How big is Howard Dean’s Iowa problem?

For about a year now, Dick Gephardt has made Iowa the centerpiece of his presidential campaign. He won the state’s caucuses in 1988, he comes from a neighboring state, and his deep ties with Iowa’s union members made him the odds-on favorite to win the state again in 2004. It’s been fairly obvious that a loss in Iowa in January would mean the end of his campaign.

One of the earliest Iowa polls of the campaign season was published in mid-July and it reinforced the conventional wisdom. Of the four candidates with double-digit support, Gephardt easily led the way with 32 percent, Dean a distant second with 19 percent.

Then August came, Dean caught fire, and Gephardt’s must-win state appeared to be slipping away. The two biggest statewide polls in Iowa published in August both showed Dean surging ahead, maintaining small leads over Gephardt after months in which Gephardt was the clear Iowa frontrunner.

Summer’s over now and so is Dean’s lead. Three statewide polls have been released in the last week and each show the same thing: Gephardt in first and gaining strength, Dean second and losing it.

A statewide Zogby poll shows Gephardt has turned a 6-point deficit into a one-point lead. Gephardt leads Dean by the same margin in a Democracy Corps poll (.pdf doc) released this week. Perhaps most encouraging for Gephardt is a Survey USA poll released on Monday that showed the Missouri congressman with a 5-point lead over Dean, 27 percent to 22 percent, after the same poll showed the two tied last month.

The trend may be temporary, of course, but for the time being it appears Dean has lost his lead in Iowa.

In fact, the biggest story out of Iowa this week wasn’t the Clark and Lieberman announcements, nor the poll results, but rather the Des Moines Register’s David Yespen column from Tuesday.

Yespen, the most important and influential political columnist in Iowa, helped push the conventional wisdom even more in Gephardt’s favor by writing this week that all indications are that “Howard Dean has peaked here and that Richard Gephardt has dug himself out of a summertime hole to reclaim his position as the front-runner in the state.”

Not exactly the lede the Dean campaign was hoping for.

“Dean’s campaign appears to have plateaued,” Yespen wrote. “The California recall took much of the limelight away from him. Then Clark’s entrance into the race pulled media attention away from Dean and gave anti-war Democrats another champion. Most important, the economy ranks higher than the Iraq war as the most important issue for Democrats. That means the campaign dialogue has shifted from issues that played to Dean’s early strength and moved toward Gephardt, who has always maintained a focus on jobs.”

Yespen didn’t mention it, but I think there’s an even more obvious explanation for Gephardt’s surge and Dean’s slip in Iowa: Medicare.

Gephardt has been using Dean’s record of hostility for Medicare as a club, beating him with it repeatedly for a couple of months now. As Gephardt reminds anyone who will listen, Newt Gingrich and the new-found Republican majorities in Congress in 1995 pushed for shifting Medicare patients to managed care and cutting over $280 billion from the federal program. Dean, at the time Vermont’s governor, endorsed the Republicans’ Medicare proposal. Complicating matters, Dean called the program “one of the worst things that ever happened,” and a “bureaucratic disaster.”

I suspect Dean’s difficulties in explaining his record on the issue is contributing as much as anything to his falling poll numbers in Iowa. I know from several sources that Dean is frequently asked about Medicare by people he meets in Iowa during his campaign stops, and Dean’s explanation — the remarks are eight years old — isn’t exactly persuasive.

As Dean acknowledged yesterday, “People are actually starting to believe the nonsense that Dick Gephardt is putting out about Medicare.”

Nonsense or not (I’d argue “not”), Dean is on the defensive, so much so that he’s beginning to spend some of his vast fortune on TV ads in Iowa. If you don’t think Dean’s getting a little sensitive about the Medicare issue, consider that one of the new ads says, “Instead of fixing the problem, the best my opponents can do is talk about what was said eight years ago.”

Historically, campaigns aren’t running negative ads as early as October. As the New York Times noted today, the commercials “are unusually negative for this stage of the campaign, when biographical commercials are the norm.”

Dean’s campaign is therefore taking a bit of a risk with ads criticizing his rivals — whom he dismisses in the spots as “politicians in Washington” — when much of the Dems’ grassroots are hoping the candidates will avoid attacking each other.

We’ll know soon enough if the gamble pays off.