Waiting on Medicaid expansion

Both candidates for governor–John Bel Edwards and David Vitter–have said they would look at expanding Medicaid coverage to the working poor. But how they do plan to do so matters, Nola.com columnist Bob Mann explains:

Edwards is unequivocal. He says he will expand Medicaid on “day one” of his administration. “I will expand Medicaid because it’s the right thing to do,”Edwards has said. He has also correctly noted that Jindal’s refusal to expand Medicaid means that $3.2 billion in Louisiana’s federal taxes have gone to other states…” While Edward says he will accept the federal funds on day one, Vitter will not. Vitter has a time-consuming and more onerous plan – asking the Obama administration to approve a waiver allowing him to create a Medicaid program tailored for Louisiana…It could take a year for the Obama administration to rule on a waiver proposal. And if the administration rejects Vitter’s plan – and it has rejected waivers from other states – Louisiana’s working poor could go without insurance another year or more. Simply put, seeking a waiver means Medicaid expansion probably won’t happen in the first year of a Vitter administration.

Mann also notes that Vitter has mentioned he wants to seek a “work requirement” for Medicaid expansion. Not only has this been rejected in other states–the purpose of Medicaid expansion is to provide health care, not punish the unemployed–but it seems an odd request considering that most Louisianans who would benefit from expansion are already working.

A Day of Reckoning

After years of assurances from the Jindal administration that the state would balance its budget and protect critical services in the face of ever dire financial problems, it might finally be time to face the music. Julie O’Donoghue with Nola.com has the story:

Just one quarter of the way into the current fiscal cycle, Louisiana is already short between $412 million and $622 million in funding, depending on how you count it.The state will have to make midyear cuts and take other measures to close that gap. In other words, the so-called balanced budget Jindal signed in June is falling apart. “I’ve been worried for some time,” said Senate President John Alario, in an interview.

The state funding gap is the result of various shortfalls and deficits that have cropped up since the state budget went into effect July 1. In the latest bit of bad financial news for the state, the Jindal administration is expected to announce Friday morning (Oct. 30) that the state ended its last fiscal cycle with a $117 million deficit, which must be absorbed in the current budget. This news comes as the state’s finances are already beset with revenue issues that includes falling oil prices, which is expected to cost Louisiana an additional $135 million in revenue this year. Plus, the state’s health care programs for the poor and uninsured are already known to be short about $335 million…

“I don’t think we’ve ever been in this position before,” said state Treasurer John Kennedy, a Republican, who has been active in state government since the early 1980s. The $335 million shortfall in health care services will likely be handled within the Department of Health and Hospitals. The remaining $287 million shortfall will have to come from somewhere else, which has higher education officials worried. While higher education certainly wouldn’t be expected to absorb the full $287 million, anything approaching even a quarter of that figure would be devastating. To put it in perspective, Louisiana’s entire community and technical colleges operating budget for this year wasn’t much more than that — about $307 million overall.

Federal budget deal is good news for states

President Barack Obama and House and Senate leaders have reached an accord on a new federal budget deal that contains good news for states, as Bob Greenstein of the Center on Budget and Policy Priorities explains:

If approved by Congress, the new budget deal from the White House and congressional leaders will mark a significant achievement by an otherwise polarized Washington.  Along with raising the debt limit until early 2017 and thereby avoiding a potentially catastrophic default, the package would: Effectively eliminate about 90 percent of the sequestration budget cuts for non-defense discretionary programs in fiscal year 2016, and about 60 percent of them in 2017, while also easing sequestration for defense by equal dollar amounts in both years — and thereby providing more substantial relief from sequestration than the Murray-Ryan deal provided for 2014 and 2015; Greatly reduce the potential for government shutdowns this year and next (essentially eliminating the risk of a shutdown over funding levels, though retaining the possibility of one over riders and other policy differences)…

Raising the debt ceiling and avoiding a government shutdown is good news for the American economy, as failing to do either could result in instability and job losses. And for state governments, easing of “sequestration”–a wonky term for across the board cuts in federal spending–means a bit more money for everything from education to safe drinking water projects.

Think of the children
Over the last year, candidates for governor have discussed their differing ideas on taxes, higher education, transportation, health care and economic development. But not enough attention has been given to the youngest among us, writes Melanie Bronfin of the Policy Institute for Children in a letter to The Advocate:

Quality early care and education is one of the best investments a state can make. A child’s most important brain development occurs from birth through age 4. Like a house, once the foundation is laid, it is difficult and expensive to go back and fix it. Economists have demonstrated that high-quality early education can produce $8 in benefits for every $1 spent. But it is not just about money. It is about a better future for Louisiana. It is about creating a state where there is a reduced need for special education services, a state where fewer children are held back and must repeat a grade, a state where more students stay in high school and graduate from college.

Almost 70 percent of Louisiana’s children age 5 and under spend significant time in child care because they have both parents, or their only parent, working. But the state appropriates zero state general fund dollars on early care and education slots for children under age 4, and, in fact, Louisiana’s Child Care Assistance Program has been cut 60 percent in the last six years. Louisiana’s Early Childhood Education Act (Act 3) of 2012 has gone largely unfunded, making it unlikely we will ever achieve the reform goals of educational access, accountability and quality care. These stumbling blocks to child development and school readiness damage the current workforce and jeopardize the future growth of skilled workers…Our state’s young children are the future health of our economy. Early care and education is a proven strategy for achieving this healthy future.

Number of the Day

Zero – State general fund dollars spent on early care and education for children under four (Source: Nola.com)