Andrew Conkling: National Kidney Month provides reminder of cost hurdles for dialysis patients
The month of March marks National Kidney Month in the U.S., an opportunity to bring awareness to something that affects more than one in seven adults and a chance to reflect on the struggles kidney patients across the U.S. face every day. Currently, kidney patients face an uneven playing field, and a lot still needs to be accomplished in order to ensure that all patients have access to the care they need. It’s an unlevel field that I’ve been operating in for most of my life. I was born with only one functioning kidney, meaning I knew early on that I would eventually need to start on dialysis. While I was able to defy doctors’ expectations and reach age 25 before I needed to begin the treatments, I quickly learned just how difficult it can be for patients to simply afford the life-saving care that dialysis treatments provide. While Medicare covers 80 percent of the cost of dialysis treatments, patients usually need to undergo treatment three or more times each week, meaning that the remaining 20 percent can rapidly add up and create an increasingly large financial hurdle for patients and their families. Despite this challenge, many states across the U.S. – including my home state of Alabama – don’t require insurers to make Medigap plans to cover the costs Medicare doesn’t pay for available at affordable rates for patients under the age of 65. It’s a serious issue that completely hamstrings what patients are able to do and limits the type of life they can lead. This issue was especially important to my long-time mentor and close friend Jack Reynolds. He lived on dialysis for 45 years and devoted his life to advocating for other patients. He credited the ability to do that to the fact that he had access to Medigap coverage. This coverage gave him the financial stability and freedom to live his life the way he wanted to, and he wanted every other dialysis patient to be able to say the same. Now, Congress is considering a bill named in his memory which would make that dream a reality. The Jack Reynolds Memorial Medigap Expansion Act, which Representatives Cindy Axne (D-IA-3) and Jaime Herrera Beutler (R-WA-3) introduced last year, would guarantee that patients across the U.S. could affordably access Medigap coverage, no matter where in the country they live. Patients would no longer have to worry about whether their state requires those plans to be available in order to pay for the treatments they need to live. Passing this bill would be both a life-saver and an enormous stress reliever for countless patients and their families. It would give them a greater sense of financial security, offer much-needed peace of mind, and make it easier for patients to become and remain eligible for a kidney transplant. This bill is a fitting commemoration of Jack’s life and legacy and would ultimately give patients the level of freedom he valued so much. Jack took me under his wing early on and showed me how public policy can have a real, tangible impact on dialysis patients’ lives. The Jack Reynolds Memorial Medigap Expansion Act is a remarkable opportunity to help a group of patients that has too often been left behind and would mark a milestone achievement for kidney care in the U.S. As we approach the close of National Kidney Month, I hope that lawmakers recognize this opportunity and pass this essential bill. Andrew Conkling is the president of the Dialysis Patient Citizens Board of Directors.
Tommy Tuberville introduces legislation to streamline 9/11 GI Bill benefits
Sen. Tommy Tuberville joined Senators John Thune and Marco Rubio to introduce legislation that will require the U.S. Department of Veterans Affairs (VA) and the U.S. Department of Defense (DoD) to modify the language used on official VA and DoD forms to clarify the information required when a service member elects to have their GI Bill benefit transferred to a dependent. Representatives Greg Murphy, M.D., Cindy Axne, and David Trone introduced the companion bill in the U.S. House of Representatives. Historically, service members have had issues with the GI Bill benefit transfer forms. If the information requested is written incorrectly, the mistake leads to eligible dependents being barred from rightfully earned educational benefits. These errors could be easily amended, however, the VA and DoD cannot amend the information on the form without this statutory authority. One such error that happens frequently is the “end date” error. Part of the transfer form requires the service member fill out a field labeled “end date.” This field refers to the date on which the benefit is no longer available to the dependent. Since this field is the cause of many incorrectly completed transfer forms, this bill would remove the “end date” to prevent further issues. The benefit would then naturally expire on the dependent’s 26th birthday. “Our service members and their families sacrifice greatly for our freedoms, and it isn’t right that confusing paperwork can get in the way of a dependent receiving education benefits after the tragedy of losing a loved one,” stated Tuberville. “This legislation provides a simple fix that can make a big difference to our service members and their families in Alabama and across the nation. It fulfills the wish of those who have honorably served and guarantees this earned benefit is preserved.” “We owe veterans and their families more than we’ll ever actually be able to repay,” said Senator Thune. “I am happy to join Senators Tuberville and Rubio in supporting this common-sense legislation that would cut through red tape and make it easier for veteran families to receive the benefits they so rightly deserve.” This legislation is supported by the Tragedy Assistance Program for Survivors, a national organization focused on providing care for families grieving the death of a military loved one. “TAPS is grateful to Senator Tuberville for introducing legislation to ensure surviving spouses and children who are using transferred entitlement are not disqualified due to a technicality. This much-needed legislation will give the Department of Veterans Affairs the authority to remove the end date on transferred entitlement and strengthens benefits for surviving families,” said Bonnie Carroll, President and Founder Tragedy Assistance Program for Survivors (TAPS). According to the bill, a service member may transfer their Post-9/11 GI Bill benefits to a spouse or child so long as the service member has done the following: Completed at least 6 years on the date the service member requests to transfer the benefit, and Agreed to add 4 more years of service, and The individual receiving the benefits has enrolled in the Defense Enrollment Eligibility Reporting System (DEERS).
Democratic candidates pour into Iowa for last-minute push
Some of the candidates have Senate obligations for the impeachment trial and have had to use surrogates.
Iowa swung fiercely to Donald Trump. Will it swing back in 2020?
Few states have changed politically with the head-snapping speed of Iowa. Heading into 2020, the question is whether it’s going to change again. In 2008, its voters propelled Barack Obama to the White House, as an overwhelmingly white state validated the candidacy of the first black president. A year later, Iowa’s Supreme Court sanctioned same-sex marriage, adding a voice of Midwestern sensibility to a national shift in public sentiment. In 2012, Iowa backed Obama again. All that change proved too much, too fast, and it came as the Great Recession punished agricultural areas, shook the foundations of rural life and stoked a roiling sense of grievance. By 2016, Donald Trump easily defeated Hillary Clinton in Iowa. Republicans were in control of the governor’s mansion and state legislature and held all but one U.S. House seat. For the first time since 1980, both U.S. Senate seats were in GOP hands. What happened? Voters were slow to embrace Obama’s signature health care law. The recession depleted college-educated voters as a share of the rural population, and Republicans successfully painted Democrats’ as the party of coastal elites. Those forces combined for a swift Republican resurgence and helped create a wide lane for Trump. The self-proclaimed billionaire populist ended up carrying Iowa by a larger percentage of the vote than in Texas, winning 93 of Iowa’s 99 counties, including places like working-class Dubuque and Wapello counties, where no Republican since Dwight D. Eisenhower had won. But now, as Democrats turn their focus to Iowa’s kickoff caucuses that begin the process of selecting Trump’s challenger, could the state be showing furtive signs of swinging back? Caucus turnout will provide some early measures of Democratic enthusiasm, and of what kind of candidate Iowa’s Democratic voters — who have a good record of picking the Democratic nominee — believe has the best chance against Trump. If Iowa’s rightward swing has stalled, it could be a foreboding sign for Trump in other upper Midwestern states he carried by much smaller margins and would need to win again. “They’ve gone too far to the right and there is the slow movement back,” Tom Vilsack, the only two-term Democratic governor in the past 50 years, said of Republicans. “This is an actual correction.” Iowans unseated two Republican U.S. House members — and nearly a third — in 2018 during midterm elections where more Iowa voters in the aggregate chose a Democrat for federal office for the first time in a decade. In doing so, Iowans sent the state’s first Democratic women to Congress: Cindy Axne, who dominated Des Moines and its suburbs, and Abby Finkenauer, who won in several working-class counties Trump carried. Democrats won 14 of the 31 Iowa counties that Trump won in 2016 but Obama won in 2008, though Trump’s return to the ballot in 2020 could change all that. “We won a number of legislative challenge races against incumbent Republicans,” veteran Iowa Democratic campaign consultant Jeff Link said. “I think that leaves little question Iowa is up for grabs next year.” There’s more going on in Iowa that simply a merely cyclical swing. Iowa’s metropolitan areas, some of the fastest growing in the country over the past two decades, have given birth to a new political front where Democrats saw gains in 2018. The once-GOP-leaning suburbs and exurbs, especially to the north and west of Des Moines and the corridor linking Cedar Rapids and the University of Iowa in Iowa City, swelled with college-educated adults in the past decade, giving rise to a new class of rising Democratic leaders. “I don’t believe it was temporary,” Iowa State University economist David Swenson said of Democrats’ 2018 gains in suburban Des Moines and Cedar Rapids. “I think it is the inexorable outcome of demographic and educational shifts that have been going on.” The Democratic caucuses will provide a test of how broad the change may be. “I think it would be folly to say Iowa is not a competitive state,” said John Stineman, a veteran Iowa GOP campaign operative and political data analyst who is unaffiliated with the Trump campaign but has advised presidential and congressional campaigns over the past 25 years. “I believe Iowa is a swing state in 2020.” For now, that is not a widely held view, as Iowa has shown signs of losing its swing state status. In the 1980s, it gave rise to a populist movement in rural areas from the left, the ascent of the religious right as a political force and the start of an enduring rural-urban balance embodied by Republican Sen. Chuck Grassley and Democratic Sen. Tom Harkin. Now, after a decade-long Republican trend, there are signs of shifting alliances in people like Jenny O’Toole. The 48-year-old insurance industry employee from suburban Cedar Rapids stood on the edge of the scrum surrounding former Vice President Joe Biden last spring, trying to get a glimpse as he shook hands and posed for pictures. “I was a Republican. Not any more,” O’Toole said. “I’m socially liberal, but economically conservative. That’s what I’m looking for.” O’Toole is among those current and new former Republicans who dot Democratic presidential events, from Iowa farm hubs to working-class river towns to booming suburbs. Janet Cosgrove, a 75-year-old Episcopal minister from Atlantic, in western Iowa, and Judy Hoakison, a 65-year-old farmer from rural southwest Iowa, are Republicans who caught Mayor Pete Buttigieg’s recent trip. If such voters are a quiet warning to Trump in Iowa, similar symptoms in Wisconsin and Michigan, where Democrats also made 2018 gains, could be even more problematic. Vilsack has seen the stage change dramatically. After 30 years of Republican dominance in Iowa’s governor’s mansion, he was elected in 1998 as a former small-city mayor and pragmatic state senator. An era of partisan balance in Iowa took hold, punctuated by Democratic presidential nominee Al Gore’s 4,144-vote victory in Iowa in 2000, and George W. Bush’s 10,059-vote re-election in 2004. After the 2006 national wave swept Democrats into total Statehouse control for the
