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Health care according to our needs: Time to consider it a human right

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

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

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

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

The Patient Protection and Affordable Care Act of 2010 (the ACA, also known as Obamacare) was designed to and did significantly address health care access and affordability for millions. It created subsidies and devised options for a large swath of the U.S. population to purchase health insurance coverage on public exchanges. It expanded Medicaid. It created coverage mandates for businesses of certain sizes, and it eliminated free-riding by instituting tax penalties for persons who went uncovered.

Comprehensive health care reform via efforts to promote more private sector coverage, the creation and subsidization of Marketplace plans under the ACA, and expand public coverage with Medicaid have yielded important improvements in aggregate wellbeing. That’s undeniable. But the overall system is still socially inadequate: health care demands exceed available and affordable health care supplies.

Moreover, our complex system of private insurance providers, health care deliverers, and pharmaceutical firms generates unconscionable profits for some while gouging patients and payees for essential drugs and medical procedures. The system denies or severely rations needed services, creates navigational burdens for households and, in the aggregate, delivers health services at substantially higher costs per capita and to fewer recipients than our industrialized peer nations.

While getting less for more, our health outcomes are worsening compared to our western competitors.

Fixing it all is problematic. Comprehensive health policy change in the U.S. is inevitably preempted by the tax increase poison pill, which argues that needed reforms would burden households and stifle economic growth.

Yet most of us have no idea what our health care costs as a fraction of our total incomes, how much waste we endure personally or socially, and, importantly, what our health care ought to cost.

We presume, for example, that our employers pay for large portions of our health insurance. They don’t. Workers do. In essence, those so-called benefits are untaxed worker earnings that are diverted for health care coverage. They are considered part of our annual total personal incomes.

Those “employer-provided” insurance payments become the fees that we (not our employers) pay to belong to private health insurance risk pools. We add them to our additional premium costs plus our myriad out of pocket outlays to get the total cost of health care relative to our family incomes. That is how much we are currently contributing. And most families cannot tell you how much that is.

Would, for example, Senator Bernie Sanders’s and Senator Elizabeth Warren’s respective Medicare for All health care visions increase the sum of household current federal taxes plus private health care contributions? Analysis suggests that for the vast majority of households, they would not.

We further know that there are multiple categories of health service delivery that are over-priced in the U.S. compared to other industrial economies. Insulin is a notorious example. Furthermore, domestic prices vary widely, depending on whether they have been negotiated down by insurance companies and by federal providers.

And of course, health delivery in the U.S. requires layers of administrative structures at all levels that must process, verify, and ultimately approve claims or seek payment from customers.

Warren and Sanders both argue that Medicare for All will provide a comprehensive array of health care services for the same or a lower price per household than we are currently paying when all private payments and public payments are counted.

For both, health care becomes a universal entitlement to be funded substantially by boosted taxes on the wealthiest and by the whole of existing private and public outlays, significant portions of which are to be reallocated to health care delivery instead of unconscionable health system profits or for the purposes of administering a byzantine health delivery, financing, and bill collections structure.

It is the inevitable alignment of health policy and financial capacity with overarching national needs.

By so doing, some may be marginally worse off (especially the wealthiest), but millions will be massively better off.

Moving forward, I see three future health policy outcomes. In the first, nothing gets done. We pretend all is well or as well as it can be. Millions will remain underserved.

In another, policy incrementalists promote targeted scope and capacity fixes within the existing health delivery and policy superstructure.

This politically pragmatic view doesn’t rock the boat. It is as frightened of Medicare for All as much as it is beholding to the vast medical industrial complex, but it concedes that some fixes are needed.

Finally, one lays out a vision based on maximizing the social good that comprehensive health delivery reform will deliver and, at the same time, minimizing the harms the existing system causes.

It says, this is where we are going, and this is how we will get there. Climb on board or get out of the way.

It and it alone significantly reduces the damage that the existing system causes and remedies the cumulative policy failures of the past 70 years.

Top image: Photo by Karla Conrad from an Iowa CCI Action Fund rally for Bernie Sanders and Medicare for All in Des Moines on December 5.

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Steve King votes against coronavirus response bill (updated)

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The U.S. House has fast-tracked a bill responding to the economic challenges created by the novel coronavirus (COVID-19) pandemic. All 223 Democrats present–including Iowa’s Representatives Abby Finkenauer (IA-01), Dave Loebsack (IA-02), and Cindy Axne (IA-03)–voted for the bill shortly before 1:00 am on March 14, joined by 140 Republicans (roll call). U.S. Representative Steve King (IA-04) was one of 40 House Republicans to vote no.

House Speaker Nancy Pelosi and Treasury Secretary Steven Mnuchin negotiated the deal over “at least 20 phone calls” on March 12 and 13. In a letter to House members, Pelosi wrote, “While we could have passed this bill on our own, I believe it was important for us to assure the American people that we can work together to manage this crisis.”

CNN’s Congressional reporter Manu Raju reported late Friday afternoon,

The House is monitoring [President Donald] Trump’s Twitter feed very closely – once he tweets his support for the Pelosi-Mnuchin coronavirus deal, GOP members are expected to embrace it. That means they can then pass it under suspension of the rules, meaning they’d fast track it to final passage.

Trump tweeted his support for the bill in the evening.

Key provisions of the legislation include:

  • free coronavirus testing for everyone who needs a test, including the uninsured”;
  • provisions that would expand unemployment insurance ― giving states more funding if there is a rise in job losses because of coronavirus”;
  • a temporary paid sick leave program:

    The legislation includes 14 paid sick days for employees, as well as three months of paid emergency leave throughout the coronavirus crisis. Employers will be reimbursed for some of these costs through tax credits. At GOP insistence, the emergency leave provision will expire in a year. And Republicans were able to insert language exempting smaller businesses from the requirements.

  • more food assistance:

    The bill also would give the Trump administration more flexibility on who’s eligible for the food stamp program, a school lunch program used to feed low-income children during the summer — in case there are extended school closures — and the Women, Infants and Children nutrition program.

  • The bill does not include a payroll tax cut Trump had wanted. Erica Werner, Mike DeBonis, Paul Kane, and Jeff Stein reported for the Washington Post,

    Lawmakers in both parties have reacted coolly to the proposal, expressing qualms about its cost and the fact that it is not targeted to those directly affected by the pandemic. The legislation negotiated between Pelosi and Mnuchin did not include a payroll tax cut, and that omission emerged as one of the obstacles to reaching a deal.

    [House Minority Leader Kevin] McCarthy said the payroll tax could be addressed down the road.

    At this writing, King has not released a statement explaining his no vote or commented on the issue on his social media feeds. I will update this post as needed. UPDATE: King posted on Twitter on March 14 that he voted no because House members weren’t given time to read what they were voting on.

    King’s Democratic challenger J.D. Scholten released a statement criticizing what he called a “shameful” vote. Excerpts:

    “COVID-19 has already taken the lives of 41 Americans. Due to the lack of widespread testing, thousands more could already be infected. Experts say 200,000 to 1.7 million Americans could die. This is not hyperbole or overreaction. We need to meet the weight and seriousness of this pandemic with the full force of our government’s resources. This is the time for unwavering support of our workers, kids, and families. Yet, Steve King cast a vote against this bipartisan legislation that would provide free COVID-19 testing, paid leave, expanded food benefits and unemployment insurance, and protections for front-line health care workers. This is a shameful, selfish, and entitled vote.

    “Rural America, especially Iowa, faces unique vulnerabilities to this public health crisis. Our population is older, sicker, and poorer. More people are uninsured and under-insured and lack access to healthcare and paid leave. Our few and far between hospitals and clinics could easily be overwhelmed by a large volume of patients. Steve King’s vote is a slap in the face to every single Iowan as he enjoys paid leave, health insurance, access to healthcare, and a six figure salary without sitting on a single committee.”

    King did vote for a spending bill assembled earlier this month to address some needs related to the coronavirus. The House approved that legislation by 415 to 2 on March 4, and Iowa’s U.S. Senators Joni Ernst and Chuck Grassley joined all but one senator to send it to the president the following day. NPR’s Claudia Grisales summarized its main points:

    The plan includes almost $7.8 billion in new funding combat the spread of the virus at the local, state, national and international levels, according to details from the panel.

    The agreement also includes a provision to allow Medicare beneficiaries to access telehealth programs that will let them remotely see providers to assess symptoms potentially tied to the coronavirus.

    “To protect public health, the bill will allow Medicare providers to extend telemedicine services to seniors regardless of where they live, at an estimated cost of $500 million,” House Speaker Nancy Pelosi said in a written statement.

    The bill also allocates more $300 million to ensure that when a vaccine is developed — which some estimate could be a year or more away — that Americans will be able to access it regardless of their ability to pay, according to a congressional aide involved in the negotiators.

    Overall, the plan allocates nearly $6.5 billion to the Department of Health and Human Services, which includes $2.2 billion for the Centers For Disease Control and Prevention to address state and local preparedness. The HHS figure also includes $3.1 billion to pay for new medical supplies such as masks at the Strategic National Stockpile and research into vaccines and therapeutics.

    Top image taken from U.S. Representative Steve King’s official Facebook page.

    The post Steve King votes against coronavirus response bill (updated) appeared first on Bleeding Heartland.

    Joni Ernst turned her back on Iowans

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    Kay Pence is Vice President of the Iowa Alliance for Retired Americans. -promoted by Laura Belin

    U.S. Senator Joni Ernst is no longer working for Iowans. She is working at the behest of President Donald Trump, no matter what he says or does. She has become a puppet to Trump no matter how low he sinks, voting with the president more than 91 percent of the time and following his lead to attack our healthcare and defund Social Security.

    The Iowa Alliance for Retired Americans recently invited Ernst and her Democratic challenger Theresa Greenfield to virtual forums celebrating the anniversaries of Medicare and Social Security. I was not surprised when Ernst failed to show up for either forum, because she has such a dismal record on both issues.  

    Ernst has voted to repeal the Affordable Care and Patient Protection Act entirely multiple times, starting in July 2015, when she voted to include repeal in a highway funding bill that was defeated. In December of that year, Ernst supported a similar amendment that passed the House and Senate, but was thankfully vetoed by President Barack Obama. Republicans knew trying to repeal the 2010 health care reform law would be fruitless, but did it anyway to waste time and tax dollars, all to please their donors.

    Ernst voted again and again to dismantle and repeal the Affordable Care Act — with absolutely no plan in place to make up the difference. No plan on how to get more people covered and insured. With the Affordable Care Act being challenged in court yet again, Ernst is keeping a lid on how she feels about that lawsuit, supported by the Trump administration.

    In contrast, Greenfield will protect coverage for those with pre-existing health conditions. She wants to improve the Affordable Care Act by creating a public option and bringing down the cost of co-pays and price of prescription drugs and life-saving medicines that seniors depend upon. Greenfield pledged to strengthen Medicare by allowing the program to negotiate drugs prices, saving beneficiaries and taxpayers millions of dollars.

    Although Ernst claims to be concerned about the Social Security trust fund, she has backed numerous proposals that would weaken its solvency. In 2014, she considered using payroll taxes to create personal savings accounts for anyone entering the workforce.

    The senator sharpened her attack on our earned retirement benefits by introducing the CRADLE Act in 2019. That bill would deceptively allow parents to draw Social Security funds for parental leave. Then in July of this year, she introduced the “FRNT LINE Act,” a scheme to reward essential workers by waiving payroll taxes.

    Ernst made her position on Social Security clear when she started telling her funders things like, Congress should hold discussions about Social Security, “behind closed doors,” and that programs like Social Security and Medicare were, “out of control.”  

    Even more worrisome than Ernst’s own attacks on our Social Security has been her silence regarding President Trump’s harebrained plan to defer payroll taxes until the end of the year and perhaps permanently. Elimination of the payroll tax, Social Security’s dedicated funding stream, would deplete the Social Security trust fund by 2023.

    Even Iowa’s senior Senator Chuck Grassley quickly rejected the plan as a raid on Social Security and said that this idea would not even make a noticeable difference in workers’ paychecks.    

    Iowans need a Senator who will not play games with our Social Security. Greenfield has made protecting Social Security a centerpiece on her campaign. At the age of 24, when her first husband, an IBEW electrical worker, tragically died on the job, it was Social Security survivor benefits that helped keep Greenfield and her two young children out of poverty. The Democrat has said flat out that she opposes the privatization of Social Security.

    Ernst turns a blind eye not only to Trump’s attacks on Social Security, but also to his comments denigrating military service members and veterans. Having served in the National Guard, Ernst should be standing up to Trump’s attacks on military families. But every chance she has had to condemn those comments (which is disgustingly far too many) she has chosen to stand by the president. 

    When outraged Iowans challenged Ernst about Trump bashing wounded war hero Senator John McCain, Ernst claimed McCain was her friend. She said she was uncomfortable when the president disparaged him, but she did nothing.

    When Trump mocked Gold Star parents, Ernst was too scared to criticize him. More recently, when news broke of Trump repeatedly characterizing fallen American soldiers and wounded veterans as “losers” and “suckers,” Ernst again said and did nothing. The senator’s praise of military families rings hollow when she stands by a commander in chief who uses the military as props in his reality show.

    Greenfield comes from a military family and has a son in the army. As soon as the disparagement story broke, she called on the Senate to work across party lines to get to the bottom of the story. If the allegations are true, Trump is not fit to lead.  

    Ernst may not have copied Trump’s attacks on veterans and service members, but she sure has followed his lead on disrespecting the doctors, nurses, and health care workers putting their lives on the line each day to fight COVID-19. Health care workers across the state and across the country were outraged when Ernst lent support to a conspiracy theory, speculating that medical professionals may be inflating the number of coronavirus cases and deaths. “These health-care providers and others are reimbursed at a higher rate if COVID is tied to it, so what do you think they’re doing?” she told an audience in Waterloo.

    Greenfield quickly rejected those comments, recognizing the danger of elevating outrageous conspiracy theories.

    While Iowa sees the greatest surge in COVID-19 cases in the country, Senator Ernst is pushing an irresponsible and blatantly false conspiracy theory about our health care workers. Iowa’s doctors, nurses and frontline health care workers have spent the last six months putting themselves in harm’s way to care for us and keep us safe.

    Greenfield has repeatedly expressed support for hardworking people in health care and called for Ernst to immediately apologize and explain herself. She has also urged the incumbent to join her in following the advice of scientists and medical experts, who have called for a statewide mask mandate.

    Truth, honesty, and respect matter. We need someone who isn’t afraid to stand up to corruption and depravity. We need someone we can be proud of to represent Iowa. Ernst is not that person. She has become a sycophant for Trump at the cost of Iowans.

    I can’t wait to cast my vote for a candidate who will stand up for veterans, seniors, healthcare workers, and all Iowans. Theresa Greenfield has my vote.

    Kay Pence is a retired Communions Workers of America (CWA) union representative and Vice President of the Iowa Alliance for Retired Americans.  Pence started her career as a technician for Northwestern Bell Telephone company in 1972 and while working full time earned a BA from Marycrest University and a MBA from Saint Ambrose University in Davenport, IA.  Pence is the mother of three sons and grandmother to six and resides in rural Eldridge, IA with her husband of 45 years.

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    Most Iowans in Congress supported latest COVID-19 package

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    The U.S. House and Senate on December 21 approved a $2.3 trillion package to fund the federal government through September 30, 2021 and provide approximately $900 billion in economic stimulus or relief connected to the coronavirus pandemic.

    No one in either chamber had time to read the legislation, which was nearly 5,600 pages long, before voting on it. Statements released by Iowans in Congress, which I’ve enclosed below, highlight many of its key provisions. The unemployment and direct payments to families are clearly insufficient to meet the needs of millions of struggling Americans. Senate Republicans blocked aid to state and local governments, many of which are facing budget shortfalls. President-elect Joe Biden has vowed to push for a much larger economic stimulus package early next year.

    The legislation headed to President Donald Trump’s desk includes some long overdue changes, such as new limits on “surprise billing” by health care providers for emergency care and some out-of-network care.

    Laura Olson reported for States Newsroom,

    House leaders divided the bill into two parts and passed the emergency relief portion on a 359-53 vote. Another portion, which included Pentagon spending for the coming year, passed 327-85. The Senate combined the two bills and cleared the package in an overwhelming 92-6 vote shortly before 11 p.m. CT.

    The roll calls (here and here) show yes votes for the three Democrats who represent Iowa in the House: Abby Finkenauer (IA-01), Dave Loebsack (IA-02), and Cindy Axne (IA-03).

    Representative Steve King (IA-04) was among a small group of House Republicans who did not vote on either bill. I didn’t see any comment on his social media feeds indicating why he was absent or whether he would have supported the legislation. Published roll call votes indicate King has missed most of the House floor action since the November election.

    GOP Senators Chuck Grassley and Joni Ernst both supported the legislation in the upper chamber.

    Statement released by Representative Abby Finkenauer, December 21:

    WASHINGTON, DC – Congresswoman Abby Finkenauer (IA-01) released the following statement on passage of the COVID-19 relief package and Fiscal Year 2021 Appropriations:

    “lowans need help as they continue to battle the COVID-19 pandemic. Since this summer, I have pushed the Senate and White House to work together with the House on a bipartisan agreement that provides the relief hard working families need.

    “While I’m happy to have helped pass a deal to help folks just before the holidays, this package will not come close to undoing the pain this year has brought — especially to those who have lost loved ones. The package passed today provides, to an extent, urgently needed help for families, small businesses and so many Iowans struggling under the hardships caused by this pandemic. However, stimulus checks should be higher, and more support given directly to Iowans who need it most.

    “While I supported this deal reached by the House, Senate, and White House, it is my sincere hope that the next Congress and Administration will provide additional help to the families, businesses, and local Iowa communities who will still need it.”

    Background on relief package and funding bill:

    In addition to $600 direct payments to families, supplemental unemployment benefits, and funding for struggling small businesses, the COVID-19 relief package and end-of-year government funding bill includes a number of bills and provisions Congresswoman Finkenauer fought for on behalf of northeast Iowa.

    Health Care

    ● The package incorporates Finkenauer’s Rural Community Hospital Demonstration Extension Act, which will ensure “tweener” hospitals like Grinnell Regional Medical Center will continue to get enhanced reimbursements for the inpatient services they provide for the next five years.
    ● The package incorporates Finkenauer’s legislation to extend Medicare’s work geographic index floor for three years, ensuring fair reimbursements for physicians in rural areas.
    ● The package includes Finkenauer-supported legislation to extend Medicaid eligibility to citizens of the Freely Associated States lawfully living in the United States, including the many Marshallese residents of the First District.

    Infrastructure

    ● Includes the bipartisan Water Resources Development Act (WRDA) of 2020, which Congresswoman Finkenauer helped craft and pass through the House. This bill will include policy provisions important to Iowans, including: additional investment in lock and dam infrastructure, changes to improve federal flood mitigation benefit-cost-ratio calculations like for flood protection construction, and Rep. Finkenauer’s amendment to cut red tape and improve communication between the US Army Corps of Engineers and local governments

    Appropriations Priorities

    ● Secured increased funding for endometriosis research, allowing the National Institutes of Health to double their investment in endometriosis research from last year’s funding levels. Endometriosis research will now also be eligible for funding through the Department of Defense Peer-Reviewed Medical Research Program.
    ● Includes a provision championed by Congresswoman Finkenauer that would increase the federal funding limit for the Silos & Smokestacks National Heritage Area. The Silos & Smokestacks National Heritage Area encompasses 117 sites and attractions across Northeast Iowa, including scenic routes, farms, wineries, museums and more. The provision would increase the Area’s federal funding limit, enabling Silos & Smokestacks to continue telling the story of America’s agricultural history, as well as promoting tourism to Northeast Iowa.
    ● Provides a $10 million increase for the Defense Department’s Manufacturing Technology Program. This funding will be used to support the University of Northern Iowa’s Additive Manufacturing Center partnership with Youngstown State University on supply chain adoption of additive manufacturing, automation, and robotics. This funding and partnership will provide industry-tailored training, access to applied research, and technical assistance to small businesses, so that they can efficiently engage in the defense manufacturing supply chain.

    Small Business

    ● The package incorporates Finkenauer’s PPE Act to allow businesses to use Paycheck Protection Program loan money to cover the expenses of providing personal protective equipment to their employees.

    Derecho Recovery

    ● Includes provisions from Finkenauer’s Disaster RELIEF Act, which would provide tax relief to Iowans impacted by August’s derecho. Specifically, the package will provide direct tax relief for Iowa families and provide a tax credit to Iowa businesses to help retain employees following the disaster.

    Statement released by Representative Cindy Axne, December 21:

    Key Axne Priorities Included in Bipartisan Agreement to Fund Critical Programs, Secure New COVID-19 Relief

    Provisions include expanded unemployment benefits, rental assistance, a new round of direct payments, an extension of the federal eviction moratorium, and measures to help Iowa’s working families, small businesses, and biofuel industry

    WASHINGTON D.C. – Today, the U.S. House of Representatives advanced a comprehensive package of legislation that includes a wide variety of priorities and provisions fought for by Rep. Cindy Axne (IA-03) over the past year.

    The bipartisan agreement, H.R. 133, includes a new round of coronavirus (COVID-19) relief for Iowa’s families and communities, provisions to help crack down on surprise medical billing, and full funding for government programs through the end of Fiscal Year 2021.

    “This is a long-overdue measure that will help Iowans in need. From direct support for Iowa families to long-term protections provided by new federal law, this legislation does a great deal to not only provide the assistance needed in the midst of a dark winter of health and economic crises, but also invest in the success of our communities and businesses for years to come,” said Rep. Axne. “While this legislation is not perfect, I’m pleased to see key priorities that I have worked to secure this Congress included in the final agreement, such as an extension of unemployment benefits and another round of direct payments, rental assistance and an extension of the eviction moratorium, authorization to roll over unused child care savings into 2021, and provisions to support expansion of broadband connectivity, assistance for our biofuels industry, and much more.”

    The COVID-19 relief sections of the legislation contain key priorities championed by Rep. Axne, including:

    ● $25 billion for the first-ever emergency federal rental assistance program to help families impacted by COVID-19 that are struggling to make rent or have past-due rent and utility payments, as well as an extension of the Centers for Disease Control and Prevention’s (CDC) eviction moratorium through January 31, 2021.
    ● An additional $300 per week for all workers receiving unemployment benefits through March 14, 2021.
    ● An additional round of Economic Impact Payments of $600 for individuals making up to $75,000 per year, $1,200 for couples making up to $150,000 per year, and $600 for each child dependent.
    ● $284 billion for first and second forgivable PPP loans, with dedicated set-asides for very small businesses and lending through community-based lenders like Community Development Financial Institutions (CDFIs).
    ● $10 billion in emergency funds for the child care sector through the Child Care and Development Block Grant (CCDBG) program to help stabilize the child care market and allow states to expand child care assistance to essential workers and working families who are in great need of child care services.
    ● Emergency provisions championed by Rep. Axne to allow unused savings in dependent care assistance plans (DCAPs) and health flexible spending accounts (FSAs) from 2020 to roll over and be used through the end of 2021, which will save families from losing up to $5,000 at the end of the year.
    ● Statutory language to allow the Department of Agriculture to provide relief funding for biofuels producers and the ethanol industry.
    ● An extension of refundable payroll tax credits for paid sick and family leave, first approved by Congress earlier this year, through the end of March 2021.

    The final agreement also includes other important items pushed by Rep. Axne, such as:

    ● Funding to improve broadband mapping – which has left many Iowa communities unable to get funding to build new broadband – and the ACCESS Broadband Act, legislation Rep. Axne cosponsored that will improve federal grant accessibility for smaller local providers.
    ● An extension of FY19 BUILD grant deadlines to provide recipients, including the Central Iowa Water Trails Project, more time to meet deadlines due to delays caused by COVID-19.
    ● A bipartisan measure to protect patients from surprise medical bills and establish a fair framework to resolve payment disputes between health care providers and health insurance companies.
    ● More than $4 billion to hard-hit families by allowing them to use their 2019 income to determine how much they receive in the Earned Income Tax Credit and Child Tax Credit.
    ● The Energy Act of 2020, which invests in clean energy research and development, and includes four bills Rep. Axne cosponsored:
    The Wind Energy Research and Development Act, to research and develop wind technologies and their grid integration.
    The Solar Energy Research and Development Act, to fund research and development of solar energy technologies.
    The ARPA-E Reauthorization Act, which reauthorizes ARPA-E and expands its authority to work on projects relating to nuclear waste clean-up and management issues and projects to improve energy infrastructure, as well as to pursue scale-up and demonstration of transformational clean energy technologies.
    The Clean Industrial Technology Act, which creates a research, development, and demonstration program on technologies to reduce emissions from the manufacturing sector, including cement, steel, and chemicals manufacturing processes, high-temperature heat generation, alternative materials, and carbon capture for industrial processes.

    Although this agreement is expected to be the last comprehensive package passed by the 116th Congress, Rep. Axne is already emphasizing the additional work left to be done in the new year.

    “While this is an important agreement that helps keep our government open and fund long-term investments that will help recovery and growth of our nation, the emergency COVID-19 provisions of this bill are still only short-term relief,” said Rep. Axne. “This cannot and should not be Congress’ last act to help those suffering through dual health and economic crises – and when the 117th Congress begins in just a few short weeks, I look forward to working with my colleagues in both parties to continue the important work of supporting our constituents. Just as we know that this virus will not disappear on January 1st, we should not think that our efforts to support families, businesses, and communities will end when the book closes on this session.”

    H.R. 133 also includes important provisions to support Iowa’s communities and critical programs that help Iowans:

    ● Essential funding for vaccine procurement and distribution – $19 billion for the Biomedical Advanced Research and Development Authority (BARDA) for manufacturing and procurement of vaccines and therapeutics and $8.75 billion to the CDC to aid distribution and tracking of vaccines across state and local public health agencies.
    ● An additional $54.3 billion for the Elementary and Secondary School Emergency Relief Fund and $22.7 billion for the Higher Education Emergency Relief Fund.
    ● Streamlines the Free Application for Federal Student Aid (FAFSA) and expands outreach and awareness to make it easier for Iowans to apply and qualify for federal student aid.
    ● Over $11 billion to the Department of Agriculture to continue to support producers, growers, and processors affected by COVID-19 market disruptions.
    ● An extension of the Pandemic Unemployment Assistance (PUA) program, which expanded coverage to the self-employed, gig workers, and others in nontraditional employment, and the Pandemic Emergency Unemployment Compensation (PEUC) program, which provides additional weeks of federally funded unemployment benefits to individuals who exhaust their regular state benefits.
    ● An extension of Iowa’s ability to use remaining funds in its $1.25 billion allocation from the Coronavirus Relief Fund until December 31, 2021.
    ● Reauthorization of the second generation biofuel tax credit, which was due to expire at the end of 2020. Rep. Axne successfully fought to renew the tax credit in the past.
    ● $13 billion for nutrition assistance, including a 15% increase in monthly SNAP benefits.

    In order to finalize the compromise agreement on necessary improvements to flood control measures, the agreement also includes the bipartisan Water Resources Development Act of 2020.

    Statement released by Senator Joni Ernst, December 21:

    Ernst: More COVID-19 Relief is Soon Headed Iowans’ Way
    Ernst worked across the aisle to ensure more help for Iowa child care centers, small businesses, farmers, health care systems; first time aid for biofuel producers, local news outlets

    WASHINGTON – U.S. Senator Joni Ernst (R-Iowa) today supported and helped deliver additional COVID-19 relief for Iowans in the bipartisan package that passed the Senate.

    “I’ve long been calling for Congress to provide additional relief to Iowans and all Americans who continue to suffer through this pandemic; and now, more COVID-19 relief is soon headed Iowans’ way,” said Senator Joni Ernst.

    “With this new bipartisan relief package, we are bolstering the Paycheck Protection Program for Iowa small businesses – including our local news outlets; supporting child care centers and working families; aiding Iowa farmers and biofuel producers; and helping make sure our health care systems – including those in Iowa’s rural areas—continue to have what they need to fight this virus and distribute the vaccine. This bipartisan bill will bring much-needed aid to Iowans on the front lines of this pandemic, those who are facing unemployment, and families fighting to stay afloat.”

    Below are just some of the key measures that Senator Ernst helped deliver for Iowans through this COVID-19 relief package:
    ● Provides direct payments of up to $600 per person and $600 per child
    ● Permits USDA to make payments to producers for losses incurred from the depopulation of livestock and poultry due to insufficient processing access
    ● Provides assistance to agricultural producers, growers, processors, specialty crops, non-specialty crops, dairy, livestock, poultry, and contract livestock and poultry producers
    ● Allows for payments to producers of advanced biofuel, biomass-based diesel, cellulosic biofuel, conventional biofuel, or renewable fuel
    ● Temporarily increases monthly SNAP benefits by 15%
    ● Increases broadband funding, including support for rural broadband and telehealth
    ● Supports grants to stabilize the child care sector and allow providers to safely reopen
    ● Allows for a second round of Paycheck Protection Program (PPP) loans for struggling businesses
    ● Makes local chambers of commerce and news outlets eligible for the PPP and improves loan access for farmers
    ● Provides for manufacturing and procurement of vaccines and therapeutics and for CDC to ensure broad-based distribution, access, and vaccine coverage to all Americans
    ● Provides resources to states and localities for COVID-19 testing, contact tracing, containment, and mitigation
    ● Supports hospitals and health care providers with additional relief funds
    ● Creates a voluntary Medicare payment designation that allows struggling rural hospitals to convert to a Rural Emergency Hospital to preserve access to emergency medical care in rural areas
    ● Funds support for mental health and substance abuse services
    ● Allows all Medicare beneficiaries to receive mental health services through telehealth on a permanent basis

    The post Most Iowans in Congress supported latest COVID-19 package appeared first on Bleeding Heartland.

    IA-Sen: Medicare for All drives Glenn Hurst’s campaign

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    A third Democrat joined the race for Iowa’s U.S. Senate seat on July 29. Dr. Glenn Hurst made clear that one issue in particular is driving his campaign.

    “I went back to school and became a doctor because I saw a need in the rural communities I love and call home,” Hurst said in a news release. “I’ve had a front-row seat to the tricks insurance companies use to avoid paying for care, drowning providers in paperwork when we should be with our patients. I’m running for the U.S. Senate because Iowans deserve better. We deserve Medicare for All.”

    Hurst introduced his campaign on Twitter using the #BoldProgressive and #MedicareForAll hashtags.

    His launch video emphasizes his work as a family physician in rural areas as well as his leadership of the Iowa Democratic Party’s Rural Caucus.

    My transcript:

    Hurst, to camera: I’ve spent my adult life caring for people. At 32, when a friend of mine was having trouble caring for her son, I became a foster parent and provided stability for my son.

    At the same time, I realized our rural community’s biggest need was doctors. So I went back to college and graduated from medical school.

    When it came time to pick where to practice medicine, I bet on rural Iowa. And when COVID hit, that’s when I took my medical education to the level of advocacy for all Iowans.

    CNN journalist: Dr. Glenn Hurst is a family medicine physician who has a health clinic in western Iowa, and he’s also chair of the Iowa Democratic Party Rural Caucus.

    Hurst, on CNN: We’re seeing our hospital beds having extended lengths of stay for COVID positive patients, compared to other forms of pneumonia.

    Yahoo finance journalist: Joining us now to discuss is Dr. Glenn Hurst. He’s the vice chair of the Iowa Democrats’ Rural Caucus.

    Hurst, on Yahoo finance: So I think rural health care is a primary issue for voters in Iowa, in rural Iowa. We struggle with not just access to insurance products. We’re struggling with access to a physician, a physician assistant, a nurse practitioner. Our hospitals are closing, our nursing homes are closing. So it is a paramount issu.

    Journalist: Dr. Glenn Hurst, thank you so much.

    I’m Glenn Hurst. I’m a father, a doctor, an Iowan. And I’m running for the U.S. Senate because Iowa deserves a healthy future.

    I’m Glenn Hurst, and I approved this message.

    Hurst was a featured speaker at a July 24 rally outside the state capitol to support Medicare for All. He recently published a book about his political activism called Where Your Hands Are: Memoir of an Indivisible. He is also an occasional Bleeding Heartland guest author who has called for Democrats to focus more on down-ballot races and “unabashedly” espouse Democratic values instead of “running to the middle.

    During the early weeks of the COVID-19 pandemic, Hurst warned on this website about the threat posed to vulnerable Iowans in nursing homes. To date, nearly 40 percent of the Iowans who died of COVID-19 (at least 2,429 individuals) had been living in nursing homes, according to federal government data Sara Anne Willette compiled.

    Former Crawford County Supervisor Dave Muhlbauer, the first Democrat to launch a 2022 Senate campaign, describes himself as an “old-school, farming, labor Democrat.”

    Former U.S. Representative Abby Finkenauer joined the Senate field last week, touting her commitment to public service and working families.

    At least one other Democrat is seriously considering this race: retired Admiral Mike Franken, the runner up in the 2020 Senate primary.


    Full text of July 29 news release:

    MINDEN, Iowa, July 29, 2021—Today Dr. Glenn Hurst of Minden, Iowa announced his candidacy for the U.S. Senate. Hurst, a physician and health administrator in Pottawattamie County, cites the impact of healthcare on his community as a driving force behind his run. 

    “I went back to school and became a doctor because I saw a need in the rural communities I love and call home,” said Hurst. “I’ve had a front-row seat to the tricks insurance companies use to avoid paying for care, drowning providers in paperwork when we should be with our patients. I’m running for the U.S. Senate because Iowans deserve better. We deserve Medicare for All.” 

    Hurst provides care and oversees clinics in his hometown of Minden, Iowa and the surrounding Pottawattamie County area. He is a leader in the Iowa Democratic Party as Chair of the Rural Caucus, a Minden City Councilman and Chair of the Third Congressional District Central Committee where he worked tirelessly on the successful re-election of Congresswoman Cindy Axne.

    A founding member of the Indivisible movement in Iowa and Nebraska, Hurst has actively organized in rural Iowa to advocate for Medicare for All, to fight for a living wage for all Iowans and to support labor unions by rallying against collective bargaining limitations. 

    Born on a U.S. military base, Hurst  moved with his family until they settled in the rural Midwest. He completed his undergraduate studies at the University of Nebraska Omaha and graduated from the University of Nebraska Medical Center as a Medical Doctor in 2006. Hurst is committed to fighting for Medicare for All, reinvesting in rural communities, and solving today’s problem with the jobs of tomorrow. 

    The post IA-Sen: Medicare for All drives Glenn Hurst’s campaign appeared first on Bleeding Heartland.

    Understanding single-payer health care: Medicare for All

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    Glenn Hurst is a family physician in southwest Iowa and a Democratic candidate for U.S. Senate.

    Several years ago, my wife and I had a friend our family called Grandma Ruth. Ruth was special to us. She was one of the first people we brought my newborn daughter to meet. She had taken a special interest in our kids and was always present for their big events. Often, we would pick her up and bring her to our house for football parties and holidays. She included us in the celebration of her life events as well. She was estranged from her own family and just became part of ours.

    I learned a lot from observing how Ruth navigated her world. She had learned how to use senior transportation services to get to doctor appointments as well as to the grocery store or other activities. She knew how to arrange Meals on Wheels and how to keep current with her disability to remain eligible for services she absolutely needed.

    Ruth had a great sense of humor. She would often remind me of what a psychiatrist had said when she caught her mumbling to herself. She said, “He told me it was ok to talk to myself, and it was even ok to answer myself. It is not a problem until you start disagreeing with yourself.”

    Ruth was living on her own in a senior apartment for a number of years until she fell and fractured her hip and then her other hip. Then her dementia progressed to where she needed 24-hour nursing care. After my wife and I and another friend took on the duties of power of attorney, I got a front-row view—from the patient and the family perspective—on how broken the health care system in this county had become.

    First, she had to become impoverished to qualify for Medicaid, because Medicare (which she had) did not cover long-term care. She was continually buying a new recliner or dresser for her room so that she did not have too many savings and would not get kicked off Medicaid. When we wanted to move her closer and out of a facility that she did not like, we had to wait for her to get sick enough to require hospitalization. We then hoped that she survived and that there was a Medicaid bed in the facility we wanted to transfer her to.

    Ruth was lucky in some ways. I have seen other patients who frequently changed pharmacies and therapy groups due to facility contracts and payor relationships. We had known her through the addiction recovery community, and she was almost completely cut off from that in the nursing home. If we had not brought meetings into her facility, she would have been cut off from the central theme of the last 40 years of her life.

    I share all of this to demonstrate how fractured and patient-unfriendly the current health care system can be for people who need to access it on a regular basis. A single-payer system, as spelled out in the Medicare for All Act, would solve many of these problems.

    A Medicare for All product would look very different from the current Medicare system. It would include coverage for vision, hearing, dental, mental health parity, and long-term care, which are absent from the current system. It would broaden services to the elderly, those who live with a disability, the geographically isolated, and the poor and underserved.

    It would be available to every person in the United States, not just those over the age of 65. It would bring efficiency to health care in the form of consistent processes for submitting claims and predictable payment timelines. It would give administrators the power to negotiate the price of pharmaceuticals. It would allow dignity and choice.

    A system that provides appropriate care for all translates into a healthier society. One in which there is a greater portion of the population that is available to contribute to the economy. One in which wasteful transportation and coordination of accessibility are streamlined into easy access for all. It improves the quality and the fund of knowledge of providers through more frequent interactions with experts outside their traditional spheres. It addresses the isolation of rural communities and demands an infrastructure that increases the opportunities for other businesses to thrive.

    The defining elements of a successful single-payer system are:

    • No networks, 
    • No premiums, 
    • No deductibles, 
    • No copays, 
    • No surprise bills,
    • Patient choice of providers,
    • No change in take-home pay for the majority of Americans.

    Implementing a Medicare for All system will build on our experience of already successful single-payer systems, which exist in the United States but for limited populations. The medical system that serves the U.S. military is like a single-payer system, as is the Veterans Administration’s medical system. Both have created efficiencies in documentation and achieved excellence in the delivery of wellness care to diverse populations across the country and around the world. 

    Our response to the COVID-19 pandemic taught many lessons with regards to technology in the physician clinic. The expanded use of telemedicine provided safe and effective access for patients in remote or quarantined settings. Electronic participation in care coordination with home care providers, nursing homes, therapists, and between providers improved the quality of care and created efficiencies that allowed more people to be served.

    One of the most important outcomes of a single-payer system is that quality of care becomes the driver of where the patient chooses to access care. In the rural setting, where patients are currently driven away from their local providers by closed networks, they would be able to access convenient care. Health outcomes would improve as chronic conditions could be locally managed in a timely manner. Home-health services provided by families would not result in loss of coverage. They would be paid and recognized as health care team members.

    In the U.S., we spend more than double the amount of most other industrialized nations on health care per capita. In 2018, that was more than $10,500 per person. The second-highest spender was Germany, which has a universal health system and spends just under $6,000 per person. Despite our excessive spending, the U.S. ranks ninth against those same countries in health outcomes for our citizens.

    Our goals to reduce health care costs and increase quality of care are not in conflict.

    Top photo of "Grandma Ruth" provided by the author and published with permission.

    The post Understanding single-payer health care: Medicare for All appeared first on Bleeding Heartland.

    Iowa CCI Action endorses Glenn Hurst for U.S. Senate

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    The Hurst for Iowa campaign just received an overwhelming endorsement from Iowa’s leading progressive organization, Iowa Citizens for Community Improvement Action Fund. In the announcement, they stated, “We’re endorsing Glenn because he’s with us on the issues and on challenging business-as-usual politics and the status quo. He shares our belief that real change comes from the ground up, and he has a plan to win and can excite a grassroots base to turn out to the polls on June 7.”

    CCI Action Fund explained the choice as follows:

    Elections are a means to advance our organizing campaigns. And when it comes to getting profits out of healthcare, we need elected officials who will go toe-to-toe with health insurance greed and Big Pharma.

    That’s why we’re excited to endorse Glenn Hurst for Senate!

    We know our privatized Medicaid system isn’t working for Iowans, private insurance too often denies the care we need, and life-saving drugs are priced out of reach for many. It’s clear we need a healthcare system that puts patients before profits and care before corporate greed.

    As a small-town rural doctor in western Iowa, Dr. Glenn Hurst knows this as well and is committed to the fight for Medicare for All.

    Susie Petra, a CCI Action member from Ames, characterized the campaign by saying,

    Glenn Hurst is a person who actually ‘walks the talk’ and shows that he can play a vital role in solving the problems our planet faces. Glenn has a firm grasp on the issues facing rural and urban Iowans – healthcare, water quality, and industrial agriculture monopolies, and how to revitalize rural Iowa. And he knows we must get profits out of healthcare and move to pass Medicare for All.

    As part of their endorsement, Iowa CCI Action Fund organizes weekly phone banking in support of their candidates.

    “These calls make a difference and help us connect more Iowans to our issue organizing work to win big change.”

    Interested parties can register to phone bank here: https://iowacci.ourpowerbase.net/civicrm/event/register...

    Individuals who wish to invest in their values by pledging a contribution toward the campaign can do so at: https://secure.actblue.com/donate/cciendorses

    The post Iowa CCI Action endorses Glenn Hurst for U.S. Senate appeared first on Bleeding Heartland.

    Capping costs no substitute for lowering drug prices

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    Sue Dinsdale is the director of Iowa Citizen Action Network and leads the Health Care For America and Lower Drug Prices NOW campaigns in Iowa.

    U.S. Senator Chuck Grassley got it right when speaking about efforts to lower prescription costs. He acknowledged the “difficulty of passing something like this in a Republican Congress,” adding, “If we want to reduce drug prices, then we need to do it now.”

    For years we’ve been hearing members of Congress promise to tackle rising drug prices without any action. Prescription drugs and the outrageous price of medicine has made reform a top issue that attracts bipartisan support. A recent national poll indicated that 91 percent of voters consider lowering drug prices a very important issue in the upcoming election, ranking it above COVID-19 worries. 

    Long before the pandemic or inflation concerns, millions have worried about being able to afford their prescriptions. Drug corporations have been raising prices faster than inflation for years, while people of all ages struggle to keep up or are forced to choose between medicine and other basic necessities.

    People in Iowa and across the nation have waited too long for a solution to prescription drug price-gouging and it is time for Congress to act. Right now there is majority support in the Senate for tackling prices through negotiations in Medicare and passing legislation that would finally put in place common sense reform to address rising prices. 

    We hear a lot about creating a national insulin cap, but any proposal that caps the cost of one or more drugs will not fundamentally address the root of the problem, which is rising prices. We need our elected representatives to help seniors and others afford their medicine by supporting price negotiations that actually stop the drug corporations from charging whatever they want and raising prices at will.

    Cost containment can only have limited impact for a limited number of patients. The burden will continue to rise for taxpayers, businesses and those paying premiums.

    Capping the cost of insulin (or co-pays for insulin) may be worthy ideas, but not a solution. It won’t stop drug corporations from setting the price of cancer drugs outrageously high and forcing up to half of cancer patients into debt to get life-saving treatments. It won’t stop drug corporations from raising prices on common drugs that seniors and the rest of us use every day. Caps may mean individuals pay less at the pharmacy, but they will pay more in premiums and more in taxes for programs like Medicare thanks to cost-shifting. 

    The price of half the drugs in Medicare, the health care program for seniors, increased faster than inflation in 2020. Those premium increases were not tied to one specific drug, but rather to thousands of commonly used medications. Currently, there is no limit on what seniors pay out of pocket for drugs in Part D, forcing many to skip doses, not fill prescriptions, or forgo other critical needs to get their medicines. 

    These are necessary fixes that Congress needs to address to limit out of pocket costs. But it shouldn’t stop there. To get to the root of the problem, we need to be able to negotiate prices for medicines in Medicare the way other government agencies already do. The Department of Veterans Affairs and Medicaid pay half of what Medicare pays for prescription medicines, thanks to negotiated prices.

    We already know that negotiating prices will get consumers a better deal than continuing to give drug corporations monopoly power to set and keep their prices high. It’s that monopoly power that enables the corporations to raise prices twice a year. In 2022 alone, drug corporations have already raised the price of over 800 medicines by more than 5 percent. Capping costs—on insulin or any other drug—is an important step toward affordability but it doesn’t curtail drug corporations’ price-gouging.  

    There is a solution: Combine cost-containment measures with policies that rein in rising costs, like Medicare negotiations and inflation caps. It’s time for our Iowa delegation to follow U.S. Representative Cindy Axne’s lead and heed the comments from Senator Grassley and support sensible legislation that would make medicines affordable for everyone. 

    Top photo of Sue Dinsdale provided by the author and published with permission.

    The post Capping costs no substitute for lowering drug prices appeared first on Bleeding Heartland.


    Iowa Democratic Party’s Disability Caucus endorses Dr. Glenn Hurst

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    Julie Russell-Steuart is a printmaker and activist who chairs the Iowa Democratic Party’s Disability Caucus.

    Glenn Hurst is a rural doctor in the small southwestern Iowa town of Minden and a founding member of Indivisble Iowa, whose activism helped elect U.S. Representative Cindy Axne. He faces Abby Finkenauer and Mike Franken in the June 7 Democratic primary for U.S. Senate.

    Dr. Hurst has earned our endorsement for his strong experience advocating for people with disabilities and because he is laser focused on improving the lives of the American people in crucial ways.

    As a country, we are in a health care crisis because of a disastrously managed COVID-19 pandemic, on top of an already stressed system that does not serve people well.

    Here in Iowa, the privatization of Medicaid led to people with disabilities experiencing a significant loss in delivery of care and availability of care supports in-home. Although reform may be on the way with the recent merging of the Iowa Department of Public Health and the Iowa Department of Human Services, a federal-level change through the Medicare for All Act would dramatically improve healthcare and do the most for not only all Iowans, but all Americans.

    Hurst has never wavered in his advocacy for Medicare For All. As a doctor, he’s had an inside view of how the current system is broken. People delay care until it's too late and have a more critical diagnosis. The insurance industry's profit-driven bottom line dictates health care decisions, rather than what doctors consider the appropriate care for patients. For many, the best treatment can’t be had.

    And then there’s the pandemic. How will health be managed as people recover from COVID-19 in a broken system? Long COVID, a confusing array of 200+ documented symptoms, may affect 23 million in the U.S. In a meeting with the Iowa Democratic Party's Disability Caucus, Hurst explained,

    Right now, the way we address long COVID is 85 million people who are at risk for getting it will get no care. We're just not gonna take care of them— that's your current healthcare system. We've got 85 million people who are uninsured or underinsured.

    Then we've got another group of people who will go bankrupt, because their healthcare provider will not have the resources to investigate, to educate themselves and understand the condition, or It'll just be an insurance product that doesn't cover those particular tests and it'll come out of your pocket. So that population will go into medical bankruptcy and will suffer and may die early as well.

    And then there's people who have “good insurance”, and I would argue there's no such thing as good insurance. All insurance is meant to limit your access to care, it's meant to limit the amount they pay. So those people who have good insurance […] we won't be addressing them or taking care of them until they arrive in crisis mode and only then we'll respond to it.

    Senator Bernie Sanders and fourteen of his colleagues introduced The Medicare For All Act last month to guarantee health care in the United States as a fundamental human right.

    The ranks of those with disabilities in Iowa will grow due to long COVID, which may persist for life. In addition to lung damage, there are four main categories of conditions: inflammation, dysautonomia, ongoing viral activity, and altered immune response. All of them can have significant, disabling health impacts, from multi-system inflammatory disease after mild COVID to permanent heart conditions.

    We need to change our inadequate and often cruel system, if we are every going to adequately care for what will be huge numbers of individuals disabled by COVID-19 (on top of the 1 in 4 Americans who already have a disability). A for-profit health care system is neither an ethical nor a sustainable business model when it causes so much additional suffering. We need Dr. Hurst’s voice and vote in Washington, DC to help pass Medicare For All.

    Hurst believes in improving the application and enforcement of the Americans With Disabilities Act, part of Iowa Senator Tom Harkin’s legacy. Even though that federal law was enacted in 1990, accessibility is still an afterthought in many public spaces. There are also more accommodations needed than the default wheelchair accessible, such as communication access for the Deaf and hard of hearing. We discussed this and other issues at our recent Disability Rights Forum.

    We are proud to endorse Dr. Glenn Hurst as the Disability Caucus candidate for U.S. Senate. Whether you are an ally, a person with a disability or have family that have disabilities, please cast your vote for him, the best representation possible. 

    From our interview with Dr. Glenn Hurst:

    How do you envision the office you seek intersecting with disability issues?

    The ADA came from the disability community and was enacted through a U.S. Senate bill. I would expect this office to continue to address issues related to that act and therefore the intersection would be significant.

    Whether it is helping with constituent issues related to the ADA and its enforcement, or the work to pass the Medicare for All Act, I foresee significant intersection with my personal role in the US Senate and those who have disabilities. Having been a foster parent to children with brain chemistry disabilities, and also the father of a child with disability, who have struggled with navigating a system that is supposed to support them, I have witnessed time after time how that system has failed. It will be a priority area of emphasis in my service to Iowa.

    What are some disability issues you think can be addressed through the power of the office?

    Medicare for All Act (M4A) will begin by providing coverage to 85 million Americans who are uninsured and underinsured, many of whom are people with chronic disabilities. It begins by providing more access points for care. It will also expand the types of services available and give patients and providers the flexibility to access them in a way that makes the most sense. It will add coverage for in-home caregivers. It will pay family members who provide medical care and give them a place on the medical team. The overarching theme of the M4A will be access and inclusion.

    Better enforcement of the ADA and fully funding its components will hopefully bring private sector organizations into compliance with the act. If a community is not accessible, it is not an option for people with disabilities, therefore local libraries, schools, and government offices will be incentivized to expand accessibility beyond ramps, automatic doors, and hearing loops to include training for respecting and serving individuals with sensory disorders, PTSD, and profound brain chemistry disorders.

    Do you have any specific experience advocating on disability issues?

    I have been a health care and disability activist for over 30 years. As a foster parent advocating for services that benefit the children in our care I have testified in State hearings and worked directly on care teams for wards of the state.

    I have also served on the Eastern Nebraska Office on Aging as a case reviewer assuring we are meeting the needs of individuals who are elderly or disabled trying to stay in their homes. I have served over ten years on the Human Rights and Dignity board for Home at Last, supporting the same goals for individuals with profound brain chemistry disabilities as well as physical disability. I am the founder of “Seniors: Fighting for our Lives”, which focused on protecting nursing home patients, who often intersect as elderly and disabled, from the failed response to the Covid crisis in Iowa. T

    his advocacy led to a national level of activism with appearances on CNN and NPR. Of course, as a physician, I work directly with patients with disabilities on a near daily basis.

    Editor’s note: Bleeding Heartland welcomes guest posts advocating for Democratic candidates in competitive primaries for local, state, or federal offices. Please read these guidelines and contact Laura Belin if you are interested in writing.

    The post Iowa Democratic Party’s Disability Caucus endorses Dr. Glenn Hurst appeared first on Bleeding Heartland.

    End the Medicaid coverage gap

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    Sue Dinsdale leads Health Care For America NOW in Iowa.

    This month Medicare and Medicaid celebrate their 57th Anniversary. These two biggest government health insurance programs in the nation were created by President Lyndon B. Johnson and the Democratic-controlled Congress in 1965. Together, they provide coverage and services to more than 150 million people in the United States, including 637,388 Medicare enrollees and 812,017 Medicaid enrollees in Iowa.

    Medicaid has been a lifeline and resource for workers, families, state budgets and people of all ages. Whether it’s regular preventive care, prenatal or maternity care for new moms, addiction treatment in the swelling opioid epidemic or rapid response to national crisis like hurricanes, terrorist attacks and epidemics, Medicaid is a fundamental pillar of the American health care system that we all depend on.

    Thanks to the Affordable Care Act, a historic number of people gained coverage between 2010 and 2022, the majority of them through Medicaid. Lawmakers over the last two years of the pandemic leveraged Medicaid to protect lives and shore up state budgets, passing legislation that provided coverage to people who had lost jobs and health care because of COVID-19. As a result, the number of uninsured people did not increase despite the turmoil the pandemic caused. The number of uninsured actually shrunk, as government action shielded people from harm and ensured they could access health care during the worst public health crisis in recent memory.  

    Over the years, both Medicare and Medicaid have been improved and expanded. More than 80 million people were getting coverage under Medicaid (including the Children's Health Insurance Program) as of March 2022. The number of people who receive Medicaid as part of the Affordable Care Act’s expansion of the program climbed to a record high 21 million people after Congress and the Biden Administration made the program easier to access in response to the pandemic. Medicaid enrollment increased by 16.7 million enrollees from February 2020 to March 2022.

    Yet despite the new enrollees, millions of people remain without coverage in the dozen states that still refuse to expand Medicaid.

    More than two million Americans nationwide could gain health coverage if federal lawmakers took action to close the Medicaid coverage gap. Congress still has the opportunity to pass a policy to give everyone an opportunity to get quality, affordable coverage under Medicaid this year, no matter where they live, what they look like or what kind of job they have. That would give everyone more to celebrate 

    With policy changes to bring Medicare into this century, Congress is working on ways to help millions of people better afford prescription medicines. For nearly 20 years, politicians of both parties have promised to lower drug prices through Medicare negotiations. (The 2003 law to create Part D, the prescription drug plan for Medicare enrollees, prohibited the government from playing a role in negotiating over drug prices.) Other programs like Medicaid and the Department of Veterans Affairs don't have that prohibition. The result is much higher costs in Medicare: taxpayers twice as much for prescription drugs in Medicare as in the Veterans Affairs. 

    Lowering drug prices through Medicare negotiations is widely supported by voters across the political spectrum including Democrats, Independents and even half of all Republicans. Polls show that Medicare negotiations to lower prices was the most popular provision of the Democrats’ reconciliation package leading into this year.

    President Joe Biden and the Democrats in Congress are moving forward to pass a bill that delivers on lower drug costs by implementing negotiations despite no support from Republicans and persistent efforts from the drug corporations to stall reform. Big Pharma has spent more than $100 million on lobbying this year alone to stop the legislation and hold onto their monopoly power to set and keep prices high. 

    We appreciate U.S. Representative Cindy Axne's track record of voting for legislation that protects seniors and families from high costs.

    Lack of access to affordable, reliable coverage puts too many Americans at risk for economic insecurity. Millions of people incur medical debt that damages their credit and impedes their ability to get housing, further their education or provide for their children all because they didn’t have adequate coverage. The dozen states without Medicaid expansion have the highest rates of medical debt, which is not the top source of all U.S. debt. One in four people with medical debt in collections is a person of color. 

    It doesn’t have to be this way. Quality, affordable, accessible health coverage is an essential component of economic security for families in our country and it is within our reach to guarantee opportunity for everyone to get it and keep it. Then we will have a true reason to celebrate.

    The post End the Medicaid coverage gap appeared first on Bleeding Heartland.





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