). -promoted by Laura Belin

John Hickenlooper is the voice the country needs right now. His bid for the Democratic nomination for president will move us forward, particularly when it comes to a policy discussion. His accomplishments as governor of Colorado from 2011 to 2019 are quite impressive.

Heather Marie Dunn is a transgender Iowan and “recovering right-winger” in Polk County. -promoted by Laura Belin

“She lied to me,” were my first thoughts when I heard Governor Kim Reynolds had signed the health and human services budget that included a mean-spirited exclusion of transgender and intersex health care from Iowa’s Medicaid system.

This commentary was a collective effort by four people on the advocacy committee of the United Spinal Association’s Iowa chapter. -promoted by Laura Belin

Is pineapple on pizza acceptable?

This irrationally controversial question has divided households since the advent of Hawaiian pizza. Gordon Ramsay decisively says that pineapple has no place on pizza while Alton Brown is a staunch defender. How do we decide which reality cooking show host is the expert?

Odds are, you will choose an expert based on your pizza preference. This is called “confirmation bias.” We are all quick to ignore information that doesn’t confirm our bias and latch on to information that does.

This is exactly what happened last week when a Republican legislator took the words of disability advocates out of context on the Iowa Senate floor.

The Iowa Department of Human Services will not audit a practice that could be inflating costs for Medicaid prescription drug payments by millions of dollars a year.

State Representative John Forbes raised concerns after finding discrepancies on bills for some prescriptions his Urbandale pharmacy filled for patients served by Amerigroup, one of Iowa’s Medicaid managed-care providers. Earlier this month, House members unanimously approved Forbes’ amendment to the health and human services budget, instructing DHS to “audit all prescription drug benefit claims managed by a pharmacy benefit manager under the Medicaid program.”

However, House and Senate Republicans dropped that section from the final version of House File 766.

State Senator Mark Costello, who floor managed the health and human services budget in the upper chamber, claimed Iowa’s Medicaid director Michael Randol and an Amerigroup representative had told him the audit was unnecessary.

By Simon Davis-Cohen for Tarbell.org

This is a reprint from Tarbell.org, a news website pioneering journalism that reveals who runs America and empowers readers with solutions. Read this on Tarbell.org.

If you have any feedback on this piece, please contact Tarbell’s engagement editor, Danielle Keeton-Olsen, at danielle@tarbell.org.

In 2016, Iowa privatized Medicaid under then-Governor Terry Branstad. He was a founding member of the American Legislative Exchange Council (ALEC). “Obamacare” is often attacked by the David and Charles Koch-backed group that opposes government action in health care or the economy.

Branstad claimed outsourcing Medicaid would save the state and taxpayers money. However, Iowa has not been able to provide any data that shows privatization saved the state money. In fact, privatization is now costing Iowa money. (Branstad resigned the governorship in 2017 to become the U.S. Ambassador to China.)