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October 2015
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medicaid expansion


Courtney Report

Many Iowans are expressing concern about Governor Branstad’s unilateral decision to privatize Iowa’s Medicaid program. If fully implemented, the Governor’s decision would have negative impacts on Iowa’s most vulnerable citizens and Iowa’s healthcare providers.

I’m concerned that people in our communities will be denied critical medical services and that local providers will not be adequately reimbursed for the medical care of patients. The long-term care of severely disabled adults and children makes up the bulk of Medicaid services in Iowa. Medicaid also covers prenatal care to pregnant women, health insurance for low-income children, and health care for low-income seniors and others.

The Governor’s plan is to turn over the care of more than a half-million Iowans—one in five Iowans—to four managed care companies by January 1, 2016. With this change, we will see administrative costs jump from 3 to 15 percent, reaching $600 million. At the same time, the overall cost to the state is supposed to fall by $100 million a year.

The math doesn’t add up. The only way these companies can collect the multimillion dollar profits guaranteed them is by denying critical services to Iowans and by failing to fully pay local health care organizations for services they provide.

The managed care companies have yet to sign contracts with the state, so providers are being asked to sign contracts that don’t include reimbursement rates. Medicaid recipients and their families have good reason to be worried about the future.

Iowans who depend on Medicaid and the people and organizations that care for them need more time. That’s why I’m calling on the federal Centers for Medicare & Medicaid Services to reject the Governor’s plan to put Iowa’s Medicaid Program in private hands or make major changes to it.

The federal government invests a significant amount in Iowa Medicaid services. We have a responsibility to federal taxpayers and to Iowans who need these services. We need to make sure, for example, that patient outcomes continue to improve and that access to health care is not decreased.

We all need to work together to make sure quality health care services remain available to local seniors, people with physical and mental disabilities, and mothers and children.

Share your concerns

If you are concerned about the Governor’s reckless privatization of Iowa Medicaid, make your voice heard.

– I’ll be hosting a listening post. Please join me if the changes to Medicaid will impact you or your loved ones. The meeting will take place from 3 to 4:30 p.m., Tuesday, October 27, at the Burlington Public Library—Meeting Room A, 210 Court Street, Burlington.

– I also encourage you to share your views with the Centers for Medicare & Medicaid Services by writing to Andrew Slavitt, acting administrator at the Centers for Medicare & Medicaid Services, at or 7500 Security Boulevard, Baltimore, MD 21244.

Where you can learn more

To learn more about privatizing Medicaid in Iowa, go to

In addition, the Iowa Department of Human Services is hosting meetings to help local Iowans understand what the transition means for them. These include:

* For Medicaid recipients and their families:
– Wednesday, October 14, 5 to 7 p.m., Davenport Public Library, Meeting Room B (321 N. Main Street, Davenport).
– Monday, October 19, 4 to 6 p.m., Burlington Public Library, Meeting Rm A (210 Court Street, Burlington).

* For community partners, advocates and other stakeholders (to attend stakeholder meetings, you must register at
– Monday, October 12, 2 to 4 p.m. and 6 to 8 p.m., Scott Community College – Student Life Ctr. (500 Belmont Road, Riverdale).
– Tuesday, October 13, 2 to 4 p.m. and 6 to 8 p.m., Pzazz Event Center (3001 Winegard Drive, Burlington).

Get answers to your questions

Medicaid recipients with questions or concerns can call Members Services at 1-800-338-8366.

Questions from providers should be directed to the Provider Services Call Center at 1-800-338-7909.

Affordable College, Medicaid, Economic Development, The Courtney Report

Courtney Report
Note: this is an editted version of Senator Courtney’s newsletter. For the whol newsletter, please go here.


We’re working to keep college affordable so that all Iowans get the educational opportunities that lead to great jobs. Almost half of bachelor’s degrees awarded in Iowa come from our private colleges and universities. Iowa Tuition Grants help them pay their way.

Iowa Tuition Grants are awarded to Iowa residents enrolled at Iowa’s private colleges and universities. Priority goes to applicants with the greatest financial need. The exact amount each student receives depends on the funding available and number of students awarded grants. Students may receive grants for up to four years of full-time, undergraduate study.

With the funding we are proposing for Iowa Tuition Grants in this year’s Senate Education Budget, the maximum annual award would be an estimated $5,000 per student next year—up from $4,550 per student this year. For the 2013-14 school year, almost 15,000 students received the grant, which is matched by their school.

Iowa is one of 11 states that have scholarship programs specifically for students attending private colleges and universities, according to the National Conference of State Legislatures. A survey from the National Association of State Student Grant & Aid Programs shows that Iowa dedicates almost 80 percent of its need-based grants to resident students attending private colleges and universities — well above the national average of 28 percent.

A boost in the Iowa Tuition Grant will ensure more students can afford the education that’s right for them, which is an important part of our efforts to expand Iowa’s middle class. For more on grants, scholarships and other help to pay for college, go to

Senate Study Bill 1281 contains an Economic Development Budget that will expand Iowa’s middle class and move our economy forward.

The state’s Economic Development Budget funds Small Business Development Centers, research and economic development at our state universities, arts, cultural and historical projects, worker safety programs, and employer and worker assistance through Workforce Field Offices.

This year, Senate Democrats have proposed a budget that:

• Increases trade assistance for Iowa small businesses to expand their sales to national and international markets.

• Provides funding for an initiative to match returning veterans with jobs at Iowa companies.

• Invests in public transit systems that provide Iowans with transportation to and from work.

• Increases funding for Occupational Safety and Health Administration (OSHA) inspectors.

• Increases funding for more wage theft investigators at Iowa Workforce Development.

In addition, the budget provides for financial assistance for businesses to locate and expand in Iowa, and for our state universities to work with businesses on research, development, marketing and entrepreneurship.

In January, Governor Branstad surprised Iowans by proposing to privatize almost all of Iowa’s Medicaid system.

Medicaid provides free or low-cost health coverage to just over a half million Iowans who are some of the most vulnerable people in our state. This includes families and children, pregnant women, seniors and people living with disabilities. More than 71 percent of Medicaid dollars go toward services for the disabled and seniors.

In the Legislature, there is bipartisan support for a responsible, cautious approach to making changes with input from stakeholders. That’s the sort of approach that has worked best in other states and has been Iowa’s traditional approach.

Under Governor Branstad’s plan, however, Iowa will make bigger changes faster than any other state regarding health care services for Iowans who need them the most. After a similar transition in Kansas, the Disability Rights Center of Kansas reported that citizens with disabilities were denied services, struggled to navigate the new system and lacked resources to advocate for themselves.

Senate Democrats are committed to providing robust oversight to ensure that Iowa’s most vulnerable citizens don’t fall through the cracks. Earlier this year, the Iowa Senate unanimously approved SF 452. The bill would have created a process to closely monitor the Medicaid transition, ensured that tax dollars are spent wisely and maintained close-to-home access to critical healthcare services. Unfortunately, the Iowa House did not take up the bill.

There’s still time to act this year. Senate Democrats will continue to advocate for proper oversight of Iowa’s Medicaid transition and focus our attention on making sure resources are used wisely for crucial health, disability and senior services.

The Senate’s Government Oversight Committee heard testimony this week from a patient and employees of the state-run Mental Health Institutes (MHIs) that have been targeted for closure by Governor Branstad.

Under current Iowa law, the state must maintain and operate MHIs in Cherokee, Clarinda, Independence and Mount Pleasant. The Governor’s unilateral decision to close the Clarinda and Mount Pleasant facilities has drawn criticism from community leaders, legislators and mental health advocates because his plan hurts Iowans who need the critical services they provide. Layoffs have already begun in Mount Pleasant.

A former patient and staff describe Clarinda and Mount Pleasant as modern, efficient operations that provide services often not available in other locations, including inpatient dual substance use disorder and mental health treatment. The facilities have trained, dedicated, professional staff that provide compassionate care to some of our most vulnerable citizens.

Anna Short, a former drug abuse counselor at Mount Pleasant, told legislators that Iowa has a mental health crisis. “A lot of our patients are mandated treatment by the courts. If we didn’t serve them, the prisons would house them, and that would cost much more to the state,” she said.

Cindy Fedler, a former nurse at Mount Pleasant, believes the transition is hard on patients, saying, “Just because someone has a mental illness, doesn’t mean they don’t know what’s going on.”

Ann Davison, a nurse from Clarinda, told the committee that since January 15, Clarinda has received 180 calls from 60 counties asking for help.

Christina, is a former patient at Clarinda, said she needed the inpatient experience and that she would not be here today without treatment at Clarinda.

The Senate has passed two bipartisan bills to address the MHI closures. SF 333 would require the Department of Human Services to admit eligible Iowans to the MHIs through the current fiscal year that ends June 30. The funds to support these services were appropriated by the Legislature and approved by the Governor last year. His administration should now follow through on its commitment to use those funds as approved.

SF 402 would set up a process for the Department of Human Services to develop and implement crucial community-based mental health services. The services must be approved by the Legislature and in place prior to considering MHI closings. The plan would include input from stakeholders and experts, require transitional services without reducing access or quality, ensure ongoing local access to highly trained community and institutional care providers, and identify stable funding for new services.

These bills have been eligible for debate in the Iowa House for weeks but have not been taken up.

Governor Endangers Vulnerable Iowans, School Funding, Workforce Development, Legislative News

Courtney Report

ed. note: This is an edited version of the Courtney newsletter. For the whole newsletter, please go here.

In January, Governor Branstad surprised Iowans by proposing to privatize almost all of Iowa’s Medicaid system.

Medicaid provides free or low-cost health coverage to just over a half million Iowans. They are some of the most vulnerable people in our state, including families and children, pregnant women, seniors and people living with disabilities. More than 71 percent of Medicaid dollars are spent on services for the disabled and seniors.

Iowa’s Governor once again decided—on his own—to make big changes at break-neck speed to the health care of other people. And once again, those affected don’t have much political power. The Branstad Administration is ignoring painful lessons learned by other states that have adopted the managed care approach.

The responsible way to address the issue would be to bring together stakeholders and take a systematic approach. Iowa Medicaid is, after all, Iowa’s second largest insurance company.

Right now, only two things are certain:

1. There will be major changes to the health care of at-risk Iowans and to essential services for seniors and the disabled. This includes the social safety net that families depend on in times of need. All of us are just one terrible accident away from needing care for the rest of our lives.

2. With a cost of $4.2 billion, this will be the largest single purchase in state history. The winners most likely will be for-profit, out-of-state companies that will take home as much as $630 million a year.

Under existing state law, the Governor has a great deal of freedom to make this transition with little or no legislative direction. That’s why the Iowa Senate unanimously approved SF 452. The bill:

• Creates a process to closely monitor the transition, ensure that tax dollars are used wisely, and give vulnerable Iowans access to critical healthcare services.

• Outlines consumer protections to ensure continued access to high-quality care, emphasizing consumer choice, self-direction, nearby access and more.

• Ensures fair reimbursement for healthcare providers, the Iowa-based organizations that will actually do the work, while taking part in coordinated care to improve health outcomes.

• Establishes a legislative oversight commission to monitor implementation and recommend corrections should problems arise.

State funding for our local schools remains undecided, even after a fourth meeting this week of the special legislative committee charged with finding a compromise between the House and the Senate.

At the most recent meeting, House Speaker Kraig Paulsen of Hiawatha insisted on setting state aid for the 2015-16 school year at 1.25 percent, but his motion failed on a tie vote. All the Republican members of the committee supported the Speaker’s meager proposal; all Democrats voted against it.

We’ve got to get past the gridlock. Students, parents, teachers, administrators and other concerned Iowans are counting on us. They say that local school boards are making critical budget decisions now. Schools will have to cut staff and teachers, stuff more students into classrooms, and reduce educational and extracurricular offerings if they don’t get more than a 1.25 percent increase in state funding.

Woodbury Central Community School officials said their local schools need more.

Superintendent Doug Glackin told a Sioux City TV station: “When we started cutting, we were cutting the fat, and then we got a 0% allowable growth in fiscal year 2011-2012 and then we started cutting the bacon. If we get to 1.25%, we’ll be cutting into the rib meat and into the loin pretty soon, and that’s never good.”

Clear Lake Superintendent Anita Micich has told the local newspaper: “You cannot starve the schools in Iowa and expect to have world-class (education) continue.”

It’s not just smaller, rural school districts. Ankeny is among the largest school districts in the state. Their school board president said that “1.25 percent is irresponsible. We’re at the point where we are cutting programming and looking at class sizes.”

If your local schools are making these same tough budget decisions, please contact me so that I can share your concerns with conference committee members as they hammer out a final decision.

I’m working to stop the slide in Iowa’s support for local students compared to other states. A 4 percent increase in funding for our K-12 schools would help when it comes to per-student investment. That’s one of the many topics I discussed with Joe Crozier of the Grant Wood AEA when he visited the Statehouse with other Iowa Areas Education Agencies.

Last year, Senator Bill Dotzler of Waterloo sent a letter to the U.S. Department of Labor (DOL) expressing concerns about Iowa Workforce Development and its director, Teresa Wahlert.

The letter was based on testimony Senator Dotzler had received from Unemployment Administrative Law Judges indicating there was undue pressure on them, concern about the fairness of the appeals system, and problems with a political appointee directly supervising the appeal judges.

This month, DOL informed the new Iowa Workforce Development director, Beth Townsend, that her predecessor had created perceived pressure on Iowa’s Administrative Law Judges (ALJs) to be biased in favor of employers or face retaliation. The DOL also recommended that the new IWD director:

• Immediately fill the Chief ALJ position on a merit staffing basis.

• Ensure that the Unemployment Compensation appeals process is insulated from outside pressures that might compromise the process’s fairness and impartiality, or appearance of fairness and impartiality.

• Ensure that ALJs are free from actual or perceived intimidation.

• Review any negative personnel actions received by ALJs during the period they were supervised by Teresa Wahlert to determine if the action was appropriately taken, and take any necessary remedial action to reverse the action if not appropriately taken.

• Not take any personnel action against individual ALJs related to their possible participation in the review of this matter moving forward.

To learn more about U.S. Department of Labor findings and recommendations for Iowa Workforce Development, go to

Iowa is doing the right thing to strengthen our middle class after the devastation of the national recession.

One of the reasons Iowa has weathered the economic downturn better than other states is that we’ve kept our fiscal house in order. Each year, we balance the state budget and set aside money for a rainy day. According to 24/7 Wall St., Iowa is one of the best-run states in the nation, with low debt, a strong credit rating and a well-managed budget.

That’s important because it allows us to invest in initiatives to strengthen our middle class, create jobs and grow our economy. And the latest financial projections by Iowa’s non-partisan Revenue Estimating Conference confirm that Iowa can afford new investments.

We must do all we can to continue strengthening our middle class. The percentage of middle-class households shrunk between 2000 and 2013 in all 50 states, Iowa included. In 2013, 51 percent of Iowa households were middle class, down from 54.1 percent in 2000, and the median income for Iowa households has dropped, according to new research from Pew.

What can we do to continue our bipartisan efforts to expand Iowa’s middle class in all 99 counties?

A good start would be renewing Iowa’s traditional, bipartisan support for public schools, freezing tuition at our public universities for a third year in a row, and investing more in community college opportunities for Iowans preparing for 21st Century jobs.

About That Replacement Health Care Plan, Ms. Ernst


Sometimes I make the mistake of believing what people say. You would think that after a while I would learn. But I heard our sparkling new senator tell me though a set of teeth that looked perfect and white that Republicans were going to “Repeal and Replace Obamacare.” I figured that maybe this time there was a real plan. So I called her office:

Me: Hey I heard the Senator’s speech last night. She said Republicans were going to “Repeal and Replace Obamacare.” So I would really like to see what they propose for replacement. This means a lot to my family.

Staffer: There is no replacement.

Me: No replacement? But I distinctly heard the Senator say last night they were ready. Maybe there is a draft? Do you have a link to a draft?

Staffer: There is no draft.

Me: Well is it in committee? Is there a committee or another senator I could send an inquiry to? I have some ideas.

Staffer: As far as I know no one is working on anything.

Me: No one is working on anything? But Republicans have been talking about this for a couple of elections. I would think by now they would have some concrete proposals. I am sure Americans would love to see them. I figured if they had this statement in their nationally broadcast reply to the State of the Union they would have something.

Staffer: Nope, no plans.

Me: Are there any plans to get to work on this soon?

Staffer: {hem…haw..hem} Er – I am sure they will be working on one.

Me: Yet this spring? Maybe during the Summer? This is really important if they are planning to repeal they better have something to take its place. This is important.

Staffer: I am sure it will be soon – we’ll let you know.

Me: Just put a notice online – we’ll be watching – it is real important – we need healthcare.

Robert Reich On Republican Priorities

Robert Reich

Robert Reich

Truer words were never spoken – Robert Reich on facebook 01/10/2015 (yesterday):

Look at the priorities of the new Republican congressional – the Keystone XL Pipeline, the Trans-Pacific Trade agreement, tax cuts for big corporations and the wealthy, rollbacks of Dodd-Frank regulations on Wall Street, cutbacks on Medicare and Medicaid and Social Security, and decimating the Affordable Care Act – and connect the dots. Republicans want the public to think the central issue of our time is the size of government. Wrong. The central issue of our time is who government is for. Every one of their initiatives advances big corporations and Wall Street, and worsens or weakens everyone else.

Elizabeth Warren is correct: The game is rigged. And the only way to unrig it is through a new progressive movement that includes not only the Democratic base but also any and all Independents and Republicans equally determined to take the economy and democracy back from the axis of Wall Street, K Street, and big corporations. Can we rely on the Democratic Party to lead the way, or will a new third party be necessary?

Those of you who voted for Republicans or just as bad, decided not to vote, had better start understanding what Republicans are all about. If you believe you are somehow immune from their greed, that will only be true as long as you are of use to them. Once they can no longer exploit you, you or your friends or family will be targets just as teachers, workers, the elderly, women, Latinos, African-Americans, college students, and any and all others who do not fit their narrow range of acceptable humans.

You will learn this lesson one way or another. Many Republicans already have, such as Bob Ney and Jack Abramoff. Best that you learn it now while there is still a chance to reverse the damage. Until you do many Americans will suffer greatly under their morally misplaced priorities.

Say Hello To ALEC’s Little Brother, ACCE

just in case legislators forget what to do

just in case legislators forget what to do

Maybe you missed it because there was no birth announcement. The lack of a birth announcement is probably due to the fact that the parents, Charles and David Koch and their corporate concubines don’t want anyone to know. Just like ACCE’s bigger brother, ALEC, ACCE works best behind closed doors and under a rock. ACCE stands for “American City County Exchange.” This will allow the Koch to – shall we say – get involved in your local city councils and county government.

If the Kochs and their lackey congress critters can’t turn the government over to business at the national level, they will work to do so at the state level through their lackey legislatures. And now if they can’t turn government into their personal servant at the national or state level, they now have a new surreptitious organization to corrupt at the local level. If you feel that government is becoming responsive only to those with money, you are right. This is just what the Kochs want. After all they have the money and lots of friends with money.

ALEC and ACCE just completed a session meeting behind closed doors with corporate biggies rubbing elbows with legislators and now supervisors and councillors. Playing kind of a reverse Santa Claus where Santa sits on the knee of the legislators asking for presents. Later there will be campaign donations in a world where campaigns are conducted mostly on the expensive media.

While ALEC seldom announces their want list, we can make some informed guesses. However, the ALEC watchdog group at the Center for Media and Democracy’s (CMD) PR Watch published what they believed to be on this year’s wish list. So from the the CMD, here is an educated forecast for what we may soon see popping up as “model legislation” for legislatures around the country:

Blocking Local Minimum Wage Increases
Citizens in red states like Alaska, Arkansas, Nebraska and South Dakota voted overwhelmingly in favor of raising their state’s minimum wage on November 4, as did Republican and Democratic voters in states like Wisconsin, where twenty communities supported advisory referendums in favor of raising the wage.

With such a clear divide between the policies that voters support and those that ALEC corporate interests like the National Restaurant Association (which has been fighting for a $2.13 sub-minimum wage) want legislators to implement, the Commerce, Insurance, and Economic Development Task Force will feature a presentation on “Minimum Wage Preemption Policies.”

ALEC has long pushed bills like the “Living Wage Preemption Act” to block city, county, or local governments from enacting progressive economic initiatives like a higher minimum wage. In light of the renewed grassroots push for fair wage laws, this bill to crush a local government’s ability to increase wages in their community will likely be a top ALEC priority in 2015. (ALEC legislators have also been active in banning local paid sick day efforts, passing 10 laws after Wisconsin’s paid sick days preemption bill was shared at ALEC’s August 2011 meeting).

Local Right to Work

The ACCE meeting will also feature a presentation titled “Local Right to Work: Protect my Paycheck.” ALEC has long pushed anti-union “Right to Work” laws, which allow non-union members to free-ride on union representation, reaping the benefits of union negotiations for wages and benefits but without paying the costs. Michigan’s right to work law, for example, was a word-for-word copy of ALEC’s model legislation and sponsored by ALEC members.

With ACCE, ALEC is now trying to promote this anti-union legislation at the local level.

In September, the Washington Examiner reported that “Conservatives are starting to push the idea that city and county governments can pass union-restricting right-to-work laws, even though it may not be legal and has been tried only a handful of times in the last 70 years.” It is unclear whether local governments have the authority to pass right to work under the Taft-Hartley National Labor Relations Act, but in August the Heritage Foundation issued a report arguing that they do. Heritage hosted a panel discussion on local right to work in August featuring representatives of ACCE, Grover Norquist’s Americans for Tax Reform, and the National Right to Work Legal Foundation, and highlighted what they viewed as opportunities for local ordinances in Kentucky, Ohio, and Pennsylvania.

Those are the two top wishes, but of course business asks for a big package which will also include:

Depriving Low-Wage Workers of Health Insurance

Electronic cigarettes – stopping legislation on vaping nicotine

Protesting “Global Taxes” on Tobacco

Regulating Ride-Share Companies – exempting Uber and Lyft from common carrier laws

Industry-Friendly Dental Bills – moving dental services to less trained “practitioners”

Rigging the Game for Insurers – pretty self explanatory

Free Trade! – again self-explanatory

School Privatization – one of ALEC’s perennials, but once more carving out new areas for business to control. From the article: As one ALEC member told an ALEC education subcommittee earlier this year, “we need to stamp out local control.”

Please go to the link and read the sickening details of how the Kochs and their compadres plan to subvert our government for their business interests.

Ernst Proud To Have Her Support

Palin Family Involved In Brawl

America averted a disaster by rejecting John McCain and his craven pick of Sarah Palin for vice president in 2008. The very thought of what a Vice-President Palin would have unleashed on this country is only less scary that the thought of what could have happened if Palin had somehow succeeded to the presidency.

Unlike other VP candidates, Palin has not just faded into the background. With all sorts of strange appearances and even stranger utterances, Palin has managed to keep herself in the news and keep the money rolling in. Much like the folks who would pay good money to flock to PT Barnum’s freak show, people still have a morbid fascination with Sarah Palin.

Once more last weekend Sarah and her family thrust themselves into the spotlight by mixing it up with their neighbors at a birthday party. Fueled by alcohol, things got out of hand when son Track ran into someone he didn’t like.

For the report of the incident we turn to the blog of Amanda Coyne:

“Hell hath no fury like a Palin family visit: Just when I was about to give up on them, the Gods of gossip came visiting this week, and as they’ve done in the past, they beckoned me to look towards Wasilla, towards the fortress of Our Lady of the North, the woman who was almost a heartbeat away from the presidency, whose family had a dramatic weekend, Wasilla style! As many of us have read, Bristol Palin was visited by a Floridian stalker on Sunday who somehow ended up on the family’s balcony. The stalker currently sits in jail. That’s pretty dramatic. But that’s the least of it. The night before, Saturday, was a doozy. The details are a little sketchy, but there’s enough of them, from enough different sources, that a story emerges, a story that according to the gossip Gods, looks kind of like this: There’s some sort of unofficial birthday/Iron Dog-type/snowmachine party in Anchorage. A nice, mellow party, until the Palin’s show up. There’s beer, of course, and maybe other things. Which is all fine, but just about the time when some people might have had one too many, a Track Palin stumbles out of a stretch Hummer, and immediately spots an ex-boyfriend of Willow’s. Track isn’t happy with this guy, the story goes. There’s words, and more. The owner of the house gets involved, and he probably wished he hadn’t. At this point, he’s up against nearly the whole Palin tribe: Palin women screaming. Palin men thumping their chests. Word is that Bristol has a particularly strong right hook, which she employed repeatedly, and it’s something to hear when Sarah screams, “Don’t you know who I am!” And it was particularly wonderful when someone in the crowd screamed back, “This isn’t some damned Hillbilly reality show!” No, it’s what happens when the former First Family of Alaska comes knocking. As people were leaving in a cab, Track was seen on the street, shirtless, flipping people off, with Sarah right behind him, and Todd somewhere in the foreground, tending to his bloody nose.”

Iowa’s connection to this is that Joni Ernst proudly accepted the Palin endorsement back in March. I would assume that endorsement and acceptance are still in place. Sarah Palin is a national embarrassment. Joni Ernst is cut from the same cloth. My feeling is that if Ernst is elected she will be an embarrassment to Iowa, not in the exact same ways as Palin, but in her own way.

Back in March Ernst accepted the Palin support:
“I’m proud to stand with the Mama Grizzly against big spenders in Washington like Bruce Braley and Nancy Pelosi. Sarah Palin is an inspiration to those of us who want to protect life, defend the Second Amendment, and get Washington out of our wallets. As our campaign builds energy toward a primary win in June, Sarah Palin’s roaring support will help me to victory, and as a result, make ‘em squeal in Washington,” said Ernst.

One thing is for sure. Just like Palin, Ernst wants to end Social Security, Medicare, Medicaid and the ACA. Ernst has let it be known that she will not work for Iowans – all the programs listed have major approval in Iowa polls. Instead she will be a tool of the Kochs and their ilk.

We need a senator that will work for Iowans.

Krugman: Medicare Spending Is Down!

save medicare
Major news that barely registered a tinkle in what passes for news media last week. I guess we shouldn’t be surprised since it was a holiday weekend and when the administration has good news it seldom makes the front section, let alone the front page. Considering the shambles that Republicans left our fiscal house in and the flat out total opposition they have shown to any attempt to fix the mess makes this news remarkable. Here is the beginning of Krugman’s column from August 31st:

So, what do you think about those Medicare numbers? What, you haven’t heard about them? Well, they haven’t been front-page news. But something remarkable has been happening on the health-spending front, and it should (but probably won’t) transform a lot of our political debate.

The story so far: We’ve all seen projections of giant federal deficits over the next few decades, and there’s a whole industry devoted to issuing dire warnings about the budget and demanding cuts in Socialsecuritymedicareandmedicaid. Policy wonks have long known, however, that there’s no such program, and that health care, rather than retirement, was driving those scary projections. Why? Because, historically, health spending has grown much faster than G.D.P., and it was assumed that this trend would continue.

But a funny thing has happened: Health spending has slowed sharply, and it’s already well below projections made just a few years ago. The falloff has been especially pronounced in Medicare, which is spending $1,000 less per beneficiary than the Congressional Budget Office projected just four years ago.

This is a really big deal, in at least three ways.

Krugman then goes on to explain why the Medicare miracle is such a big deal here.

Don’t forget that about six months ago the main stream media all but ignored the major story that the budget deficit has been shrinking at an incredible rate, the fastest ever since WWII. When the Bush cronies were done destroying things they left an annual shortfall of nearly $1.5 trillion with an annual trillion dollar deficit expected every year. The Obama Administration has cut this down to under half a trillion deficit and cut the deficit to GDP ratio from nearly 10% coming in to office to under 3% for this year.

By the way, don’t forget that as President Clinton was leaving office, his administration had cut the then massive debt left by Republican administrations to the point where projections had the United States out of debt within a decade.

You may also recall that President Clinton presided over a roaring economy that was struggling badly under Bush the Elder – remember the phrase “it’s the economy, stupid.” We have seen the stock market come back from a major setback at the end of the Bush II administration to soar to new heights.

In short, given the outright entrenched opposition of Republicans who have tried to stop Obama at every turn, the Obama administration has produced some remarkable economic numbers.

Can you just imagine what could happen if Republicans were working for the good of all Americans instead of only working for the corporations and the rich 1%? If Republicans do not wish to work for the good of the majority of Americans, why don’t we just leave them behind to wallow in their stew while Democrats take the country to new heights. It can be done. It should be done.

If I had an employee who worked against my company as hard as the Republicans work against their employers (you and I), I would fire them in a second. You have the power to do that.

Paul Krugman

Paul Krugman

TPP And Other Thoughts

just curious

just curious

I haven’t done a hodge-podge column for a while. Mostly because I turned my brain off over the holidays. My first comment is that I find it so hard to believe how mean, how brutal, how anti-people the Republican party is getting. We have been talking about it for years and it continues to get worse and worse. These %$&@ have cut off food stamps for millions and also cut off unemployment insurance for another 1.5 million.

Of course the real story beyond that is that in general, Republicans are a group that believe in Jesus. Now I don’t do religion anymore, but like many I was raised as a Catholic. That meant 12 years of studying the Bible and what Christianity meant. I think anyone in this country can tell you that the very basis of being a Christian is to help the poor. At the same time one of the very fundamentals of government is to keep the governed alive. Since we are self-governing, one of our very, very basic duties would be to keep each others alive.

Cutting food stamps, cutting jobs, cutting unemployment insurance and so on should be called out for those who believe in Christ as the mortal sin that it is. Now religion is not the reason that we should have such policies. We should have such policies because as noted before keeping each other alive is a fundamental of self government. But to be a believer and vote against the basic tenets of your own religion seems to me to earn such people a special place in the hell they believe in.

TPP, anyone?
From Dailykos:
“Whether or not the president obtains the listed negotiating objectives, the bill would empower the president to sign a trade pact before Congress votes on it with a guarantee that the executive branch can write legislation to implement the pact and alter wide swaths of existing U.S. law and obtain both House and Senate votes within 90 days. That legislation is not subject to markup and amendment in committee, all amendments are forbidden during floor votes and a maximum of 20 hours of debate is permitted in the House and Senate.”

That should scare you right to the quick. TPP will be a disaster for all except the very rich. Odd that this may be the one time that Obama wants something and the Tea Party agrees. The Tea Party knows what a disaster it will be, thus delighting them no doubt. Not sure why Obama would want it.

Gee, maybe our corporatist press could ask him?

Dems In Iowa House Say NO to ALEC

Great job.

Press Believes Its Own Memes?

One thing that jumped out at me during this Christie affair is that the corporate media loves to believe the themes it develops over the years. John McCain was (is?) a “maverick.” Never was, McCain is a hard right crank, but apparently he must buy the boys a beer once in a while and snarl an occasional quotable line.
– Republicans good at national defense? Not unless you think wasting time, money and personnel wandering in a desert with no plan is good defense.
– Republicans good with finance? Just go look at the markets under Dems, then Republicans. Just look at debt under Dems, then Republicans. You will quickly get that nonsense out of your head.
– Republicans religious? See my comment above. The way they act is condemned by most major religions, thus they have to take one and twist it beyond recognition. Even the pope has called them out on this.
– Christie a bipartisan leader? Never was, never will be. He is a true believer republican, he just avoids the cliches, so must be refreshing for the corporate press. But he is a caricature of the New Jersey thug politician.

Medical Spending Slows

Salon has a quite interesting article on the debate over the cause of the dramatic slowing in medical spending in this country. Most importantly medical spending is slowing like it never has before. Why I do not care, but finally one thing in life is show some signs of coming into control.

Harkin Email on ACA Implementation

Tom HarkinMany of you probably got this email from Senator Harkin’s office. If not, I am sure there will be some information of interest in here. Remember, the ACA exchanges are to be set up and ready to go by October 1. Iowa via Gov. Branstad chose to let the Dept. of Health and Human Services set up our exchange. 

Dear Dave,
Because of your interest in health insurance reform, I would like to take a moment update you about an important development in the implementation of the landmark health reform law, the Affordable Care Act (ACA).

As you may know, the Health Insurance Marketplace is an integral component of the ACA that offers consumers and small businesses a new way to shop for affordable, comprehensive health insurance. Open enrollment in the new Health Insurance Marketplace will begin on October 1, 2013, with plan coverage beginning January 1, 2014. This is great news for all Iowans and small businesses, but it is particularly positive for the 255,072 non-elderly Iowans who are currently uninsured – 92 percent of whom may qualify for either tax credits to purchase coverage through the Marketplace or for expanded Medicaid.

To prepare consumers for the upcoming enrollment period, the Department of Health and Human Services (HHS) has launched new Marketplace educational tools at This website allows visitors to select criteria that fits their income levels and health needs, and receive detailed information about personalized health coverage options available to them. The website also provides information about ACA consumer protections already in effect, including:

* Access to affordable prescription drugs for seniors, which in 2012 saved 39,260 Iowans over $25.8 million, an average of $685 per Medicare beneficiary;

* Coverage for preventive services with no deductible or co-pay, available to 801,000 Iowans with private insurance;

* New coverage options for young adults under age 26;

* No lifetime limits on health benefits;

* No discrimination against children with pre-existing conditions, a protection that will be extended to all adults on January 1, 2014.

In addition, the new website includes a database of frequently-asked-questions about the law in an easy-to-understand, straightforward format. The Marketplace website also features a 24-hour toll-free call center (1-800-318-2596), online chat, and can provide information to consumers and small businesses in over 150 languages. Representatives are also equipped to assist the hearing impaired through TTY/TDD technology (1-855-889-4325).

I encourage you to visit this website to learn more about the open enrollment period and find out more about the benefits already in place.


Tom Harkin
United States Senator