# Medicare



The human cost of Big Pharma's greed: Overcharging the Hepatitis C cure

Did you know drug companies exploit charities to increase their profits? Neither did I before reading this piece by Austin Frerick. -promoted by desmoinesdem

Susan, a 52-year-old mother of two from Indianola, thought she had landed the perfect job. She would be sitting behind a desk in Des Moines after years of working on her feet in retail and even got new benefits like the day off on Christmas Eve. But her excitement ended when her life insurance application was denied because she had Hepatitis C.

Susan is one of 3.5 million Americans living with chronic Hepatitis C, nearly 80 percent of whom are “baby boomers” (born between 1945 and 1965). Susan, like most other baby boomers, was likely infected during a blood transfusion before hospitals screened blood for the virus. The infection can last a lifetime and lead to serious liver problems, including cirrhosis (scarring of the liver) or liver cancer. Many other baby boomers in Iowa only recently discovered that they were infected, either through a routine physical or when they started showing symptoms. A new report by the state Department of Public Health found that reported cases in Iowa have increased by nearly 200 percent since 2000.

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David Young on the Affordable Care Act: Raising more questions than answers

Former Des Moines Register investigative reporter Tom Witosky dissects a letter he received from the Republican who represents Iowa’s third Congressional district. -promoted by desmoinesdem

Congressman David Young has scheduled a town hall meeting for today at Living History Farms. Clearly, one of the topics to be discussed will be the Affordable Health Care Act and what the Republican majority intends to do to it.

As fate would have it, I received a lengthy response from Congressman Young about my concerns about the Republican plans on Tuesday.

First some background. Up until I became eligible for Medicare almost a year ago, my wife and I purchased our health insurance on the federal exchange.

Our experience was good. We kept our doctors, the level of deduction was acceptable (stay healthy and you don’t need to worry about it) and the premium cost was acceptable. We received no subsidy. Especially important is the ACA requiring coverage of all purchasers with a pre-existing condition. My wife, who is still purchasing her health insurance on the exchange, has one that insurance companies commonly declined to cover or placed limits on.

I provide this background because Young’s letter to me outlines a position that attempted to persuade me major problems exist within the ACA that apparently deserve radical change.

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Loebsack will attend both Trump's inauguration and the Women's March

At least 60 U.S. House Democrats have said they will boycott Donald Trump’s inauguration on January 20. But the lone Democrat in Iowa’s Congressional delegation said today he will attend both Trump’s swearing-in and the massive Women’s March on Washington scheduled for the following day.

Here’s the statement from Representative Dave Loebsack:

There is no question that our nation, and in fact the President-elect himself, would be best served if he started behaving in a manner more reflective of the leader of the free world. The President-elect’s divisive, disturbing and distasteful remarks should have no place in our society. That being said, I have an enormous amount of respect for our nation’s history of peaceful transition of power and will stand with President Obama, President and Secretary Clinton and others who are attending. The next day, I will be attending the Women’s March in Washington with my daughter where I will join folks across the country to stand firm and fight against policies that will harm hard-working Iowans while working to create jobs, grow the economy, help our veterans and strengthen Social Security and Medicare.

Hundreds of Iowans are going to the capital for the Women’s March. I would be happy to publish one or more first-person accounts from the event. Guidelines for Bleeding Heartland guest authors are here.

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A year's worth of guest posts, plus tips for guest authors

One of my blogging new year’s resolutions for 2016 was to publish more work by other authors, and I’m grateful to the many talented writers who helped me meet that goal. After the jump I’ve linked to all 140 guest posts published here last year.

I encourage readers to consider writing for this site in 2017. Guest authors can write about any political issue of local, state, or national importance. As you can see from the stories enclosed below, a wide range of topics and perspectives are welcome here.

Pieces can be short or long, funny or sad. You can write in a detached voice or let your emotions show.

Posts can analyze what happened or advocate for what should happen, either in terms of public policy or a political strategy for Democrats. Authors can share first-person accounts of campaign events or more personal reflections about public figures.

Guest authors do not need to e-mail a draft to me or ask permission to pursue a story idea. Just register for an account (using the “sign up” link near the upper right), log in, write a post, edit as needed, and hit “submit for review” when you are ready to publish. The piece will be “pending” until I approve it for publication, to prevent spammers from using the site to sell their wares. You can write under your own name or choose any pseudonym not already claimed by another Bleeding Heartland user. I do not reveal authors’ identity without their permission.

I also want to thank everyone who comments on posts here. If you’ve never participated that way, feel free to register for a user account and share your views. If you used to comment occasionally but have not done so lately, you may need to reset your password. Let me know if you have any problems registering for an account, logging in, or changing a password. My address is near the lower right-hand corner of this page.

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Democrats in Denial

Jeff Cox presses his case on why Donald Trump won the presidency. Many Democrats from the party’s Bernie Sanders wing will agree. -promoted by desmoinesdem

What Went Wrong, and the Way Forward.

Democrats continue to be in denial about what went wrong in the November elections. It was not the fault of the FBI, or “the Russians”, or the unjustly vilified Julian Assange, or Wikileaks, or Clinton’s emails. It was a nationwide rejection of the policies of the Democratic Party, which have generated an economic recovery characterized by low wages, wealth inequality, job insecurity, and health care insecurity.

Our first political task is to turn the Democratic Party back into a majority party at every level of government and in all parts of the country, as it was in the wake of the New Deal. In order to do that, it is important to understand what went wrong under Democratic leadership.

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Donald Trump's behavior is not normal

Nearly every day brings news of another Donald Trump cabinet appointee whose agenda would hurt millions of Americans. Yesterday, we learned that the next secretary of Health and Human Services will be U.S. House Budget Committee Chair Tom Price, who favors rapid privatization of Medicare, less protection for people with pre-existing health conditions, and total repeal of the Medicaid expansion that has saved lives.

But I want to set government policy aside for now and focus on an equally urgent matter. The president-elect is not mentally fit for the world’s most important job. Unfortunately, all signs point to Republicans in Congress enabling and normalizing his erratic and dangerous behavior.

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The Big Fight Democrats Can't Afford to Lose

Thanks to susaniniowa for stating it so clearly: “This is the first moment of the election of 2018. If we blow it, we can expect to lose.” -promoted by desmoinesdem

I have been reading a lot of social media comments from Bernie Sanders supporters who think he “sold out” because he said Clinton would remain an important voice in the party. I think they are profoundly wrong about Bernie, and about how to respond to what we face now. We cannot confront the coming threats to the well-being of our fellow citizens and the planet itself if we allow ourselves to be divided. Our first and biggest fight may come as soon as January. We cannot afford to lose it.

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Trump found yet another way to take American politics to a dark place

Donald Trump proved in his final debate against Hillary Clinton that he hasn’t run out of ways to demonstrate he is unfit to serve as president.

About an hour in, Chris Wallace asked the Republican nominee a simple question: will he accept the result of this election? Trump said, “I will look at it at the time,” then rattled off a bunch of bogus talking points. To his credit, Wallace pressed Trump on whether he would honor the tradition of a “peaceful transition of power,” with the loser conceding to the winner. “Are you saying you’re not prepared now to commit to that principle?”

Trump responded, “What I’m saying is that I will tell you at the time. I’ll keep you in suspense.”

Normal candidates may make gaffes. Unorthodox candidates may say things that are shunned in polite company. But before Trump, even the most offensive candidate didn’t refuse to accept the will of the voters. Associated Press reporters Julie Pace and Lisa Lerer conveyed the enormity of Trump’s break with tradition in the lede to their debate wrap-up: “Threatening to upend a fundamental pillar of American democracy […].”

Every GOP candidate and office-holder must repudiate Trump and affirm that they will respect the outcome on November 8. Iowa Secretary of State Paul Pate spoke out on Monday, describing Trump’s warnings about “large scale voter fraud” as “not helpful” and “misinformation.” Governor Terry Branstad tried to have it both ways, expressing “confidence” in the election system but claiming Trump has been a victim of media bias, and that Iowa county auditors won’t be able to prevent all attempts at voter fraud.

That’s not good enough. By suggesting the result might be illegitimate, Trump could provoke political violence that is unprecedented following a U.S. election in our lifetimes.

Any comments about the third debate are welcome in this thread. For those who missed it, the full video is here, a full transcript is here, and the Los Angeles Times published transcripts of some noteworthy exchanges. Links to a few good fact checks: NPR, New York Times, ABC, Factcheck.org, and Politifact. I enclose below the clip with Trump’s rigged election claims and Clinton’s response to his “horrifying” remarks.

A few other moments stuck out in my mind:

• Clinton’s strong defense of a reproductive rights: “I will defend Roe v. Wade and I will defend women’s rights to make their own healthcare decisions.” Members of CNN’s focus group liked Clinton’s answer to that question better than any other from the Democrat.

• The exchange over immigration policy, in which Trump referred to some “bad hombres” while Clinton pointed out, “We have undocumented immigrants in America who are paying more federal income tax than a billionaire.”

• Clinton saying Russian President Vladimir Putin would “rather have a puppet as the president of the United States” and telling Trump, “You are willing to spout the Putin line, sign up for his wish list, break up NATO, do whatever he wants to do.”

• Trump interrupting with “Such a nasty woman” while Clinton answered a question about Social Security and Medicare. Mental health experts say narcissists “project onto others qualities, traits, and behaviors they can’t—or won’t—accept in themselves.”

Wallace was a much better moderator than I anticipated from a Fox News personality, despite a few missteps.

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Thoughts on Gary Johnson's Des Moines rally and Iowa prospects

Libertarian presidential candidate and former New Mexico Governor Gary Johnson made his first Iowa campaign stop this year over the holiday weekend. His September 3 rally in Des Moines attracted hundreds of people, making it possibly the largest Libertarian event in Iowa history. You can watch his full speech at C-SPAN or Caffeinated Thoughts.

Johnson will qualify for the ballot in all 50 states and is consistently polling far better than the Green Party’s Jill Stein, the only other minor-party candidate routinely included in public opinion surveys. I continue to hear the Libertarian’s radio ads on various Des Moines-based stations and have seen pro-Johnson television commercials by the Purple PAC on some cable networks.

The four most recent Iowa polls measured Johnson’s support at 8 percent (Emerson College), 12 percent (Quinnipiac), 6 percent (Suffolk), and 12 percent (Marist). Polls have historically overstated support for third-party candidates. Nevertheless, if the competition between Hillary Clinton and Donald Trump remains very close here, even a 2-3 percent showing for Johnson could determine who wins Iowa’s six electoral votes.

Though I wasn’t able to attend Saturday’s rally, listening to Johnson’s stump speech reinforced my view that he is on track to outperform all previous Libertarian presidential candidates in Iowa by a considerable margin.

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An Iowa mom's perfect care package for Mylan CEO Heather Bresch

Outrage has been building for several days over news that the Mylan corporation jacked up wholesale prices for EpiPens from $56.64 to $317.82 between 2007 and 2015. Mylan is the sole suppler of devices patients can use to inject epinephrine in case of life-threatening allergic reactions. Manufacturing costs for EpiPens have not increased, and the active ingredient is a “generic drug that has been in use for decades.” Adding to the scandal, the annual total compensation for Mylan CEO Heather Bresch has increased from $2,453,456 to $18,931,068 since 2007. The company exploited a loophole called “inversion” two years ago to reduce its tax bill.

Yesterday Democratic presidential nominee Hillary Clinton called on Mylan to reduce the price of EpiPens. Members of Congress including Iowa’s Senator Chuck Grassley have asked the company to explain the pricing changes and asked the Food and Drug Administration “to answer questions about its approval process and other steps for alternatives to the EpiPen.” Michael Hiltzik reported for the Los Angeles Times that another device used to self-inject epinephrine “was taken off the market last year because of manufacturing defects,” and a similar product from a generics company “hasn’t yet won approval from the Food and Drug Administration.” Another generic product is available at a lower cost but works differently, “in ways that can lead to critical errors if users aren’t properly trained,” and it “can’t be substituted when filling a prescription” for an EpiPen.

Mylan promised today to offer more assistance for people who need to buy EpiPens. But as Andrew Pollack reported for the New York Times, the extra discounts are “not lowering the list price of EpiPen, just making it easier for consumers to pay for it. So insurance companies, federal health programs like Medicare and Medicaid and school districts that stock the products could still pay the same price.” Bresch sounded shameless this morning during a CNBC interview, justifying the price increase because of higher marketing and distribution costs and other improvements to the product. “No one is more frustrated than I am,” she claimed.

My friend Colleen Kinney, a Des Moines mother of a child with severe food allergy, is mailing Bresch a care package today. She gave me permission to publish this photo of the cookies she baked and will send along with a note: “Heather Bresch, Please provide explanation for epipen price hike. Enjoy these treats. If my son ate these, he would die without Mylan’s epi-pen.”

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Patty Judge, in new tv ads: "Washington changed Chuck"

Democratic U.S. Senate nominee Patty Judge took the fight to 36-year Senator Chuck Grassley in her campaign’s first two general election television commercials, launched on Tuesday. Both 30-second spots assert that Grassley has “changed” during his long tenure in Washington. One spot features Judge delivering the message alongside a cardboard cutout of the incumbent. A string of “ordinary Iowans” question the cardboard Grassley during the other ad. Scroll down for videos and transcripts.

Grassley hasn’t run any commercials since the two ads his campaign aired before the June primary, which Bleeding Heartland analyzed here and here. I’m surprised he didn’t prepare a spot to run during the Rio Olympics, after reporting more than $1.2 million in contributions during the second quarter and nearly $6 million cash on hand as of June 30. Judge’s campaign raised $347,707 during the second quarter and had only $228,292 cash on hand at the end of June.

Three of the four Iowa polls released this month showed Grassley’s support barely above 50 percent; Judge was running 9 or 10 points behind. The most recent survey, conducted by CBS/YouGov, found Grassley leading Judge by only 45 percent to 38 percent. An incumbent polling below 50 percent traditionally signals an opening for the challenger.

But contrary to KCRG’s misleading headline and write-up, a 45-38 lead is not a “statistical tie.” The margin of error of plus or minus 4 percent in CBS/YouGov’s poll means that assuming professional sampling methods, there’s a 95 percent chance that Grassley’s support is between 41 and 49 percent, and that Judge’s support is between 34 and 42 percent. In other words, Grassley is extremely likely to be ahead if CBS/YouGov’s respondents are representative of the likely voter universe. He’s just not dominating the race by the kind of margins he’s enjoyed over previous Democratic opponents.

Over the weekend, the Des Moines Register’s Jason Noble reviewed data from earlier re-election campaigns pointing to Grassley’s strong performance among no-party voters, as well as his “crossover appeal” for thousands of Iowa Democrats.

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IA-03: Jim Mowrer introduces himself to Democrats as a fighter

The three candidates seeking to unseat first-term Republican Representative David Young have been working the phones and attending Democratic events all over Iowa’s third Congressional district as Iowa’s June 7 primary approaches.

The campaigns are also finding other ways to convey their messages to voters they can’t reach in person. A post in progress will cover an eight-page newspaper-style handout featuring Desmund Adams. Bleeding Heartland discussed Mike Sherzan’s first direct mail and television commercials here.

Jim Mowrer has introduced himself to Democrats with a tv ad and at least six mailings, starting shortly before early voting began on April 28. A recurring theme in Mowrer’s outreach is the Iraq War veteran’s commitment to fight for Democratic values and priorities, especially Social Security. Like U.S. Representative Dave Loebsack, Iowa’s only Democrat left in Congress, Mowrer grew up with relatives who depended on Social Security benefits after a family tragedy.

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IA-01: Monica Vernon first to go up on tv

image from Monica Vernon’s debut television commercial

Today Cedar Rapids City Council member Monica Vernon launched the first television commercial of this year’s campaign in Iowa’s first Congressional district. I enclose below the video and transcript from “The Schumachers,” which features three generations of a Iowa family that owns the Cobble Hill restaurant in Cedar Rapids.

Vernon faces former Iowa House Speaker Pat Murphy in the June 7 Democratic primary. Compared to the introductory spot for Vernon, Murphy’s four television commercials before the 2014 primary focused more on his own biography and political record. Those ads are still available on YouTube: “Story” (which began running the second week of April 2014), “Joint Effort” (starting in late April), “Voice” (starting in mid-May), and “Right Choice” (starting in late May).

Murphy’s budget for television commercials is likely to be more limited for this year’s race, judging by his year-end financial report. We’ll know more once Congressional candidates have disclosed their fundraising and expenditures for the first quarter of 2016. Those reports are due on April 15; Bleeding Heartland will cover them shortly thereafter.

UPDATE: Added below the Murphy campaign’s statement on this ad, which touched on his main argument against Vernon’s candidacy: she was a registered Republican until 2009.

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IA-03: Mike Sherzan promises to be "a voice for hardworking families"

The first direct mail piece on behalf of a Democratic candidate in Iowa’s third Congressional district hit our mailbox yesterday. Mike Sherzan’s mailer incorporated several messages tested in an internal poll a few weeks ago, regarding Sherzan’s working-class family background, respect for hard work, and fair treatment of employees, including “equal pay and equal opportunity” for women. Follow me after the jump for photos and the text.

The Des Moines Register’s Brianne Pfannenstiel reported on Sherzan’s recent tour of the district. Register political columnist Kathie Obradovich recently profiled the other two Democratic candidates, Jim Mowrer and Desmund Adams.

Any comments about the IA-03 race are welcome in this thread. The winner of the June 7 primary will take on first-term Representative David Young in a district with an even partisan voting index. The latest figures from the Iowa Secretary of State’s office indicate that the sixteen counties in central and southwest Iowa contain 158,291 active registered Democrats, 170,361 Republicans, and 152,430 no-party voters.

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Mike Sherzan becomes third Democratic candidate in IA-03

Mike Sherzan fuzzy photo 12345433_1536683933290188_7888591554410449181_n_zpspx3oabs2.jpg

Mike Sherzan announced today that he will seek the Democratic nomination in Iowa’s third Congressional district. He recently stepped down as leader of the financial services company he founded in order to focus his full attention on the Congressional race. I enclose below Sherzan’s press release and statements from his campaign website, which outline the candidate’s four priority issues: protecting retirement security by not privatizing Medicare or Social Security; promoting clean energy, with a focus on renewables and ag-based technologies; increasing the number of college graduates by reducing the cost of tuition and student loans; and rebuilding the middle-class by supporting equal pay for women and a minimum wage hike.

Sherzan has had a successful career in finance and may be able to largely self-fund his campaign, but he is distancing himself from stereotypes about corporate leaders who run for office. His “about” page and policy statements repeatedly refer to growing up in a family of modest means and working his way through college, with the help of Social Security benefits after his father’s sudden passing. Speaking to Bleeding Heartland last month, Sherzan emphasized that he “comes from a Democratic background” and urged people not to “judge my positions based on my business experience,” adding that “government was never meant to be a business.” His campaign is on Twitter and Facebook, though strangely, at this writing the campaign launch hasn’t been announced on either of those pages.

Sherzan briefly ran for Congress during the last election cycle but withdrew from that race in April 2013, citing unspecified health issues. He now joins Desmund Adams and Jim Mowrer in a Democratic field that may expand to include former Governor Chet Culver, who is in no hurry to make a decision. A few hours after Sherzan announced, Mowrer’s campaign rolled out a new batch of endorsements, which I’ve added at the end of this post. The 2014 challenger to Representative Steve King in IA-04 has lined up the most support from Iowa Democratic insiders, including Representative Dave Loebsack (IA-02), former Lieutenant Governor Sally Pederson, and eight current state legislators.

The winner of next June’s Democratic primary will face first-term Representative David Young in what may become Iowa’s most competitive Congressional district. The sixteen counties in IA-03 contain 150,733 active registered Democrats, 163,699 Republicans, and 166,740 no-party voters, according to the latest figures from the Iowa Secretary of State’s office. Polk County will be central to every candidate’s strategy for winning the nomination, because two-thirds of the registered Democrats in IA-03 live in the district’s most populous county.

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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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Background on Kim Weaver, Democratic challenger to Steve King in IA-04

While the four presidential hopefuls attracted the most attention at last night’s “Wing Ding” in Clear Lake, some big Iowa political news preceded their pitches. Kim Weaver delivered her first major speech as a Congressional candidate in the fourth district. Given the smooth delivery, I would never have guessed she hasn’t run for office before.

After telling the audience a little about her background, Weaver talked about some of her key issues: protecting Social Security, Medicare, and Medicaid; supporting the middle class; raising the minimum wage; fighting to change a “predatory” student loan system; supporting women’s access to health care; immigration reform including a pathway to citizenship; clean water and environmental protections. The packed house frequently applauded, especially loudly when Weaver said, “These are some of the things I stand for. What I stand against is Steve King.” Iowa Democrats love to hate King. Weaver argued the seven-term incumbent “doesn’t represent Iowa values,” citing his offensive comments about immigrants and votes against Katrina aid and even a Farm Bill (because he thought it contained too much hunger assistance).

Weaver’s campaign is online at WeaverforCongress.com, as well as on Facebook and Twitter. Her website contains brief statements on most of the issues her stump speech covered. After the jump I’ve posted her announcement video and excerpts from her official bio.

Taking on King is a daunting task for any Democrat. The 39 counties in IA-04 contain 119,020 active registered Democrats, 176,515 Republicans, and 174,355 no-party voters, according to the latest figures from the Iowa Secretary of State’s office.

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IA-Sen: Rob Hogg exploring challenge to Chuck Grassley

Democratic State Senator Rob Hogg announced today,

I have formed an exploratory committee to consider becoming a candidate for the United States Senate in 2016.  Like many Iowans, I believe we need Congress to work better for all of our citizens and our country’s future.  If we had a Congress that worked better, we could:

> Build a vibrant, full-employment economy that works for all Americans.

> Improve public health and public safety through prevention, prevention, and more prevention.

> Strengthen Social Security and Medicare and fulfill our commitments to seniors, veterans, and people living with disabilities.

> Confront the challenge of our century – climate change – through solutions that work for our economy, our health, and our environment.

Hogg didn’t set a timetable for deciding on a U.S. Senate bid but said he will travel around Iowa in the coming weeks. His full press release and official bio are after the jump. His exploratory committee is on the web here. He’s on Twitter @SenatorRobHogg and on Facebook here.

Hogg was just re-elected to his third four-year term in the Iowa Senate last November, so he would not have to give up his legislative seat in order to run for U.S. Senate in 2016. Most recently, he has chaired the Iowa Senate Government Oversight Committee; before that, he chaired the Judiciary Committee. He is among the most outspoken Iowa lawmakers on climate change and other environmental issues.

Two Democrats have already announced plans to run against Grassley: former State Representative Bob Krause and former State Senator Tom Fiegen. They recently discussed their key issues with Mike Glover of the Iowa Daily Democrat. Krause and Fiegen also competed in the 2010 Democratic primary, which Roxanne Conlin won with about 77 percent of the vote.

UPDATE: Added below further comments from Hogg, via Iowa Starting Line.

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Iowa Congressional voting catch-up thread: Defense, trade, Medicare, chemicals, and power plants

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.

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House passes first 2016 spending bills: How the Iowans voted

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).

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Grassley, Ernst vote for Medicare reimbursement deal

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.

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Iowa Income: Who Gets What?

(Thanks to daveswen for this post. Facts don't support widespread beliefs about Iowans allegedly being too dependent on federal programs. - promoted by desmoinesdem)

Depending on where you live in Iowa and who you interact with, you may have some quirky conclusions about how income gets made.  It’s common and correct to conclude that many folks get along with the help of public assistance: many in fact wouldn’t get along at all without public aid.  But most of us don’t have a clue how money gets made in this state, let alone who the recipients of public assistance are.  We go to annual estimates by the U.S. Bureau of Economic Analysis to get the numbers.

Here's how $138.34 billion in 2013 total personal income was divided up: Two-thirds ($91.3 billion) came from total earnings, which are wages and salaries, payments to proprietors, and the value of all employer-supplied benefits like medical insurance and retirement contributions.  Investment incomes (dividends, interests, and rents) made up 18 percent ($24.7 billion).  And transfers – payments by the federal government or, to a lesser extent, state government to individuals either in cash, vouchers, or direct assistance – were 16 percent of state income. 

Stated differently, 84 percent of our incomes came from market activity, and 16 percent came from governmental tranfers.  Market incomes trumped government payments to individuals by a ratio of better than 5 to 1.  

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IA-Sen: Final Braley/Ernst debate liveblog and discussion thread

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.

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IA-Sen: First Braley/Ernst debate liveblog and discussion thread

In a few minutes Representative Bruce Braley and State Senator Joni Ernst will start their first debate at Simpson College in Indianola. You can watch the debate on KCCI-TV in the Des Moines viewing area and on C-SPAN across the country (in central Iowa that’s channel 95).

I previewed what I see as the biggest potential pitfalls for each candidate here. I’ll be liveblogging after the jump and will also update later with some reaction to the debate.

UPDATE: KCCI has posted the debate video online. I cleaned up some typos and filled in gaps in the liveblog below.

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IA-Sen: "No Labels" group sucker punches Bruce Braley

Few members of Congress have done more to link themselves with the “No Labels” movement than U.S. Representative Bruce Braley. He spoke at the group’s launch event in December 2010. He participated in the group’s December 2011 release of a 12-point action plan to “Make Congress Work.” In 2012, Braley co-sponsored “No Budget, No Pay” legislation supported by No Labels; similar language was included in a budget bill President Barack Obama signed the following year. A review of Braley’s voting record on a wide range of issues shows many examples of the Democrat voting with the majority of House Republicans and against most members of his own caucus.

When Braley received the No Labels “Problem Solver Seal of Approval” this July, his U.S. Senate campaign enthusiastically spread the news along with a long list of his bipartisan accomplishments in the House.

It must have come as a shock when No Labels turned around and gave Republican State Senator Joni Ernst the same “Problem Solver Seal of Approval” a few days ago. Just in time for the Senate nominees’ first debate on Sunday, without any bipartisan legislative accomplishments to speak of, Ernst got outside validation for her campaign’s otherwise laughable pivot from the “mother, soldier, conservative” tag line to “mother, soldier, independent leader.” All she had to do to gain equal status with Braley was pay lip service to the No Labels “National Strategic Agenda.”

I’ve long believed that No Labels is an “astroturf” (fake grassroots) movement founded on false premises, and that Democrats who got mixed up with the latest incarnation of Beltway “centrists” were making a mistake. Braley may not be the last to learn this lesson the hard way. Follow me after the jump for more thoughts on No Labels’ wrong-headed policy stands and political choices.  

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Weekend open thread: IA-Sen ad wars edition

What’s on your mind this weekend, Bleeding Heartland readers? This is an open thread. I live-blogged yesterday’s gubernatorial debate, for those who missed it.

Today’s Sunday Des Moines Register includes a big feature by Jason Noble and Jeffrey C. Kummer on the $13.8 million spent so far on television commercials to influence Iowa’s U.S. Senate race. I’ve posted some excerpts after the jump.

Does anyone else think we’ve passed the point of diminishing returns on tv ads in this race? The vast majority of ads aired have been negative, and the overall quality has been poor. One of the biggest anti-Ernst spenders, NextGen Climate Action, has not produced a decent commercial yet. Most of the output has been so bad, I honestly believe Braley would be better off if NextGen had not gotten involved in this campaign at all. The Sierra Club’s spots are only marginally better. Some of the Braley campaign’s own negative ads have struck me as potentially effective, but at this point I suspect most Iowans are tuning out political ads. The volume has been overwhelming in the targeted media markets.

Pro-Republican groups, starting with fronts for the Koch brothers and now including one of Karl Rove’s outfits, keep pounding at the same two points to make Braley look bad: he insulted Senator Chuck Grassley and allegedly all Iowa farmers, and he missed a lot of House Veterans Affairs Committee meetings. But I have to wonder: once someone has heard 500 times about Braley’s alleged insult to Iowa farmers, will hearing it another ten or twenty times make any difference? Craig Robinson thinks Republicans are putting too many eggs in these baskets, and I tend to agree. The biggest accomplishment of these anti-Braley ads has been to force the Democrat to spend a lot of his money countering these charges (for instance, with tv spots on his connection to his grandparents’ farm or about what he has done for Iowa veterans). They have dictated the terms of his positive messages.

Probably the best outside ad money spent so far has been by the Chamber of Commerce. They’re running ads with Senator Chuck Grassley and Iowa Secretary of Agriculture Bill Northey endorsing Ernst. Simple, positive messages.

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IA-03: First Staci Appel/David Young debate discussion thread (updated)

Democrat Staci Appel and Republican David Young are holding their first debate in the third Congressional district race. Iowa Public Television will live-stream the Council Bluffs debate on the “Iowa Press” page. You can also watch on C-SPAN 2, which is channel 87 for Mediacom subscribers in Des Moines. I will be live-blogging the debate after the jump.

P.S.-I’ve also enclosed below the Democratic Congressional Campaign Committee’s latest television commercial against Young. The format seems a little stale, and I wonder how many people even remember Young’s magic-themed ads before the Republican primary.

UPDATE: I didn’t realize the Appel campaign is also running a new ad. Scroll to the end to see that video and transcript.

FRIDAY UPDATE: Iowa Public Television has the debate video up on the “Iowa Press” page and will broadcast this debate tonight at 7 pm and Sunday morning.

I’ve added lots more below, including post-debate spin and Young’s second television commercial of the general election campaign, which started running on September 12. Young is presenting himself as a reasonable, moderate, experienced problem-solver. The theme of the Democratic communication is that Young spent the debate hiding from more radical positions he took as a Republican primary candidate for U.S. Senate and later for IA-03. That’s accurate, but the reality is that Young does not present as a wild-eyed extremist. Voters may conclude that he was just pandering to wingnuts during the primary campaign.

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IA-03 news roundup: NRCC more interested, Appel releases first ad against Young

As expected, Iowa’s third Congressional district campaign between former State Senator Staci Appel and Senator Chuck Grassley’s former chief of staff David Young is shaping up to be the most competitive and most expensive of Iowa’s four U.S. House races. Within days of Young’s surprise victory at a GOP special nominating convention, the Appel campaign released its first paid advertisement highlighting Young’s long career as a Congressional staffer and support for cutting Social Security and Medicare. Meanwhile, the National Republican Congressional Committee added Young to its list of “contenders” and is now paying for robocalls attacking Appel.

Follow me after the jump for details on the latest IA-03 campaign developments.

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Profiles in cowardice: Must-pass Medicare bill edition

Members of Congress sometimes go to astonishing lengths to avoid doing their jobs. Rarely working a full five-day week is old news; I’m talking about the procedural gimmicks that let members avoid tough votes on the record. House leaders occasionally move bills through the controversial “deem and pass” method when the majority know something needs to pass but would prefer not to be seen voting for it. In contrast, today Republican and Democratic leaders pulled a fast one on their own back benchers.

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IA-Sen: Sam Clovis running, Joni Ernst retains high-powered consultant

Sam Clovis announced yesterday that he will seek the Republican nomination for U.S. Senate. Clovis is ending his conservative talk radio program and has a sabbatical for the coming academic year from Morningside College in Sioux City. After the jump I’ve posted more background on Clovis, including the statement of purpose he posted on his campaign website, as well as highlights from his news conference yesterday. You can watch clips from his speech here, and he is on Twitter here. Many Iowa conservatives will buy what Clovis is selling, but can he raise the money to run a strong statewide campaign?

Meanwhile, Alexander Burns reported at Politico yesterday that State Senator Joni Ernst is consulting with GOP strategist David Polyansky as she lays the groundwork for a Senate campaign.

“She’s making all the steps necessary to advance towards a campaign,” said one Republican close to Ernst. “I think she has the core nucleus [of a campaign] in place so that, should she decide to pull the trigger, she’d be able to do so fairly soon.”

The Sunday Des Moines Register featured a guest editorial by Mark Jacobs, a former energy company executive who is also considering the Senate race. After the jump I’ve posted some bullet points from that editorial, which focused on next steps for Iowa in education reform.

If no candidate wins at least 35 percent of the vote in the June 2014 primary, a statewide convention will determine the GOP nominee for Senate.

UPDATE: I should have mentioned that Polyansky previously worked for the presidential campaigns of Mike Huckabee and Michele Bachmann, although he bailed on Bachmann a few months before the Iowa caucuses.

SECOND UPDATE: I keep forgetting Paul Lunde, who is also seeking the GOP nomination for Senate. James Lynch reports that if elected, Lunde “plans to introduce what he calls the ‘second Bill of Rights’ – 12 constitutional amendments that include making Social Security and Medicare permanent, changing the Electoral College, instituting a limited national sales tax and setting term limits for members of Congress.”

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How Harkin and Grassley voted on the Senate budget and amendments

The U.S. Senate approved a budget for fiscal year 2014 at 4:38 am on Saturday after voting on amendments for most of the night. The budget passed by 50 votes to 49 (roll call). Iowa’s Senator Chuck Grassley and the rest of the Senate Republicans voted no, joined by four Democrats representing red states. The rest of the Democrats, including Senator Tom Harkin, voted for the budget.

As is often the case, Senate votes on various amendments were more interesting than the final party-line vote on the budget. Follow me after the jump for details on how Grassley and Harkin voted on some of those amendments. I’ve also enclosed statements from Grassley and Harkin.

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House approves Paul Ryan's budget: How the Iowans voted

Yesterday the U.S. House approved a fiscal year 2014 budget prepared by House Budget Committee Chairman Paul Ryan. The bill also sets budget levels for fiscal years 2015 through 2023. Bleeding Heartland covered Iowa reaction to the latest Ryan budget here. After the jump I have details on yesterday’s vote and statements released by members of the Iowa delegation.

Despite the spin from some Congressional Republicans and Governor Terry Branstad, it’s important to remember that Ryan’s budget is not balanced and will not be balanced even 10 years from now. Both the non-partisan Tax Policy Center and the Center on Budget and Policy Priorities have noted that Ryan does not say how he would offset trillions in lost revenue from income tax cuts he proposes. In addition, the Ryan budget “understates defense spending by $100 billion over the next ten years” and assumes that the 2010 health care reform law will be repealed, which obviously won’t happen. The Ryan plan isn’t about eliminating the federal deficit, it’s a plan to end Medicare as a single-payer program and change the role of the federal government in the lives of low-income Americans.

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Iowa reaction to Paul Ryan's new budget

U.S. House Budget Committee Chair Paul Ryan presented his new federal budget blueprint today. As before, he would end Medicare as a single-payer system for all Americans under age 55, slash spending on programs for the poor such as food stamps and Medicaid, and cut taxes for some, though the details there are fuzzy. He would not cut the defense budget or Social Security. Ryan says his budget would be balanced in 10 years, but he relies on some assumptions that won’t happen, such as repeal of the 2010 health care reform law.

I’ve enclosed Iowa political reaction to the Ryan budget below and will update this post as needed.

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State of the Union and Rubio response discussion thread

President Barack Obama delivers another State of the Union address tonight, and U.S. Senator Marco Rubio of Florida is set to give the Republican response. I will miss most of the president’s speech but plan to watch the replay later and will update this post with highlights. Meanwhile, feel free to comment on any topics raised during the speeches in this thread.

UPDATE: Highlights from the speeches and reaction from the Iowans in Congress are after the jump.

I find it depressing that when I came home to catch up on the news, the blogosphere and twitterverse were obsessing over Rubio taking a drink of water during his remarks. So sue him, he’s not the most camera-savvy politician in Washington (yet). Who cares?

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IA-03: Mike Sherzan first Democrat to announce

Democrat Mike Sherzan announced today that he is running for Congress in Iowa’s third district. I’ve enclosed his press release after the jump, along with excerpts from Sherzan’s comments to the National Journal. He’s on Facebook here and on Twitter here. For now, the Sherzan for Iowa website is only set up to collect donations and the names of volunteers.

Bleeding Heartland covered Sherzan’s biography in this post. If Republican incumbent Tom Latham decides to run for the open U.S. Senate seat, I expect several other Democrats to run in the IA-03 primary, including possibly State Senator Matt McCoy. Otherwise, the field may be clear for Sherzan to take on Latham, which will be an uphill battle. On paper, this looks like a swing district, with 159,939 active registered Democrats, 166,109 Republicans, and 157,442 no-party voters as of February 2013. But Latham consistently outperforms the top of the Republican ticket and gained more votes than Mitt Romney in every IA-03 county last November.

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