We welcome first-time guest Shane Vander Hart this week. He writes at shanevanderhart.com. Please give him a follow while you’re there.
We dug into school choice first. Rob Sand wants to bring back the ESA income cap and add audits, while Zach Lahn talks expansion without much detail. Shane and Laura sparred over what audits would even target, since tuition dollars aren’t currently subject to oversight once schools receive them.
Then we turned to the new Emerson/Nexstar poll. Sand is up 5.5 points on Lahn, boosted by a 26-point lead with independents. The Senate race is tighter, Hinson over Turek 47.5 to 45, but Turek leads independents by nearly 12 points, a warning sign for Republicans this cycle.
We also covered Brenna Bird’s new Medicaid fraud task force, which drew criticism from two former state officials who say the existing Medicaid Fraud Control Unit just needs more funding. Laura flagged that the task force ignores MCOs illegally denying care.
Looking ahead, Laura’s tracking healthcare messaging in the 1st District, Kathie’s watching Sunday’s Libertarian convention to replace their bounced 3rd District candidate, and Shane has a piece coming Monday on Sand’s ESA means test.
Want to sharpen your writing and get the inside scoop on Iowa politics at the same time? Join us September 27-30 at the Okoboji Writers' & Songwriters' Retreat on beautiful West Lake Okoboji, featuring Iowa Down Ballot analysts Laura Belin and Kathie Obradovich. They'll walk you through finding public information, getting your opinion pieces published, and plenty more. Spots are limited, so scan the QR code at the beginning and end of the video or head to okobojiwritersretreat.com to sign up. If you’d like to make a donation to help the Iowa Writer’s Collaborative which supports this show please click the button below. Thanks!
Auto-generated transcript below:
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Dave Price: Hi, everyone, and welcome to the Iowa Down Ballot Podcast. I am Dave Price, joined by not two.
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Dave Price: But 3 media friends this week. Laura Belin, Kathie Obradovich are regulars. They’re here, of course. But we have a newbie, a rookie, Shane Vander Hart. Who the heck is this person? Hi, Shane.
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Shane: Hey!
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Shane: Hey Dave, how are you?
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Dave Price: Who are you?
Shane: Who am I? Well, I’m just a guy, no. I write a substack, shanevanderhart.com, very original.
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Shane: So, it’s…
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Dave Price: Branding, baby, branding.
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Shane: Yeah, yeah, so it’s… it’s a piece of my mind, basically, the subtitle’s Piece of My Mind About Faith, Culture, Politics, Media, and Public Policy, because
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Shane: drilling down on one particular thing is boring, and so I can… it just leaves it broad and wide open, so whatever I want to write about, I can just do that.
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Dave Price: Outstanding. We have had some private conversations, really, for a number of weeks, and we took last week off.
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Dave Price: For a little vacation, rest up as we get ready for the final sprint.
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Dave Price: I… one of the biggest… I’m just gonna talk out loud about what has been challenging for me. There is no conservative version of Laura Belin.
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Dave Price: That is… that has… because that has always been my dream, right? Laura is this unique…
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Dave Price: entity. Nobody does what Laura does. Kathie runs this sprawling enterprise, so she’s her own thing, too.
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Dave Price: But… but that… she has a different… a different mission.
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Dave Price: There is no conservative version of Laura, and so we have had private conversations about, like, how do we get some conservative voices in here? You know, way back in the day, we had Kevin Hall, Craig Robinson, they were doing some things, and they did it differently than Laura does.
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Dave Price: But nobody does the kind of deep dive stuff from the conservative side that Laura does, and that is something that I’ve always thought could probably give our conversations here each week a little more depth.
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Dave Price: So…
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Dave Price: Shane, who has 43 different jobs, so it makes it very challenging to schedule with this man, but you have been around conservative politics for a while, and I appreciate right now you’re… you’re probably a lost man.
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Dave Price: You are not… you are not the Republican guy who I met 20 years ago or whatever, when we met up for coffee at Smokey Row in Des Moines, when you were doing some other… you had caffeinated thoughts and some other things you were doing. You later launched Iowa Torch, you’ve been a youth pastor in your career, all kinds of stuff.
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Dave Price: So…
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Dave Price: welcome, because it’s nice to add yet another… yet another voice to this. And I wonder, since you’re our guest this week, maybe you lead off, but one thing that we have talked a little bit about on this podcast, but not a lot, would be looking at the idea of school choice.
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Dave Price: And how that might play out in the gubernatorial race. Laura has done a lot of reporting, Kathie’s staff has done reporting on this as well. Shane, you are working for a couple of members who clearly have.
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Shane: Mistaken it, yeah.
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Dave Price: a stake in this and a lot of interest in this expansion. So, talk about what you have seen so far from Rob Sand and Zach Lahn in this area.
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Shane: Okay, well, as far as, school choice, it’s hard to say exactly how prominent it’s gonna be in the election. Right now, it seems, obviously, focused more on the economy, and…
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Shane: I think Rob Sands,
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Shane: his hits on Lahn about where he, you know, where he resides has been landing, especially with independents, but…
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Shane: I see two candidates that are pretty far apart on the issue. Of course.
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Shane: Rob seems like he has, moderated himself to a point where he’s not… he’s not advocating getting rid of ESAs altogether, but just putting… bringing back the income cap, which I hope I’m…
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Shane: I hope I’m,
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Shane: talking about his position accurately, but… So I don’t know if that’s what he truly believes, or if that’s what he…
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Shane: thinks that’s what… the only thing he’s gonna be able to get accomplished, with… with the current political environment and the likelihood that if he’s elected governor, he’s going to have a Republican legislature to work with, so…
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Shane: It’s been interesting. Lahn hasn’t said a lot on the campaign trail that I’ve seen, other than he’s supportive of VSAs.
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Shane: I think we’re going to be trying to drill down where he really lands more on specific issues that impact private schools, not just ESAs, but independent accreditation and other things as well.
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Dave Price: Laura, what’s your take on where is the base on this?
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Laura Belin: Well, the Democratic base is extremely opposed to the school voucher program. I think I agree with Shane’s summary. I would just add a couple of things to what Rob Sands says when he talks about this issue, which he does a lot. He brings it up a lot at his town halls. And…
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Laura Belin: he definitely wants to bring back the income caps on it, but also wants to have audits, like, if public money is going to these schools, we should be able to see where the public money is going. There should be more restrictions on what they can do with the money. And finally, he says that these private schools, if they want to take the taxpayer money, they should accept all of the students who want to attend that school. So that is…
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Laura Belin: what I’ve heard from him. And I’ve heard impressed by Democratic audiences or voters saying, hey, why aren’t you calling for repealing this program? And he’ll say exactly what Shane just said. If I’m elected, I’m going to be working with a Republican legislature. I was really surprised this week with the Emerson College poll, and I know we’re going to talk about the poll more later, but they asked a question about this issue, not exactly using the phrase school vouchers, but
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Laura Belin: State-funded private school tuition assistance.
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Laura Belin: And the electorate was really evenly split on it, with just a little more than 40% each way, which I would have expected the electorate to be more against the voucher program, just based on how much I’ve heard Rob Sand talking about it.
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Kathie Obradovich: We went up and covered, Zach Lahn up in Britt at the Hancock County Fair, I want to say it was last weekend, so not too long ago. And, he’s…
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Kathie Obradovich: careful about how he talks about ESA. So, he said he would like to see expansion of the program, but then he sort of couches that as saying he wants, more innovative schools to be able to, you know, participate. So I’m not sure what he means by innovative schools.
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Kathie Obradovich: Secondly, he says,
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Kathie Obradovich: that, you know, along with strengthening the ESA program, however he wants to do that, he wants to make public schools more competitive, and he likes to talk about competition. And so it’ll be interesting to see what he means… again, a lot of these are not fully fleshed out, what he means by making public schools more competitive. Does that mean you level the playing field with the rules that public schools and private schools have to
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Kathie Obradovich: Follow, or is it… is there something else that he has in mind?
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Dave Price: What do you have, Shane?
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Dave Price: Your wheels are turning, I can tell.
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Shane: Yeah, well, ESAs, not school vouchers. Those are two different types of programs. Vouchers are direct payments to schools. As far as limiting what ESAs go to.
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Shane: It is extremely limited what’s eligible under ESAs, so I’m not entirely sure what Sand is thinking as far as how he would like to limit ESAs, but
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Shane: Tuition, it goes to tuition first. These schools have to be accredited, either independent accreditation or,
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Shane: accreditation through the state of Iowa, which most Catholic schools are usually accredited through the state of Iowa. Most Protestant and other types of private schools are accredited through independent accreditation. So tuition is first, and then there’s a very,
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Shane: tight list of eligible expenses that have to be… that are allowed after tuition, that are purchased through the Odyssey Marketplace.
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Shane: so it’s not like somebody’s buying amusement park tickets, or, you know, things that we would deem extravagant through this program. So, you know, I guess I would like to hear…
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Shane: Rob say exactly
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Shane: what kind of expenses he’s talking about, what he thinks is being done that would be extravagant that falls under this program. I don’t see it.
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Laura Belin: I think what he’s talking about is not what the families can use the money for. The families have to use the money for tuition first.
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Shane: Right.
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Laura Belin: It’s what the schools can do with the money that they’re getting from all those ESA accounts, and a phrase that he likes to use is.
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Shane: But…
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Laura Belin: There’s only one thing on God’s green earth that the schools can’t do, and that’s give families a rebate. Other than that, they could pay for luxury vacations, steak and lobster dinners.
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Shane: Yeah.
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Laura Belin: anything with the money because it’s not subject to audit, so that… that’s the point.
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Shane: because Christian schools are known to do that.
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Shane: They… We’re not just talking about.
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Kathie Obradovich: at Christian schools here, though.
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Shane: Yeah, well, I, you know, basically, ESAs are allowing, finally, a lot of private schools to be able to pay their teachers competitively.
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Shane: And that’s… if you want to know where the money’s going, it’s going to that, mainly. So…
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Shane: I guess if we’re going to be talking about auditing and private entities, let’s… are we going to do that for any private entity that receives public funds?
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Shane: Because there are a lot out there. Do we audit every single college? Does the state auditors, do they audit grocery stores that receive SNAP funding? Do we audit, I mean, doctors’ offices that receive Medicaid? I mean.
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Shane: we’re gonna be talking about Medicaid fraud here in a little bit, but…
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Shane: You know, we don’t generally do that to a point, even though a lot of these organizations and even private schools actually
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Shane: there are… Fiscal and financial,
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Shane: responsibilities they have, not only to their donors and to their board, but also to the accrediting agencies that accredit them. A lot of these schools actually are audited on a regular basis, so just not by the state auditor’s office.
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Dave Price: Hey, Kathie, will you wrap this topic up? How do we know, as we sit here and talk about this in August, how do we get a feel for…
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Dave Price: What kind of driver this issue will be for voters?
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Kathie Obradovich: Yeah, so, I mean, we’re going to talk about polling.
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Kathie Obradovich: And that is one way, right? You do get a sense, at least of where voters feel about issues. Sometimes those are combined with how big of a priority that is. So, I mean, we know that the campaigns do these polling. We don’t always see it, and when we do see it, we don’t always
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Kathie Obradovich: You know, we don’t always believe it.
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Dave Price: You know?
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Kathie Obradovich: And so, so, you know, we don’t necessarily publish all the internal polls that we may have seen, but, you know, some of these reputable polls, at least give you an idea sometimes on these issues of where voters are. The other thing, too, is, you know, if you can get out with the campaigns enough.
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Kathie Obradovich: And hear what the questions are that people ask, and how often you’ve seen questions come up. That, that, you know.
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Kathie Obradovich: different gatherings may be more or less grassroots, you know, depending on who’s there. But, you know, I think it’ll be interesting, so…
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Kathie Obradovich: Just a plug, you know, a…
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Kathie Obradovich: separate media entities event, and I’m looking forward to the State Fair soapbox that the Register does, coming up, just to see what, you know, people there are asking candidates about. Those are… that is not necessarily a partisan crowd.
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Kathie Obradovich: And some of these people are seeing some of these candidates for the very first time, so I’ll be looking forward to seeing what’s on their minds.
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Dave Price: To use an example that Shane did, you know, when you were talking about how SAND is landing some effective messaging against Lahn with, this guy lives in Kansas kind of thing, or doesn’t live here enough, all that kind of stuff.
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Dave Price: while we may not see a lot… we’re not gonna have as much polling, perhaps, with the register not doing the Iowa poll, but I feel like we can also tell…
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Dave Price: what the campaigns have found out from their own polling based on what messaging they are using, and if these ESAs, if SAN thinks these are going to be a strength for him and a weakness for Lahn, I’m gonna guess organically he’s gonna bring this up a bunch, right? And if his polling shows that, as Laura already teased ahead with this Emerson polling, if it’s more of a mixed bag, perhaps there’s not a
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Dave Price: A lot of benefit for him to really hammer on this.
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Kathie Obradovich: But you’re also talking about interest groups, right? So, you know, you’re speaking, you know, Rob Sand almost certainly is speaking to, you know, the ISEA, the State Education Association, which is the teachers’ union, and would be a big, you know, an opportunity for support from that group.
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Kathie Obradovich: So, I mean, you know, the messaging’s not just speaking to, run-of-the-mill voters, they’re speaking to their interest groups as well.
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Dave Price: Laura, you already… sorry that I forgot to silence my phone, excuse me for being rude. You already teased ahead to this Emerson College Nextstar media poll, so this would be my former employer as part of the Nexstar family. And you talked about…
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Dave Price: at least it addressed the issue of ESAs, but let’s look at some of the top-line numbers. However, this weekend, you have a post looking beyond the top-line numbers, but in particular, they’re looking at the gubernatorial race and the U.S. Senate race that we have in the state of Iowa in November. I wonder if you can start with the gubernatorial race.
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Dave Price: It shows that Rob Sand is up.
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Dave Price: in this race, but you’re also looking behind… beyond some of the top-line numbers. What are you finding?
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Laura Belin: Overall, it’s a pretty good poll for San. He’s up by about 5.5 points, which is outside the poll’s margin of error.
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Laura Belin: And he has a big lead among independents. He’s got a 26-point lead among independents in the sample. And I know that his campaign has really put a lot of muscle into trying to identify and mobilize those voters who aren’t affiliated with either party, and he’s put forward a bunch of proposals to empower no-party voters, including completely overhauling our state primary system.
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Laura Belin: So.
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Laura Belin: he’s looking strong. Also, they asked… now, this was after they asked about favorability, and the… and the head-to-head matchup against Zach Lahn. They asked, how important is it to you for a candidate for statewide office to have lived in Iowa for most of their adult life? And about three-quarters of the sample said that was either very important or somewhat important. So, I think that that’s probably, as you mentioned, Dave.
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Laura Belin: when we hear campaigns emphasizing a message, it may be because their own internal polling is telling them that’s effective. But the other thing this poll showed is that he’s much better known than Zach Lahn. That’s not too surprising because
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Laura Belin: Zach Lahn, I mean, before last November, when he announced his gubernatorial bid, I had literally never heard of him in my life, whereas Rob Sand’s been a statewide elected official for the last 8 years, so that, you could say that the optimistic view for Zach Lahn is he has an opportunity, if he can become better known, to try to raise his numbers a little bit, but Sand already has a much… a more… a better split on his favorable
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Laura Belin: favorable rating.
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Dave Price: Shane, you are in Indy these days, as you stepped aside from the.
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Shane: I’ve had Democrats come up to my door.
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Dave Price: Is that right? Yeah. They think you’re a free agent. So, to Laura’s point there, when you look at Sands’ strength with independents, and clearly he has really worked, and he knows the math, Laura, as we’ve mentioned on this show a bunch of times, I believe was the first person to really deep-dive the voter registration numbers
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Dave Price: a bunch of months ago, and back then, I believe the gap was about 200,000, the registered Republican advantage. It’s narrowed some now. But that was Laura’s reality check to some of these Democrats a while back to say, hey, yeah, you know, things may be feeling good, but let’s look at the big picture numbers. So for Sand to do well, realistically, he has.
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Shane: He has to, he has to.
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Shane: Yeah, and by a pretty large margin. So… and so he’s smart to take that tactic, and I think, you know, his campaign messaging, for the most part, not redder, not bluer, but better and truer, okay.
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Shane: catchy, nice, works perfectly well, especially among indies that are kind of tired of the two-party system. So, you know, I definitely… he’s got some smart messaging, and obviously he’s got a huge campaign war chest to get out messaging on the airwaves, so that’s gonna be of huge benefit to him.
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Shane: And I’m sure he remembers his last election, where, you know, he just won by the, you know, skin of his teeth, so he definitely has to make some huge, huge inroads, and…
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Shane: On the flip side, Lahn has to recognize that he can’t just reach out to MAGA base and Republican voters, but he needs to also make some inroads into, independents, those that maybe have actually voted for Trump, but are now kind of getting turned off.
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Shane: So, I would be worried, if I were him, looking at this polling, especially with the independent numbers. It doesn’t look good. I mean, this is… looks like it’s setting up a scenario for a sandwyn.
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Shane: obviously, just a snapshot in time in August, so there’s… there’s a lot of time to go, but he does need to get his name out there more. Because I… like Laura, it’s like, Zach who? I have never heard of this guy before.
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Dave Price: So, Kathie, the… one of the fun things for me to talk to you week after week on this, and I appreciate that, you know, you’re the…
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Dave Price: you’re the driving force of the Iowa Capital Dispatch, but for a bunch of years, you knew the inner workings of the Iowa poll at the Des Moines Register, so you have more than a passing knowledge of how polling works. We always say on this show, we don’t want to make too big a deal out of polling, and it’s a snapshot in time, blah blah blah.
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Dave Price: Having said all of that, what did you think when you looked, just speaking on the gubernatorial race here, what did you think when you looked at this Emerson-Nexstar poll?
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Kathie Obradovich: Yeah, so first of all, Emerson is a, you know, it is a name in polling. They’ve done, lots of polling over the years, they’re very experienced. Every pollster is different, you know, and the thing that I liked
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Kathie Obradovich: most about, about, Ann Selzer’s polling, was that she didn’t bake assumptions in.
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Kathie Obradovich: the electorate. In other words, she, didn’t try to project
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Kathie Obradovich: you know, what the… what the electorate was gonna look like, you know, how many, you know, so she didn’t, like, cut off people who hadn’t voted in the last two elections, because that… that, you know, gets… gets rid of new voters, for example, and caucus polling was even more complicated as a result. So…
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Kathie Obradovich: So, you know, every poll is different. I think Emerson
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Kathie Obradovich: you know, Laura, you looked at, you know, whether their samples seem to lean right or left, and I have… I have not dug into that, but I do think that they are, you know, a relatively respected name with any, with any poll.
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Kathie Obradovich: you know, I like to look at the number of undecideds, and, you know, so I think…
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Kathie Obradovich: You know, both in the Senate race and gubernatorial race, there’s room, you know, there’s wiggle room there. You know, but if I’m… if I’m Zach Lahn looking at this
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Kathie Obradovich: Paul, and I kind of agree with Shane, he needs to get out and get his name out more. We’ve been looking… we had a week, I think it was 2 weeks ago, where Rob Sand had 3 events in Central Iowa, or at least, he, you know, he shared a media release with us early, so we had that and 2 events.
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Kathie Obradovich: Anyway…
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Kathie Obradovich: they were, and we were looking for Zach Lahn events that we could cover, you know, to try to provide some balance, and we couldn’t find one. He finally had a couple up in north central Iowa, and we were able to send a reporter up, but he, you know, not having a lot of public events.
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Kathie Obradovich: not doing as many, you know, yeah, he’s putting out news releases saying Rob Sand is a fraud, or whatever, bad guy. But, you know, those are… those are not necessarily the kinds of things that we jump on, so we’re, you know, we’re looking for, we’re looking for opportunities to cover Zach Lahn, and he’s not giving us enough yet.
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Shane: Yeah, he’s not going to be able to win the airwave battle right now based on funding, so this is… this is the only way for him to really get his name out there. To answer your question regarding the Emerson polling, it looks like they’re pretty fair. I was looking at the crosstab breakdown, and…
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Shane: Let’s see. It looks like, they had about 283 Republicans, 222 Democrats, and about 206
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Shane: independence, so I think a pretty accurate weighting as far as registration numbers.
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Laura Belin: It was about a 40%… yeah, 40% Republican, 31% Democrat, 29% Independent, but as Kathie pointed out, I mean, there’s a lot of guesswork that goes into that, and if you had gone into the…
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Laura Belin: 2014 midterm, polling the electorate, expecting that the turnout was going to match the 2012 presidential election.
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Shane: wrong. Yeah.
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Laura Belin: So, you know, he… it looks like a reasonable snapshot, but we really don’t know what the electorate’s gonna look like in November.
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Dave Price: Okay, let’s look at that U.S. Senate race. So, in this case, now this one’s within the margin of error, and as Laura already pointed out in the gubernatorial race, Rob Sands’ lead was beyond the margin of error, so that… we’ll see if that ends up being significant. But Ashley Hinson in this one, 47.5.
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Dave Price: And Josh Turek, 45, with 6.1.
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Dave Price: undecided. Laura, as you started digging into the Senate race, what were you noticing?
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Laura Belin: Well, Ashley Hinson is much better known than Josh Turek. She’s not as well known as Rob Sand, but they both have similar favorable ratings. She has slightly higher unfavorable than Josh Turek, but Josh Turek just isn’t known to a lot of people. So you could look at that two ways. You could say he has more of an opportunity to grow as he becomes better known, or you could say Republicans have more of an opportunity to define him.
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Laura Belin: before he can get his support up. I’m waiting for some pollster to name Thomas Lahn the Libertarian who will be on the ballot in the Senate race. They had an option for other… for the Senate, but I think that they should name the Libertarian Thomas Lahn and see what happens with that, because I feel that he has potential to get more than the 1.5% that this poll
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Laura Belin: Found go to other.
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Dave Price: Lahn and Lahn.
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Laura Belin: No.
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Dave Price: Different race, but…
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Dave Price: Shane, also in this Senate race, there is a gap with the Indies, and so you have, in this case, Turek with almost
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Dave Price: almost 12-point advantage with independents. So, despite down in the polls with you, although it’s very, very close, so essentially a statistical tie, perhaps, but again, this gap with independents. So, we’re in… we’re in August. Is that a concern for the Republican side?
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Shane: Oh, it should be. It should always be a concern with midterm elections when your… the… your party’s president is in office. There’s always the… especially when he’s got the unfavorability rating that he has. In Iowa, a state that has voted for him twice… you know, well, three different times.
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Shane: And… and he’s underwater with his favorability rating, so that is definitely where you’re gonna… you’re gonna see that with the independent vote. And, you know, I… more independents are aware of Ashley Hinson, so…
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Shane: it’s not quite as bad as you see with the gubernatorial race, but yeah, Republicans cannot
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Shane: Depend on just their huge voter registration advantage.
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Dave Price: Kathie, what do you make of the fact that Rob Sand has a more comfortable lead in the gubernatorial race, but it’s essentially a tie in this Senate race, with Hansen perhaps slightly ahead?
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Kathie Obradovich: Yeah, I mean, it’s exactly like Laura said. Hinson is better known. She’s not… she’s not universally known, because, you know, she represents
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Kathie Obradovich: you know, a specific area of the state in Congress, but the area of the state that she represents right now is a lot bigger than, you know, as a state representative that Josh Turek was representing in Council Bluffs. So… so yeah, he has to,
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Kathie Obradovich: you know, remain competitive enough with fundraising, and, you know, of course, with all the downsides of that, which means, you know, there’s gonna be outside money, there’s gonna be, you know, and that’s a… that is controversial with people, but I think both sides are gonna be dealing with that.
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Kathie Obradovich: But yeah, he’s gotta, you know, introduce himself to voters all across the state, and make the most of the dissatisfaction that people have with Donald Trump, because Ashley Hinson has been, I think, a pretty reliable vote, for House Republicans and for Trump’s agenda. So, I mean, they have to be able to make the most of that dissatisfaction.
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Kathie Obradovich: But… avoid running against Donald Trump, because…
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Kathie Obradovich: Yeah, that is not… he’s not on the ballot, but…
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Kathie Obradovich: That has not been successful in the past. I mean, Democrats focused on Donald Trump to the exclusion of
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Kathie Obradovich: offering a better and, you know, more, a more compelling message, and you can’t stop by saying Donald Trump is bad. If that’s, you know, if that’s what you’re gonna try to do for a message, you’ve got to offer something better. And that’s where, you know, I think Josh Turk has got to be…
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Kathie Obradovich: you know, very thoughtful, not just, you know, to get his name out there, but to be thoughtful about what it is that he’s offering, especially rural voters who are maybe disenchanted with tariffs and the cost of fertilizer and the Iran war.
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Dave Price: you know, just cost of living in general. Kathie, I wonder if you can start us off for our final big topic of the week. Since we took last week off, we did not get to dig into this, but Iowa Capital Dispatch has had reporting on this. Brenna Bird, the Attorney General, is headed up
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Dave Price: this task force that will look at cases of suspected Medicaid fraud. So that was… that was the initial launch, but then there was this news conference with two former state directors who both worked under Democrats.
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Dave Price: who say that this is kind of a misguided approach, and this is not the way you need to be going after this. What did you make from this so far?
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Kathie Obradovich: Yeah, so, this was a task force that was created by the governor, it’s being headed by Brenne Burr, the Attorney General, and it is,
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Kathie Obradovich: and I was kind of happy to see this, that it is more focused on law enforcement than it is about prevention. I worry that prevention basically creates a lot of red tape, both recipients and providers, and essentially leads to people
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Kathie Obradovich: Dropping out or losing access, because people don’t want to deal with the red tape. So, I was happy to see it focus more on law enforcement.
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Kathie Obradovich: But what, Kevin Tekow, who is a former director of the Department of Inspections and Appeals, which is now
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Kathie Obradovich: Dial, which is inspections, Appeals, and Licensing, and Dean Lerner, who is also a former director of that agency. And then they’ve also gone on to do, like, Kevin Tekow was a former U.S. attorney, for example, so they’ve also done some law enforcement work.
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Kathie Obradovich: Basically, they’re saying, you know, instead of doing this task force, that they should focus on putting more funding into the existing structures of state government that already investigate Medicaid fraud and do a good job of it. So, in the Department of Inspections, Appeals, and Licensing, there is currently a Medicaid fraud control unit
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Kathie Obradovich: Which basically exists, obviously, to investigate Medicaid fraud. Both TechOut and Lerner are arguing that the state is underfunding this agency, and that, you know, for every… they’re saying for every dollar spent.
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Kathie Obradovich: that it recovers $4 to $5, for taxpayers. So, so that is part of it. They also say you need to, you need to upgrade your data.
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Kathie Obradovich: you know, improve your technology, etc. And they had a couple of other recommendations as well. You know, I think these recommendations are worth considering. I don’t see anything wrong with having a task force to talk about this, frankly. There’s, you know, and because Medicaid,
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Kathie Obradovich: is facing, cuts and increases in some of the regulation, that looking at fraud is, you know, a good idea, but I do think that some of these recommendations are worth being discussed as well.
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Dave Price: Shane, this has been part of a national conversation that’s focused on Medicaid and Medicare, too, but let’s just focus on Medicaid. But with the Trump administration, other Republican governors have talked about Medicaid oversight, and we know that the feds are
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Dave Price: zeroing in on the error rate, with Medicaid, and states would have to potentially take over more of the cost if they go above that threshold. Iowa’s below the threshold, the current numbers. But what do you make about both Brenna Bird’s
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Dave Price: sort of mission, if you will, under the… under the direction of Governor Kim Reynolds, but then also this, the two former state officials saying this is not the way to go.
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Shane: Right, well, I think obviously going after fraud is low-hanging fruit, and everybody’s against it. There’s bipartisan consensus. We don’t want to see the program
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Shane: cheated, and if we could recover some taxpayer funding through that, all the better. I agree with Kathie. I don’t see why you can’t, you know, fund… I think, yeah, definitely fund…
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Shane: the Medicaid Fraud Control Unit more, because I was looking at… I was looking at the Iowa Capital Dispatch’s article on this, and seeing where Iowa was as far as staffers compared to other states, and it’s like, whoa, yeah, we could definitely do a better job there.
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Shane: But as far as the task force itself, it might generate some great ideas. You might have some technology improvements that are advocated for through this. You’ve got the director of Iowa’s Medicaid Fraud Control Unit as part of the task force, so…
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Shane: you know, I’m ambivalent about task force… task forces as far as how effective they are, but if it gets the conversation rolling, and maybe this be part of that, let’s better fund this unit, I think that’s a win-win. I don’t see a problem with it.
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Dave Price: What’s your take, Laura?
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Laura Belin: Well, one thing that Rob Sand mentioned when this task force was created, this was not connected to the recent press conference by the former state officials, but that the task force is very skewed toward
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Laura Belin: government and these… the private companies that manage the Medicaid program, and they’re… it’s not really patient advocate, and why isn’t this task force looking at the illegal denials of care? I mean, if you’re only looking at fraud, of course, none of us want to see any fraud in the Medicaid program, but there have been a lot of reports, compelling reports, that these MCOs are denying care and services to people
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Laura Belin: who are legally entitled to them. And it seems like that is just not of any interest at all to the current administration, so that strikes me as an area where a task force that’s looking more holistically at Medicaid might also want to look at that side.
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Dave Price: Alright, let’s make that the final word on that. I wonder if we can close out this week by teasing what you’re working on. Laura, I already sort of heavily teased what you did, because you did a Saturday morning post, but do you want to tee that up?
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Laura Belin: Yeah, I… well, I did a post kind of digging into the Emerson poll numbers, and then a couple of days ago, I did a separate post about the role that access to healthcare is playing in the first congressional district campaign after Christina Bahannon launched her first TV ad, and then earlier in the year, Marionette Miller Makes TV ad also was much about healthcare, and that included a little bit of information about some polling in the first district, too.
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Dave Price: Kathie, it’s probably difficult for you to zero in on one, but Kenya?
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Kathie Obradovich: Well, I’ll give a very little… a very short-term thing. We haven’t talked about the Libertarians today, and they are… they’re going to have their convention, interestingly, on Sunday night, from 8 to 10 p.m. Who has a convention?
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Shane: That is weird.
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Kathie Obradovich: But…
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Dave Price: Yeah, non-traditional folks sometimes.
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Kathie Obradovich: They are planning to pick a substitute candidate for Marco Battalia.
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Dave Price: Good.
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Kathie Obradovich: was kicked off the ballot, and… or if we want to call him Mark Anderson, because he was kicked off for not using his legal name. And, so we’ll see, we’ll certainly have.
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Dave Price: And that’s the congressional race, we should say. It’s already interrupted, in the 3rd District.
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Kathie Obradovich: 3rd district congressional race, exactly. So, it does, you know, that is a really close race as well. We didn’t have polling on it this time, but I think most people, you know, are looking at that as a potential close race. So having a, third party slash, you know, independent candidate, in that race could very well
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Kathie Obradovich: affect the dynamic, so it’s worth watching anyway.
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Dave Price: And you, ShaneVanderhart.com?
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Shane: Yeah, well.
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Dave Price: Is that your legal name?
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Shane: Yes, that is my legal name, even though you will not find me on the ballot ever, anywhere.
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Shane: So… I… Yeah, I’m putting out an article on Monday about Rob Sands’ means test.
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Shane: With ESAs, so addressing that.
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Dave Price: Outstanding. Shane, thanks for jumping in with us this week. Thanks for adding to the conversation.
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Shane: Very welcome.
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Dave Price: Kathie and Laura, thank you, as always. I know I said this privately, but…
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Dave Price: These two women are so… Super, super flexible.
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Dave Price: so that we can all get on here at the same time. I… my family didn’t get back until Friday. My… my 16-year-old son put this epic road trip together that I’ve never been part of in my life, but we went on this, literally a two-week road trip.
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Dave Price: where we went through, and I’m gonna write about this in different pieces the next couple of months, because they’ve reminded me of some things, but we took this trip through Teddy Roosevelt National Park in North Dakota, and then we went to Glacier in Montana, we went to Banff.
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Dave Price: West of Calgary, and then we continued on and went through Calgary and a bunch of all these random stops, which was so super fun, and then hit Winnipeg and came back home.
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Dave Price: My car is a mess, and it will take countless weeks to clean this thing, but I am so super thankful to… you too, of course, Shane, for joining us, but to Kathie and Laura, there’s no way to say this enough on this podcast. Your flexibility is so super helpful as we try to get together week after week, and we are recording this
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Dave Price: at lunchtime on a Saturday, which we usually try to do this show on a Friday, so…
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Kathie Obradovich: And thanks to Spencer, too, by the way.
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Dave Price: Very, very much so. Spencer Dirks, who produces this sucker, all the post-production and stuff that has to get done, so this means that Spencer has to crank this thing out on Saturday night so that we can drop this on Sunday morning. So, I know this is sort of how the sausage is made, but it’s very, very, very, very, very much appreciate all of you being willing to jump around. And in this case, it was totally due
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Dave Price: Accommodate my family’s schedule, so… Very, very thankful.
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Dave Price: Thankful to all of you who’ve become new subscribers. Realized we took a week off last week as we get ready for the final push, the final countdown.
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Dave Price: Which was also on our family playlist on our road trip, by the way. My son put that on his Apple playlist. But thank you to all of you who’ve become new subscribers, especially thank you to those who’ve become new paid subscribers, who help to pay the production costs of this week after week. We very much appreciate that, and if you are willing to become a new paid subscriber, you can help us keep pushing through this November election.
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Dave Price: Thanks for joining us this week, and have a great weekend, have a great week, we will talk to you next weekend.
