Wednesday, March 5, 2014

Wednesday, March 5, 2014

Budget gimmicks get fresh scrutiny; New Orleans doctors say Medicaid expansion is urgent; Advocate: No repeat of retirement fights in 2014; and Constitutional amendment seeks to protect home-care programs. $7,084,434,484 - Total value of Louisiana’s tax exemptions in 2012-13. (Source: Tax Exemption Budget)

Budget gimmicks get fresh scrutiny
Two stories in the weekend papers — by journalists who have covered the state budget longer than anyone — shine an important light on the various tricks the governor and Legislature have used to keep things in balance, and the possible consequences for the next governor. From the AP’s Melinda Deslatte: “The maneuvers leave any governor to follow Jindal, who is term-limited in early 2016, with fewer dollars socked away in savings accounts, less money from annual interest earnings to pay for ongoing expenses and lingering disputes tied to the fund sweeps. The Republican governor has steered tobacco settlement dollars away from health and education trust funds and into the annual operating budget; zeroed out a list of funds that had dedicated fees and other balances planned for specific projects or purposes; and drained an elderly trust fund that once contained more than $830 million. His administration has even gotten into a fight with a group of legally blind vendors for tapping into the vendors’ trust fund to pay for the state’s legal dispute over a contract for food services operations at Fort Polk.”

The previous day, The Advocate’s Michelle Millhollon weighed in with a detailed story about the budget gimmicks that included a helpful history lesson on how previous governors coped with budget challenges. “In six years, Jindal has managed to cut the state workforce and to shift state government functions to private companies. It’s in the sustainability of his state spending plans that he draws criticism. Some legislators say they are tired of gimmicks such as selling a state building to ensure Medicaid recipients can go to the doctor. The solution is harder than it seems. Cut spending? Sure, but no one can decide where to cut. Increase taxes? Not on Jindal’s watch.”

Of course, there is a solution to these chronic structural deficits that has proved a non-starter in Louisiana: new revenues. As the Pelican State struggles through another year with budget gimmicks and fund-raids, states such as Michigan and California that raised taxes as part of their budget-balancing strategies are now enjoying healthy surpluses.

New Orleans doctors say Medicaid expansion is urgent
While a broad coalition of policy advocates has been arguing in favor of increased Medicaid coverage for years, the leaders of the state’s medical establishment — doctors and hospitals — have mostly stayed on the sidelines. But that could be changing, judging from a letter in The Times-Picayune by three doctors who are alarmed by recent changes in the health program for the poor and disabled. “Recent state Medicaid changes are leaving our most vulnerable patients without access to physi­cians, health services and essen­tial medications,” they wrote. “The changes disrupt the relationships doctors have with patients and do not make economic sense. As physi­cians in the Interim LSU Hospi­tal Emergency Department and a local community clinic, we have seen patients return time and again to the ER because they have been unable to fill their essential prescriptions or access their physicians.The people most affected by these changes often live on the economic margins of our communities. Frequently, their chronic diseases get worse at the end of the month when they run out of food and cannot eat properly. Few have jobs that have sick leave and a day in the ER is lost wages.”

And in case you missed it last week, the Daily Show made the case for Medicaid expansion better than any press release.

Advocate: No repeat of retirement fights in 2014
Gov. Bobby Jindal’s longstanding efforts to make state employees work longer for smaller benefits appear to be over. The Advocate reports that the administration will not be renewing its push to raise the payroll tax on state workers, push back the retirement age and force new state employees into a 401(k)-style pension plan — efforts he has tried repeatedly to pass in recent years only to be rejected by the Legislature and the state Supreme Court. Instead, the major question for the state pension system is whether retirees will get a raise. “The leaders of Louisiana’s two largest statewide retirement systems are predicting a legislative session in which employee benefits and pension eligibility battles give way to granting 1.5 percent cost of living adjustments to retirees and discussion of ways to get more money directed to paying off pension systems’ long-term debt requirements.”

Constitutional amendment seeks to protect home-care programs
If you can’t beat em, join em. That, at least, seems to be the motivation behind a proposed constitutional amendment by Sen. Fred Mills that seeks to lock down funding for home- and community-based services in the state budget. Mills’ Senate Bill 355 comes a year after hospitals and nursing homes won support for a constitutional amendment that protects their Medicaid funding — a potentially costly move, since the nursing home program will need a large infusion of state dollars next year after a state trust fund runs dry. As The Times-Picayune notes, legislation has also been filed for the upcoming session that would protect funding for higher education. “Mills’ bill is part of a trend in Louisiana legislation, where state lawmakers try to lock up funding for programs they deem essential. Gov. Bobby Jindal has made dramatic cuts, particularly to higher education and health care funding, in an effort to balance the state budget without raising taxes during his two terms in office.Mills and other legislators — under pressure from advocates — have responded by trying to make it more difficult for the governor to take money from their preferred programs.” 


$7,084,434,484 - Total value of Louisiana’s tax exemptions in 2012-13. (Source: Tax Exemption Budget)