In The Spotlight

Senate health bill fails every litmus test

The Senate health bill would lead to 22 million more people uninsured nationally, including hundreds of thousands of Louisianans. It would raise average after-tax-credit marketplace premiums in Louisiana by 105 percent and it contains a glaring loophole that would mean people with pre-existing conditions would not be protected.

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NEW REPORT: The American Health Care Act Would Reverse Recent Coverage Gains and Strain Louisiana’s Budget

The American Health Care Act would be devastating for the state budget, health care providers and residents of all parts of the state.

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Tax bills fall short on revenue

While these bills would eliminate a costly and unorthodox tax break, they fall far short of the revenue that is needed to address the looming $1.3 billion fiscal cliff in 2018 and put the state budget back on a more sustainable path. In fact, passage of these bills - which would require a vote of the people - would make it harder for policymakers to solve the state’s structural revenue shortfall in a future special session.

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The Daily Dime

Stymied in his efforts to repeal the Affordable Care Act, President Donald Trump has threatened repeatedly to withhold the federal subsidy payments to health insurers that reduce the cost of copayments and deductibles that keep coverage affordable for people with low incomes.

Number of the Day

4  -  Number of poor families with children receiving TANF cash assistance out of every 100 poor families with children in Louisiana - the lowest percentage in the nation. (Source: The Urban Institute)

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Our Two Cents Blog

Setting the record straight on Medicaid

Posted on August 4, 2017

The Medicaid program turned 52 years old this week. That’s how long it’s been since President Lyndon B. Johnson signed into law the unique federal-state partnership that now finances the  health-care that nearly 1.6 million Louisianans depend on. Medicaid covers the majority of births in Louisiana, as well as most nursing home stays. It covers 714,000 children – and, thanks to a long-overdue policy change, more than 433,000 low-income adults now have coverage as well.

Medicaid is not without critics. Politicians in Washington and Baton Rouge have tried to cut the program by claiming it is “broken” and that costs are “out of control.” But a look at the facts show that such claims are inaccurate and misleading. So it’s time to set the record straight:

Fact #1: Louisiana operates a lean Medicaid program.

Evidence: Spending on Louisiana’s Medicaid program has increased substantially over the last decade due to myriad factors.  One reason for Medicaid cost growth is increasing health-care costs across the board, which impacts costs for both public and private insurers and providers. Medicaid actually serves comparable patients less expensively than private coverage, because of Medicaid’s lower reimbursements to providers and use of managed care. (Providers often cite low Medicaid reimbursement rate as a problem, but reducing funding for the program would only make this worse.) Another reason for increasing Medicaid costs in the state budget is the dramatic decrease in the state’s federal matching rate. Between fiscal years 2008 and 2010, the federal government paid between 72 and 82 percent of Louisiana’s total Medicaid expenses. In fiscal year 2016, the federal government paid just 62 percent of total expenses. 

In 2014, (the most recent year for which national data is available) the state’s per beneficiary spending was $4,796, which was $940 below the national average and $5,596 below North Dakota, the state with the highest per-beneficiary spending. And, according to the Louisiana House Fiscal Division, the state’s Medicaid spending growth between 1991 and 2016 was 6.7 percent compared to the national average of 7 percent.

Louisiana’s expansion of Medicaid in July 2016 has allowed an additional 433,000 low-income adults to enroll in the program, which has substantially increased the overall cost of the state’s Medicaid program. However, as discussed in a later section, due to a favorable federal matching rate for expansion enrollees and payments from Louisiana Medicaid providers, the expansion is actually saving the state money.

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