Obamacare change would hurt Louisiana

Posted on June 19, 2017

Gov. John Bel Edwards is among a bipartisan slate of seven governors who signed a letter to U.S. Senate leaders urging them to take a bipartisan approach to solving America’s healthcare problems instead of pushing the version being negotiated behind closed doors that lacks Democratic support. From the AP:

In a letter to Senate Majority Leader Mitch McConnell and Minority Leader Chuck Schumer, the governors, including three moderate Republicans, argue that “true and lasting reforms are best approached by finding common ground in a bipartisan fashion.” The governors implore the leaders to focus on stabilizing the individual insurance markets, give states flexibility and ensure affordable cover. … The governors said they oppose the bill the House narrowly passed last month, citing its deep cuts to Medicaid, the federal-state health insurance program for low-income Americans.

Lafayette attorney Nell Hahn, who recently retired from a distinguished career at The Advocacy Center working on behalf of people with disabilities, explains why the changes being debated by the Senate would be particularly bad for Louisiana. Writing in The Advocate:

These changes will affect the whole country, but their impact will be much greater in states like Louisiana that have high poverty, high unemployment, and large rural and minority populations. Other factors that will increase the impact in Louisiana are our overall poor health status; large numbers of people with disabilities, including mental health problems; high opioid abuse; and high rate of new HIV cases. In fact, according to the Kaiser Family Foundation, Louisiana is one of 11 states that is likely to bear the brunt of the cuts in Medicaid.

A New Orleans pediatrician, Kimberly Mukerjee, writes for Times-Picayune that the AHCA threatens to undo one of the great public health gains of recent decades – improved coverage for children.

The Children’s Health Insurance Program (LaCHIP in Louisiana) covers an additional 8.9 million U.S. children in working families. Roughly 764,000 children, almost half of all kids in Louisiana, rely on Medicaid and LaCHIP.  Between 2008 and 2015, these programs and the Affordable Care Act brought the rate of uninsured children in Louisiana to its lowest ever, from 7 percent to 4 percent, surpassing national rates. Now is not the time to disrupt this progress.

Programming note: Tomorrow (June 20), LBP will release a report about the American Health Care Act and its effects on Louisiana. The author of the report, Jeanie Donovan, and healthcare leaders will be available for questions at a 11:30 a.m. news conference at CareSouth, 3140 Florida Street, Baton Rouge.   


Post-mortems on a ‘do-nothing’ session

The reporters who covered the 2017 Legislature – regular and special sessions – agree: Lawmakers fought a lot but accomplished little. And next year’s budget and tax debates will be much, much worse.  The AP’s Melinda Deslatte:

The state had relatively solid financial footing, without massive budget gaps, for the financial year that begins July 1. Lawmakers generally just needed to set spending priorities and determine what they could afford. Those are the basic decisions expected of the legislative branch, which holds the state’s purse strings. But lawmakers’ philosophical, partisan and personality divides made even those straightforward choices tough. And for the first time in 17 years, they failed to finish an operating budget in their regular legislative session, costing taxpayers extra money so they could go into overtime. If it was this much of a saga to create a 2017-18 spending plan, haggling over the next one is certain to be a mess, with lawmakers staring down a budget gap estimated to top $1 billion for the 2018-19 fiscal year.

The Advocate’s Tyler Bridges reports that even modest efforts to raise revenues were shot down by the House:

The House Republican leadership did support one major revenue-raising measure during the regular session. That bill would have raised $173 million a year by renewing the state sales tax on some 100 transactions that had been untaxed in recent years. But the House, at the behest of the Louisiana Chemical Association, gutted the bill by exempting businesses from paying sales tax on the electricity they use in manufacturing. With the bill now generating much less revenue, the full House killed it anyway because Democrats voted as a bloc against it. They wanted the House to support a similar measure sponsored by a Democrat.

While another special session is almost inevitable, Julia O’Donoghue reports for Times-Picayune that Gov. John Bel Edwards doesn’t want to call lawmakers back into session until a consensus has emerged on how revenues can be raised to avoid the $1.2 billion fiscal cliff.

Yet Edwards said Friday evening he wouldn’t call a special session unless he thought the conservative Louisiana House would be willing to pass or renew taxes. If it isn’t, the governor would be willing to let them tackle $1.2 billion worth of cuts, which would likely result in the closure of hospitals and universities around the state, to deal with the fiscal cliff.


The state of the House GOP

The Legislature’s inability to carry out its most basic governing task – passing a budget in the regular session – has given rise to questions about its leadership, particularly in the House. The Advocate’s Tyler Bridges wonders whether the conflicts will lead to changes in the House leadership:

“Many of us are getting tired of just a particular segment of the Republican Party running this chamber,” state Rep. Rob Shadoin, R-Ruston, said in an interview on the last day of the regular session. Shadoin was one of 10 Republicans who on Wednesday of the special session broke ranks with the Republican leadership on the initial vote for the Senate’s version of the budget, which would appropriate 100 percent of the available anticipated money for the fiscal year that begins on July 1.

The inimitable Jim Beam cheers the rebellious baker’s dozen in the House who helped avoid unnecessary cuts:

(Rep. Franklin) Foil said he wanted to spend less money, “But I felt like $60 million hold-back was close enough to the goal of protecting ourselves from mid-year budget cuts. It also fully funds TOPS and other good things.” He was talking about the $60 million agencies will be asked to put aside in the event those funds are needed down the line. The budget has other major pluses. A financially decimated higher education system is fully funded for the first time in a decade. State employees who haven’t had a pay raise in 10 years will get a 2 percent increase. More money is going to prisons, health services and State Police. Agencies are also facing budget cuts. Mental health services will have to be curtailed and the private-public partnerships that took over the charity hospital system will see reductions.


Car is gone, but the debt remains

The subprime lending market – high-interest loans for borrowers with shaky financial underpinnings – is back. But this time it’s not houses but cars that are being financed with expensive loans that can be difficult or impossible for low-income people to repay. As Jessica Silver-Greenberg and Michael Corkery report for the New York Times’ Dealbook, such loans are on the rise. Even worse, lenders are using the courts to make delinquent borrowers pay – sometimes long after their vehicles have been repossessed.

These are people desperate enough to take on thousands of dollars of debt at interest rates as high as 24 percent for one simple reason: Without a car, they have no way to get to work or to doctors. With their low credit scores, buying or leasing a new car is not an option. And when all the interest and fees of a subprime loan are added up, even a used car with mechanical defects and many miles on the odometer can end up costing more than a new car. Subprime lenders are willing to take a chance on these risky borrowers because when they default, the lenders can repossess their cars and persuade judges in 46 states to give them the power to seize borrowers’ paychecks to cover the balance of the car loan.


Number of the Day

764,000 – Number of children in Louisiana who rely on Medicaid or the Children’s Health Insurance Program for their health coverage (Source: Times-Picayune)


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