Monday, August 3, 2015

Monday, August 3, 2015

Medicaid Turns 50; Poverty is not an insoluble problem; New tax raises car insurance rates and; Advocate: Bond ratings matter

Medicaid Turns 50

As the Daily Dime enjoyed a brief summer hiatus, the federal Medicaid program celebrated its 50th anniversary. To mark the occasion, LBP released a report by Steve Spires that shows how this program has become a lifeline for vulnerable Louisianans – particularly children. According to “Medicaid at 50: A Louisiana Success,


Three in ten Louisianans count on Medicaid for essential health services, like doctor visits, hospital stays and prescription drugs. More than half of Medicaid patients are children, and another 26 percent are seniors and people with disabilities. Medicaid pays for 70 percent of births and 70 percent of nursing home beds. Medicaid is a critical part of our health care system, accounting for one in every five health care dollars in Louisiana. It is the main source of funding for our charity hospitals and long-term care services for the elderly and people with disabilities. Without Medicaid, it would be harder for all Louisianans to get the care they need.


But The Advocate’s newest columnist, Jeff Sadow, is no fan of the program and thinks Gov. Bobby Jindal was right to reject the federal dollars that could be used to provide health coverage to more than 300,000 eligible low-income Louisiana adults. That prompted a response from LBP Director Jan Moller, who pointed out that states are actually saving money through Medicaid expansion and that independent studies are showing that people with health coverage fare better than the uninsured.


Rather than expand coverage, Sadow advocates sticking with the health care status quo. But that simply isn’t good enough. Here in Baton Rouge, the closure of Baton Rouge General’s mid-city emergency room shows what can happen when hospitals struggle under the financial weight of uninsured patients. In states that expanded Medicaid, uncompensated care is down, and hospitals and doctors are getting paid for seeing patients. And that is good for everyone, because you can’t get care at your local hospital if it is forced to shut its doors.


Poverty is not an insoluble problem

Columnist Bob Mann has been asking why the four major candidates for governor aren’t talking more about poverty on the campaign trail. Even though Louisiana has the nation’s third-highest poverty rate – and one of the highest rates of economic inequality – Mann doesn’t buy the notion that public policy can’t play a key role in lifting up struggling families.

In the weeks since I asked why our candidates for governor aren’t debating poverty, several readers posed variations of these questions: “But what, really, can we accomplish? I mean, there’s not a lot we can do about poverty, right?” Wrong. There is much we can do. It’s not just a matter of resources; it’s also a question of will. For starters, the candidates – for governor on down – could simply talk to the working poor about their lives. Maybe they wouldn’t be so quick to vilify or dismiss a hardworking single mom with three kids and two jobs after they visited her home and heard her story. At the very least, we could reform cruel laws that overtax the poor. But there’s more, much more, we can do.


Mann points to a questionnaire developed by the United Way of Southeast Louisiana that asks candidates whether they’re willing to support an increase in the Earned Income Tax Credit, equal pay for women, expanded Medicaid coverage and a higher minimum wage, among other things.


New tax raises car insurance rates

Louisiana drivers already pay some of the highest car insurance rates in the country. And now a new law is about to make driving even more expensive. As The Advocate’s Marsha Shuler reports, the Legislature tacked $10 onto the cost of getting a copy of a driver’s record from the Office of Motor Vehicles – which will raise nearly $22 million a year from motorists. The vast majority of the driving records are requested by insurance companies on behalf of people seeking coverage. The extra cost, which is going from $6 to $16, will get passed on to customers.


Baton Rouge insurance company owner Gene Guffey called the $10 fee increase an “outrage.” “It’s just a little computer print-out,” Guffey said. Guffey said people already are struggling to pay insurance premium costs. “They are sneaking a rate increase on us,” he said. Guffey has emailed legislators, including Pugh, asking what were they thinking. also are impacted. Donelon said a large number of policies are written directly by insurance companies, such as the Progressive Group of Insurance Companies, which does half its business through a toll-free line.


The dollars will go to fund the Louisiana State Police, whose officers have received two hefty pay increases in the past year.


Advocate: Bond ratings matter

The Advocate’s editorial board hopes that a change of leadership in the governor’s office will eventually lead the national bond rating agencies to look more favorably on Louisiana’s credit rating. The agencies’ outlooks are critical, as they affect the state’s ability to borrow money at favorable interest rates.


At least $542 million in the budget is in one-time money used to prop up the operating plan for the fiscal year that began July 1. While that’s less one-time money than last year because of legislative tax increases, it’s still no sign that a bond rating agency could consider fiscally responsible. If we’re resorting to all these financial gimmicks and dubious funding sources during relatively good economic times, what reassurance can we give the bond agencies or anyone else that Louisiana’s outlook is anything better than negative? Our state is living on borrowed time.


Number of the Day

$4,511 – Average cost per Medicaid beneficiary in Louisiana, one of the lowest in the country (Source: LBP via Department of Health and Hospitals)