Wednesday, January 13, 2016

Wednesday, January 13, 2016

Medicaid expansion moving ahead; Yes, it is really that bad; State of the Union; and Powerball baby!

Medicaid expansion moving ahead

Gov. John Bel Edwards signed an executive order on Tuesday directing the Department of Health and Hospitals to move forward with Medicaid expansion no later than July 1. The order is life-changing news for hundreds of thousands of uninsured Louisianans who work low-wage jobs that don’t offer health coverage. Additionally, the experience of other states shows that Medicaid expansion will bring new federal health dollars to the state and save millions in state funds. Kevin Litten with The Times-Picayune/ reports:


“By July 1, we expect more than 300,000 hard-working citizens will have the comfort and security of health coverage,” Edwards said. “This will not only afford them peace of mind, but also help prevent them from slipping further into poverty and give them a fighting chance for a better life.” With Edwards’ executive order in place, the Department of Health and Hospitals will now begin to prepare for a massive enrollment process that will mean hiring 248 new people to confirm eligibility and issue Medicaid insurance cards to those people. The state has secured financial commitments from health care providers to fund the estimated $2.8 million in startup costs for the expansion.


Health care providers have a powerful incentive to help the state get Medicaid expansion up and running: Once it’s in place, hospitals can be reimbursed for the cost of care for previously uninsured patients they wouldn’t otherwise be paid for treating. In response, some emergency rooms across the state have shuttered because they could no longer afford to treat uninsured patients. Edwards said he hopes that begins to change, saying the closed emergency rooms across the state hurt uninsured patients and more upper-income patients with health insurance who need care quickly. In a statement, the Louisiana Hospital Association said “reducing the number of uninsured adults in Louisiana makes it easier to improve access to needed care,” and will reduce costs for people on private insurance.


Yes, it is really that bad
The Legislature’s fiscal analysts met with the newly sworn-in members of the state House on Tuesday for a deep dive into Louisiana’s fiscal morass. The Advocate’s Elizabeth Crisp has details:


“This is one of the worst times that I have witnessed, myself,” Legislative Fiscal Officer John Carpenter told the chamber. Carpenter somberly urged the lawmakers — 29 new to the House this year — to view the budget crisis as an opportunity. “We have one good opportunity here to actually get it right,” he said. Much of the budget talk was met with mild interest from House members who mingled about and talked throughout the more than two hours of presentations. The chamber was called to order so the analysts could be heard over loud chatter as they discussed state spending for education, transportation and health care, among other areas.

A handful of members appeared to be listening intently, scribbling notes into their folders and asking questions to get more specific details. Some of those more engaged members also asked questions in an effort to draw the rest of the body’s attention to certain points, though it had little effect….“Everybody understands the urgency of the financial situation that we’re in,” Barras said after the chamber wrapped up its presentations Tuesday. “The size of the deficit is established.” Barras said he expects the state will work to cut some parts of the budget, as well as bring in new revenue. “I need the members to understand and vote with confidence,” he said.


State of the Union
Just two days before he is set to visit Baton Rouge, President Barack Obama gave his eighth and last State of the Union address to a joint session of Congress on Tuesday evening. The New York Times has the full text, but especially noteworthy was the president’s words on how the 21st century economy affects working people:


What is true — and the reason that a lot of Americans feel anxious — is that the economy has been changing in profound ways, changes that started long before the Great Recession hit, changes that have not let up. Today, technology doesn’t just replace jobs on the assembly line, but any job where work can be automated. Companies in a global economy can locate anywhere, and they face tougher competition. As a result, workers have less leverage for a raise. Companies have less loyalty to their communities. And more and more wealth and income is concentrated at the very top. All these trends have squeezed workers, even when they have jobs, even when the economy is growing. It’s made it harder for a hardworking family to pull itself out of poverty, harder for young people to start their careers, tougher for workers to retire when they want to. And although none of these trends are unique to America, they do offend our uniquely American belief that everybody who works hard should get a fair shot.


The president’s diagnosis of workers’ malaise suggests policies that increase investments in education and worker training–and beyond that, policies that boost wages and strengthen worker protections like paid sick-time and family-leave–are more important than ever if America wants to protect equality of opportunity.


Powerball baby!

The Daily Dime won’t divulge if–or how many–Powerball tickets it may have bought, but given the record $1.4 billion jackpot, if the Dime were to hypothetically play the numbers, it wouldn’t be alone. On the upside, as Julie O’Donaghue with writes, it isn’t just regular folk that play the lotto who stand to win:


At least 35 percent of all lottery sales in Louisiana — including Powerball tickets — is returned to the state. Currently, lottery sales are 17 percent above what was anticipated for the state’s fiscal cycle. Powerball alone is up 70 percent above expectations during the first six months of the current budget year… Last Saturday alone — when the most recent Powerball drawing took place — Louisiana retailers did $10 million in Powerball ticket sales. For a smaller jackpot — let’s say $40 million — the state typically sees between $300,000 and $400,000 in sales on the day of the drawing, Chopin said.


Most of the excess lotto cash is slated to support K-12 education, according to state law. Unfortunately, it can’t be used to help the current budget shortfall:


Currently, Louisiana actually has a shortfall of approximately $20 million in its primary and secondary education budget. Former Gov. Bobby Jindal’s administration didn’t include enough money to cover the total enrollment in Louisiana’s public schools this year, so Gov. John Bel Edwards and the Louisiana Legislature must find extra cash to accommodate the larger enrollment. But even if Powerball brings in more money this year, it can’t be used to cover the existing public schools shortfall. The lottery revenue can only be used to help with next year’s budget, according to state regulations. It can’t be used to plug the immediate hole, said Greg Albrecht, the Louisiana Legislature’s chief economist who predicts the revenue collections for the state.


Number of the Day


300,000 – Minimum number of Louisianans–mostly uninsured workers–who are expected to gain health coverage as the state expands Medicaid (Source: