Thursday, March 20, 2014

Thursday, March 20, 2014

Story details Louisiana’s bungled attempt to cut Medicaid prenatal services; Poverty doesn’t have to produce poor health outcomes; Medicaid expansion benefits people with disabilities; Daily Advertiser supports payday loan reform; and Train from New Orleans to Baton Rouge would cost $262 million. 17 percent — The percent by which Louisiana corporate tax collections are expected to drop next year. (Source: Legislative Fiscal Office)

Story details Louisiana’s bungled attempt to cut Medicaid  prenatal services
You may recall the brouhaha that ensued last fall when Gov. Bobby Jindal’s administration decided to eliminate Medicaid-financed prenatal care for thousands of pregnant women by lowering the income threshold to participate in the LaMOMS program. The state’s reasoning was that women who earned above 133 percent of the federal poverty line could get covered in the federal health insurance marketplace and would not need state assistance. But that turned out not to be the case, and the state reversed course in mid-November, before the change would have taken effect on Jan. 1 – all the while blaming federal health-care authorities for the apparent mix-up.

A Chicago-based reporter for the website RH Reality Check did some digging and came away with some startling findings. It turns out state health authorities apparently made no effort to verify whether becoming pregnant was a “qualifying life event” that would allow them to sign up for insurance through the exchange. Instead, they relied on the “glossary” section of the website, which contained a typo that was later fixed.

“It’s unclear why Louisiana officials hadn’t consulted the rules of the ACA itself or contacted health-care experts before going ahead with the Medicaid cuts,” Katherine Don wrote. “’A glossary is not a law,’ said the Center on Budget and Policy Priorities’ Judy Solomon. ‘Pregnancy is not on the list [of ‘qualifying life events]. You can Google it.’”

Moreover, when the state reversed course, it decided that pregnant women with incomes between 133 and 200 percent of poverty would be added to the LaCHIP program for children, not the LaMOMS program that covers women. As a result, there are questions about whether pregnant women are fully covered, or whether the state will only pay for services that benefit their fetuses. “Further, women will no longer receive the 60 days of postpartum care that is required through LaMOMS,” Don writes. The entire story is worth a read.

Poverty doesn’t have to produce poor health outcomes
The Los Angeles Times continues its outstanding series of articles about regional health care disparities with a look at northern Maine, a region that shares Louisiana’s high concentration of rural poverty and chronic disease but enjoys much better health outcomes. Noam Levey reports:  “Residents of the region receive recommended screenings and medical care more often than other Americans. They suffer fewer complications in nursing homes and are less frequently prescribed risky medications. And they are nearly half as likely to die from preventable diseases as residents of other low-income areas, according to data from the Commonwealth Fund, a nonpartisan research foundation that studies healthcare systems.

“Maine’s success owes much to … care that (is) intensely personal, data-driven and highly coordinated. The approach grew out of a decades-long effort by local leaders that many experts consider a model for how to improve community health.”

Medicaid expansion benefits people with disabilities
Gov. Bobby Jindal claims that Medicaid expansion is discriminatory because it provides a more favorable match rate for the expansion population than for the pregnant women, children and people with disabilities who are currently covered by Medicaid. But that argument simply doesn’t hold water, according to an editorial by LBP policy analyst Steve Spires. “This is a bizarre argument, as there is nothing in the new federal health care law that discourages states from investing in services for people with disabilities. Having a higher match rate for the expansion population does not prioritize one group over another. It is simply a financing mechanism.

“The reality is that Medicaid expansion would help the disabled community, and the real threat to services is the administration’s refusal to accept available federal dollars. Medicaid expansion offers the best hope of sustaining services for vulnerable populations.”

Daily Advertiser supports payday loan reform
On Thursday’s opinion pages, the Daily Advertiser and Gannet Louisiana endorsed Senate Bill 84 by Senator Ben Nevers of Bogalusa.  The bill would cap the annual percentage rate that payday lenders can charge at 36 percent.  Louisiana has one of the highest concentrations of payday lenders in the country and the APRs they charge can easily soar into above 700 percent. The high interest rate combined with the very short term of the loan traps thousands of Louisianans in long-term cycles of debt that often results in bankruptcy, bank account overdrafts and delinquency on other bills. “We commend Nevers’ efforts at holding down the usurious interest rates now being charged. And we urge legislators on both sides of the aisle to support this effort to help some of the state’s most economically vulnerable citizens.” Learn more about payday lending in Louisiana.

Train from New Orleans to Baton Rouge would cost $262 million
A new feasibility study showed a train from New Orleans to Baton Rouge could serve 210,000 people in its first year and cost passengers $10 per trip, according to “The capital investment to start the service will cost $262 million, 80 percent of which could be underwritten by federal funds, the study says. The proposed rail is nearly half as costly — both in infrastructure and operating expenses — as the high-speed rail plan that Gov. Bobby Jindal put an end to in 2010.”


17 percent — The percent by which Louisiana corporate tax collections are expected to drop next year. (Source: Legislative Fiscal Office)