Playing politics with health care

Posted on December 6, 2017

The health care received by 1.5 million Louisianans hangs in the balance as questions loom over whether Gov. John Bel Edwards has the unilateral authority to renew the state’s contracts with five managed-care insurance companies. The Medicaid contracts expire on Jan. 31, and 16 GOP state senators recently asked Attorney General Jeff Landry to weigh in on whether Edwards has the right to renew them on an emergency basis. House Republicans on the Joint Legislative Committee on the Budget have already rejected the deals, but they may come up for another vote. The AP’s Melinda Deslatte has the story:

The current managed-care contracts were negotiated by former Gov. Bobby Jindal’s administration. The Edwards administration tweaked the terms, adding what it says are more dollars tied to performance and more quality measures. The Joint Legislative Committee on the Budget has held three hearings on the extensions. At the first hearing, no vote was taken because lawmakers wanted more questions answered. At the second, senators on the committee voted unanimously for the deals, and most House GOP lawmakers voted against them. The third hearing, all but two House Republicans refused to support the deals, while senators didn’t vote after House members blocked passage. Edwards accused House Republicans of being obstructionists and playing politics with health care services.


Ideology trumps the facts

What does a U.S. senator do when ideological opposition to budget deficits is contradicted by his vote for a tax bill that will – at a bare minimum – add $1 trillion to the debt over the next decade? If you’re Louisiana’s Bill Cassidy or John Kennedy, you simply deny the conclusion of the nonpartisan Joint Committee on Taxation, the panel that Congress hired to make such projections, in favor of a more suitable narrative. The Advocate’s Lanny Keller detects a trend, and says politicians in D.C. and Baton Rouge are suddenly denying inconvenient facts brought to them by nonpartisan policy experts.

In Baton Rouge, one of the trends of the GOP criticisms of Gov. John Bel Edwards and the budget is that forecasts are wrong, that the various instruments created over decades to deal with Louisiana’s chronic overspending are part of the problem instead of possible solutions. Fiscal reforms included creation of a Revenue Estimating Conference, a board requiring unanimous agreement on tax forecasts before lawmakers can spend the money. During the national recession of the last decade, Louisiana’s forecasts were off, although not as much as many other states, even though our state has a more volatile tax system because of energy prices and poor budget decisions over decades.


Stepping into the breach

Open enrollment for the federal Health Insurance Marketplace ends Dec. 15. Cuts by President Donald Trump’s administration for outreach activities prompted concerned citizens and advocates to work to pick up the slack. Christine Petrin and Frances Gill, Tulane University medical students, wrote to The Advocate to outline how they and other med students are pitching in through partnership with the health care non-profit 504HealthNet.

In Louisiana, funding for navigators — people trained to help consumers shop for and purchase health insurance — was cut by 80 percent, dropping from $1.5 million to just $300,000. Nonprofit organizations across the state are shifting funds and reallocating grant money to retain as many navigators as they can. Still, many others have been laid off due to inadequate funding. To compensate, a number of new players are entering the field, including medical students from the Tulane University School of Medicine, such as ourselves.


Inequality curbing innovation

David Leonhardt writes for The New York Times about a new study from Stanford economists that finds that inequality is stifling innovation. This finding comes at a time when Congress is considering legislation that would widen the gulf between the richest, most powerful people and those who struggle to provide their kids with the tools needed to succeed. The problem: kids from disadvantaged background don’t have the same access to social networks, mentorship and educational opportunity as their more well-off peers.

This fact may be the starkest: Low-income students who are among the very best math students — those who score in the top 5 percent of all third graders — are no more likely to become inventors than below-average math students from affluent families. … Women, African-Americans, Latinos, Southerners, and low- and middle-income children are far less likely to grow up to become patent holders and inventors. Our society appears to be missing out on most potential inventors from these groups.


Number of the Day

9 – Days remaining in the open enrollment period for Americans who want to buy health coverage through the federal Health Insurance Marketplace. (Source:


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