U.S. Sens. Blanche Lincoln of Arkansas and Ben Nelson of Nebraska are two of three members of the Senate Democratic Caucus who have yet to say whether they will act to prevent a planned Republican filibuster of the Senate’s health care reform bill. (The third is Sen. Mary Landrieu of Louisiana.)

(Update: Nelson, citing a personal history of rejecting “efforts to obstruct,” has said he will vote to allow the bill to move forward.)

“[Senate Majority Leader] Harry Reid has scheduled a critical vote this Saturday night that will allow the Senate to take-up his bill,” the RNC wrote today in an e-mail that urges supporters to contact Lincoln’s and Nelson’s offices.

“This is the best opportunity there will be to stop President [Barack] Obama, Harry Reid and Nancy Pelosi from imposing their government-run health care plan on America.”

Speaking with reporters on Thursday, U.S. Sen. Tom Harkin predicted that the planned filibuster would fail because “no Democrat wants to be the one that stopped” health care reform.

Democrats, who currently control the Senate, will need 60 votes to overcome a filibuster. That means, in addition to holding their caucus of 58 votes together, the Democrats will need the support of independent Sens. Bernie Sanders of Vermont and Joe Lieberman of Connecticut.

Perhaps more notably, Vice President Joe Biden will still headline the dinner (as far as we know). That will put him pretty far outside the Washington beltway as the Senate’s health bill is finalized.

U.S. Sen. Tom Harkin (D-Iowa) on Capitol Hill (Lauren Victoria Burke/WDCPIX.COM)

“I’m going to take this out and attack the opponents on this, and be proactive in saying that we have a deal here that’s gonna make it better for the American people,” Harkin said Thursday morning in a conference call with reporters.

Harkin said he “can only hope” that Republicans who have opposed reform efforts will make the legislation a theme in their speeches on the campaign trail.

“I hope it is an issue next year,” he said.

“There are a lot of things that will start going into effect next year, for example, we started a high-risk pool for people with pre-existing conditions. I want to see [Republicans] say that is not a good deal.”

Harkin noted that the bill prohibits rescission, provides coverage for those who retire early and are not eligible for Medicare, offers tax credits to small businesses that provide health coverage to employees, eliminates co-pays and deductibles for preventative care, allows children to continue on family policies through age 26, and bans lifetime benefit limits.

“The biggest single cause of bankruptcies in Iowa is health care expenses when people bump up against their lifetime limits,” Harkin said. “We banned those. I’d like to see the Republicans go out next year and tell everyone that is a bad deal.”

In addition, Harkin is convinced that voters “are not going to look kindly upon the Republicans for their delaying tactics” in connection with reform efforts.

“Let’s have the amendments. Let’s have the votes. I’m not afraid of that,” he said. “I’m more than willing to have these amendments and have the votes, but you are just going to filibuster the bill — well, it’s time to get to a vote.”

Harkin, who celebrates his 70th birthday today, also renewed his call for members of the Senate to work all weekend, if necessary, in order to pass reform efforts on to the conference committee. He now anticipates that a health care reform bill will be ready for a Presidential signature by January.

Here is a transcript of some of Harkin’s comments:

I can only hope so. I hope that we pass the bill, that it goes to conference and that we give it to the President and he signs it. I hope it is an issue next year. I hope they come out — I hope the Republicans next year, when things start going into effect — there are a lot of things that will start going into effect next year, for example, we start a high-risk pool for people with pre-existing conditions to go into. I want to see them say that is not a good deal. We stopped recissions, so that insurance companies cannot drop you when you become sick. I’d like to see the Republicans next year go out and say that is a bad deal for the people of America.

We have a new re-insurance for retirees, to cover retirees who aren’t yet eligible for Medicare. We have a provision in there that will provide for coverage for these [individuals]. I’d like to see them go out and tell people from age 55 to 65 that this is a bad deal for them.

We have small business tax credits. Tax credits that go up to about 50 percent for small businesses to be able to get coverage for their employees. I’d like to see Republicans go to every small business in Iowa and tell them that is a bad deal.

Our bill bans lifetime limits. How many times do people go into bankruptcy in this country and in Iowa? The biggest single cause of bankruptcies in Iowa is health care expenses when people bump up against their lifetime limits. We banned those. I’d like to see the Republicans go out next year and tell everyone that is a bad deal.

We provide for no co-pays and no deductibles for certain prevention screenings and wellness benefits. I’d like to see see them go out and say that is a bad deal.

Our bill, next year, would require insurers to permit children to stay on their family policies until they are age 26. I’d like to see the Republicans go out next year and just say that is a bad deal for everyone.

Well, you get my point. I’d love to have this debate next year.

Not only defending — promoting.

You know my old stock thing: Never defend, always attack.

Poll after poll, people want this. It is just like the public option. Almost 2-to-1 people support a public option — and among Democrats it is 4-to-1, and among doctors 3-to-1 in this country.

So, I’d like to see the Republicans go out and tell people this is a bad deal.

I also think that people are not going to look kindly upon the Republicans for their delaying tactics on this. Let’s bring it up for a vote. Let’s have the amendments, as we did in our committee. Let’s have the amendments. Let’s have the votes. I’m not afraid of that. I’m more than willing to have these amendments and have the votes, but if you are just going to filibuster the bill — well, it’s time to get to a vote.

During an interview with MSNBC host Rachel Maddow, Harkin said no one in the Democratic caucus wants to be the person who derails health care legislation.

“We’ve all had our input. We’ve had our debate. But I believe now that the team is together,” he said. “And our team is going to hold together and we’ll have those 60 votes to move ahead.”

Harkin said the bill, which includes a public insurance option that states can opt out of, is not what he would have written. But in order to get the votes needed to move forward it was necessary to put the opt out in the bill, he said.

“I think it’s a reasonable compromise,” Harkin said. “Whether or not a state will opt out or not is up to the states. I would think a majority in every state would want to have that competitive edge a public option would present.”

Here’s video from Harkin’s appearance. His segment starts at 3:45.

The national phone survey of 772 adults, with a margin of error of plus or minus 3.5 percent, found that 52 percent believe government action would do more harm than good, and the remaining 48 percent supported change.

The poll showed a distinctly partisan split, as government action was preferred by 54 percent of Democrats, compared to only 40 percent of Republicans.

Women were far more likely to support health care reform. Nearly 58 percent of women would like to see change, compared to only 41 percent of men. The majority of both Republican and Democratic women supported reform (65 percent and 54 percent, respectively). Most Democratic men also supported reform (60 percent), but most Republican men did not (37 percent support).

“Women tend to align with the Democratic Party and its initiatives more so than men,” said Frederick Boehmke, associate professor of political science in the UI College of Liberal Arts and Sciences and faculty adviser for the Hawkeye Poll. “Fifty-three percent of women in our sample voted for Obama, compared to only 34 percent of men.”

Just over half of individuals with a high school education or less, some college, or a college degree believed health care reform would do more harm (51 percent, 52 percent and 53 percent, respectively). Those with advanced or professional degrees were most in favor of reform, with 54 percent agreeing that change is needed to control costs and expand coverage.

Respondents under age 35 appeared to be most opposed to health care reform, with 61 percent indicating that it would be a bad move, but the polling team cautioned that the number of respondents in this group was small. Adults ages 55 to 69 were most supportive of reform, with 53 percent saying they prefer it.

The poll also found that 52 percent of respondents disapprove of the job President Barack Obama is doing, a number that doesn’t surprise pollsters.

“It appears that Americans are frustrated by the lack of tangible legislative results, particularly on health care reform, and the lack of significant turnaround in unemployment since Obama took office,” said Nathan Darus, a UI doctoral candidate in political science. “New presidents are inexperienced as national-level executives. As they learn the ropes, they experience policy failures that play into disapproval.”

Of the 772 respondents, 46 percent were women and 54 percent were men. Twenty-nine percent were Democrats, 40 percent were independents, and 31 percent were Republican. Nearly 64 percent considered themselves moderate, while 20 percent were liberal and 16 percent were conservative. Reported results are weighted by state population.

The two latest victims reported lived in Floyd and Johnson counties. Both had risk factors that increased the chance of complications from the virus.

Among all H1N1 cases in Iowa, the most common risk factors for complications from the virus were immune-compromised (such as cancer), respiratory (such as asthma, and neuromuscular. In addition, more than 50 percent of the Iowans hospitalized were overweight or obese, which may be associated with medical conditions, such as diabetes, which increase the chance of complications.

According to health department officials, deaths in Iowa have mirrored the state population, with age groups and all major racial and ethnic groups being impacted. Nearly half of the deaths have occurred in adults between the ages of 25 and 49. Five of the deaths were among adults from age 50 to 64, while three deaths were among adults 18 to 24. In Iowa, there has only been one child death and one death for persons over the age of 64.

Two of the state’s fatalities were cases that had no underlying risk factors from medical complications.

Iowans who want more information about influenza surveillance in Iowa should visit the department’s Web site. The state also maintains a public 24-hour hotline for those with questions about the virus, 1-800-447-1985.

Though each Iowan seems to have his or her own ideas for how money should be cut from the budget, few blame the Democrats for overspending on their key priorities over the past few years.

In all, majorities support Democrats’ expansion of health insurance coverage for children, spending on public schools, repairing roads and bridges, raising teacher pay, and developing renewable energy. A plurality supports expanded free preschool.

On most budget items, pluralities of Iowans agree with the idea of cutting everything by an equal amount, except when it comes to health insurance for low-income residents and the Iowa State Patrol, which majorities say should be spared from cuts. This seems to conform to Gov. Chet Culver’s decision to make an across-the-board budget cut now and use the beginning of the legislative session next year to restore some funding for key priorities.

That said, Iowans have mixed feelings about the decisions that have been made to cut the state budget. Though only 19 percent of respondents said they were “Very Confident” or “Mostly Confident” about the budget-cutting decisions, 44 percent were “Just Somewhat Confident.” 35 percent were not confident.

(Incidentally, it seems strange that this question had three positive responses and just one negative response. These responses may fit people’s opinions best, but they also can also be confusing to interpret. The Register story itself seems to add up “Somewhat Confident” and “Not Confident” to demonstrate a disapproving majority, but “Somewhat Confident” doesn’t sound very disapproving to me. It was the closest thing to a middle ground that pollsters offered, and it implies slight approval, not disapproval.)

You can read the Register’s write-up of the poll here.

U.S. Sen. Tom Harkin (Lauren Victoria Burke/WDCPIX.COM)

Not only will the Senate be working weekends through December on health care reform legislation, but it could also spend the upcoming weekend in session, Sen. Tom Harkin told D.C.-based newspaper The Hill.

Harkin, who chairs the Health, Education, Labor and Pensions (HELP) Committee, said Democrats will have the 60 votes needed to overcome a GOP filibuster. And if Republicans try to stall debate by asking that the entire bill be read on the Senate floor he promises a delay to Thanksgiving break.

If that happens, Harkin said, the majority party is likely to use a procedural maneuver to keep the Senate in session this weekend.

“If the Republicans want to stay here this Saturday and Sunday to read the bill, then let them stay here,” Harkin said, adding that Democrats would hold a “live quorum,” where the sergeant at arms requests the presence of all absent senators.

“I’ll tell you, we’re going to do something like that,” Harkin said. “We are planning to do something that would require Republicans to be there 24 hours a day, and if they leave the floor, we’ll ask unanimous consent to dispense with the reading, and that’ll be the end of it.”

The goal, Harkin said, is to pass a bill before the Christmas holiday. He predicts a motion to proceed to a vote will be held Friday.

Marijuana (Photo: Wikipedia)

Several states have legalized the use of marijuana for medical purposes, and other states, including Iowa, are considering it.

Prompted by a court decision, the Iowa Pharmacy Board held public hearings on the subject across the state this year, and they could issue a recommendation to the legislature for further action on marijuana policy before the 2010 session begins.

The (Cedar Rapids) Gazette caught up with patients who are using the substance and were willing to speak openly about it, even though their actions could result in criminal charges and even jail time:

“It allows me to get up every day and function as a mother,” said Lisa Jackson, 43, of rural Crawfordsville, who has the long-term pain syndrome fibromyalgia.

[...]

Jackson and Jimmy Morrison, 23, of Muscatine were among those who testified in favor of allowing medical marijuana.

They said they struggle to get out of bed, and smoking marijuana helps.

Morrison said he suffers from anxiety and bipolar disorder and smoking marijuana about three times a day helps him manage his illnesses.

“My productivity has gone up so much, people don’t even know,” Morrison said. “I run a painting business, and I’m a media director at a church,” says Morrison.

“Of the 39 Democrats who voted against the bill, 33 represent districts with higher-than-average rural populations,” report Julie Ardery and Bill Bishop of the Daily Yonder. “Six nay votes came from Democrats in the 20 most rural districts in the nation.”

A direct urban-rural comparison of votes within the Iowa delegation is not possible since lawmakers from the Hawkeye State split along party lines — there was no Democratic opposition.

Many of the Democratic legislators who did vote against the final reform bill voiced their concerns that provisions in the bill would have an adverse impact on the unique health care challenges facing rural America. In the build up to the weekend vote, however, several advocacy groups with ties to geographically rural areas applauded the move toward health care reform in a joint letter to Speaker of the House Nancy Pelosi. The groups noted certain aspects of the plan, such as the increase in Medicaid coverage to 150 percent of the poverty line and the addition of long-term care insurance programs for adults with disabilities, as key to drawing their support.

Rural experts aren’t ready to call the current health care reform bill a panacea for rural Americans, but support seems to be pulled between one camp that is willing to accept partial solutions and one that is not.

For instance, the bill does seek to stem provider drain in rural areas by offering incentives such as the National Health Service Corps, graduate medical education and other primary care initiatives. Such incentives, however, continue to be mostly tied to physicians and do not always include opportunities to increase rural workforces through support staff initiatives.

The bill also expands the 340B prescription drug discount drug program to programs that typically serve geographically rural areas, and provides new life for some Medicare programs that were slated to expire. Most importantly, the House bill restructures payments connected to the public option to allow for negotiated rates, an item that is considered key to providing a level reimbursement playing field between urban and rural providers.

Key provisions missing from the House bill, however, include incentives related to Critical Access Hospitals such as flexible bed counts, local control on identifying such facilities and a reconfiguration of stimulus monies that many rural providers felt provided an unfair advantage to urban or non-CAHs.

Perhaps the missing provision that has most angered rural advocates is a clause that would have provided for equal representation on the Medicare Payment Advisory Commission and the proposed health commission. Although an amendment to that effect was proposed by U.S. Rep. Greg Walden (R-OR) it was not included in the final bill, and the amendment was not brought up for a full vote before the final bill was passed.

Just like all other health care advocates throughout the nation, rural interests have now turned their attention toward the final Senate bill, expected to begin debate either late week or early next week.