Amendments complicate state budget picture

Louisiana voters agreed Tuesday to give special constitutional protection to institutional health-care providers, approving a pair of amendments to the state charter that will make it tougher to balance the budget during difficult financial times, reports Nola.com. Amendments 1 and 2, which benefit hospitals and nursing homes, respectively, provide special protection for Medicaid rates paid to those facilities. That means less flexibility for state legislators when the state faces financial shortfalls such as the $1.2 billion gap in the upcoming 2015-16 budget cycle.

Voters passed all but one of the amendments that will provide dedicated funding to different areas of the state. Some have criticized dedications as the reason health and higher education have been cut so badly over the past several years. A majority of the voters, however, felt they are the only way to protect certain areas from cuts.

The amendments had drawn opposition from the Council for a Better Louisiana, LBP, AARP Louisiana and every major newspaper in the state. But 56 percent of state voters disagreed.

Click here for full election results from the Secretary of State’s office.

What if the Supreme Court had ruled differently?

An additional 3 million low-income Americans – most of them in Southern states like Louisiana – would have health coverage today had the U.S. Supreme Court ruled differently in 2012 in its landmark decision on the federal Affordable Care Act. The court decided that extending Medicaid coverage to adults below 138 percent of the federal poverty line should be optional for states, instead of required under the law. As The New York Times’ Upshot blog reports:

Today, the odds of having health insurance are much lower for people living in Tennessee than in neighboring Kentucky, for example, and lower in Texas than in Arkansas. Sharp differences are seen outside the South, too. Maine, which didn’t expand Medicaid, has many more residents without insurance than neighboring New Hampshire. In a hypothetical world with a different Supreme Court ruling, those differences would be smoothed out.

The Times includes an excellent interactive map that shows, on a parish-by-parish level, what the uninsured rate is today and what it would have been under Medicaid expansion. In East Baton Rouge Parish, for example, the current 14.9 percent uninsured rate would be 11.1 percent.

Midterms: Inequality lurked beneath the surface

There will be an avalanche of analysis in the coming days interpreting the mid-term elections and what they mean for the next two years and beyond. One of the best takes came last week from Richard Reeves of the Brookings Institution, who said income inequality was rarely mentioned explicitly, but was an implicit issue in many races.

Inequality is the issue that dare not speak its name in the current political contests. But it lies just beneath the surface. Worrying out loud about inequality is almost tantamount to a declaration of support for revolutionary socialism from the top of a barricade—as Fed Chair Janet Yellen learned last week, in what was, in fact, a pretty conservative speech. As far as I can glean, not a single candidate in the key battlegrounds has mentioned Thomas Piketty’s book Capital, the gini coefficient—a standard measure of inequality—or trends in 90th/50th percentile income indices, one of my own favorites. But inequality is there alright, lurking underneath contemporary political discourse and finding expression in arguments over health care, taxation and—above all—the minimum wage.

Do neighborhoods matter?

A study released last year sparked a scholarly debate over whether children from low-income families get long-term benefits from moving to good neighborhoods with strong schools. Douglas Rice of the Center on Budget and Policy Priorities looks at the evidence and concludes that they do:

Some observers question the value of good neighborhoods, citing findings from Moving to Opportunity (MTO), a 15-year, random-assignment study of nearly 5,000 low-income families that the federal government designed explicitly to see whether moving to low-poverty neighborhoods benefits low-income children and their families. It found that moving to lower-poverty neighborhoods yielded only mixed health results for children and no educational gains, relative to children in the control group. But to conclude that neighborhoods don’t matter much to children is unwise. For one, it ignores the substantial research suggesting that growing up in neighborhoods of extreme poverty impairs children’s health and cognitive development — and that low-income children who grow up in low-poverty neighborhoods and attend high-quality schools can make substantial academic gains.

Number of the Day

$2.76 billion – Amount of discretionary general-fund dollars in the $26 billion state budget. (Source: House Fiscal Division)