Budget bill: Health care in the spotlight
Funding for medical education and safety-net health-care services for the poor remains far below what’s needed to maintain current service levels, members of the Senate Finance Committee were told Sunday as they began their review of the state budget. As The AP’s Melinda Deslatte reports, the LSU medical schools in Shreveport and New Orleans are short a combined $50 million, and the nine “partnership” hospitals are seeking another $150 million.
Larry Hollier, chancellor of the LSU Health Sciences Center-New Orleans, said he’d have to “start taking out programs” like dental hygiene and undergraduate nursing. Plus, the medical school officials said they face further hits if the safety net hospitals and clinics where they train students take reductions and scale back patient care. But the Edwards administration and the safety net hospitals disagree over the financing needed to keep the facilities on track. Hospital representatives said they’re about $150 million short to continue all services. [Health and Hospitals Secretary Rebecca] Gee said the House-approved budget covers hospital costs, calling the financing “reasonable.” “I’m scratching my head as to why we’ve spent so much time on that particular issue,” she said.
Deslatte notes that the current version of the budget, crafted in two days of debate on the House floor, looks quite different from what House leaders proposed. It has more money going to health care and less money for TOPS scholarships.
As the budget heads to the Senate, K-12 education, public colleges, state parks and a wide array of government programs would take hits. The Edwards administration said the House reworking of the budget could shutter some health programs for the elderly and disabled and create problems for the state prisons system. Edwards wants to hold a June special session on taxes to raise additional money to stave off cuts. Republican House leaders have shown resistance to the idea. As he thanked the House for its “hard work” on the budget, Edwards returned to the idea of a special session.
The Advocate’ Mark Ballard says the early reviews are not kind for House Appropriations Committee Chairman Cameron Henry of Metairie, who was a back-bench critic of Gov. Bobby Jindal and now has the unenviable task of steering the budget bill through the lower chamber.
Senate President John Alario, R-Westwego, referred to Plan Henry as “a scheme.” Democratic Gov. John Bel Edwards called it a “political stunt.” And Dr. Rebekah Gee, whose mammoth Department of Health and Hospitals bore the brunt of the proposed spending cuts, called it “leprechaun financing.” The independent, nonpartisan Council for a Better Louisiana called the plan a “faux budget that appears to score some political points in one corner, while exacerbating serious problems in another.” Henry countered that threats of closed medical training and charity hospitals were nothing more than scare tactics. When all the playground bickering was done, what’s clear is that actually drafting a spending plan without enough money to pay the bills is a lot harder than it appears when chatting on talk radio.
Juvenile justice is still a mess
The longtime head of the state’s Office of Juvenile Justice retired abruptly last week. Mary Livers leaves behind an agency that’s been devastated by budget cuts and which has failed to live up to promised reforms that aimed to treat young offenders in more therapeutic, community-based settings. As The Advocate’s Maya Lau reports in a lengthy Sunday story, the good news is that Louisiana’s juvenile caseload has dropped by nearly half since 2005. But for the children who remain in the system, progress has been slow.
There was the mysterious closure of a large youth prison outside Baton Rouge in 2014, when its 76 offenders were spirited to other facilities in the dark of night, leaving behind equipment and belongings in a move that caused some of the center’s 154 employees to lose their jobs. Then, last year, two teenage boys overpowered guards and escaped from the Bridge City Center for Youth outside New Orleans. Young men at that facility, which has seen violence for years, “are so out of control,” employees told a judge last month, that they’re breaking one another’s jaws, climbing on roofs and smashing down doors multiple times a day. The juvenile system’s finances have been so depleted that officials have had to persuade utility workers to not shut off the lights at facilities over unpaid bills. And while there’s been progress in the state’s youth incarceration system — recidivism has dropped — some of the more ambitious efforts have stalled.
‘Raise the Age’ in national spotlight
Efforts in the state Legislature to ensure that children accused of crimes get tried in the juvenile justice system instead of adult courts received national attention over the weekend. The New York Times’ Erik Eckholm notes that The Pelican State is part of a national trend.
Seventeen-year-olds cannot vote, buy cigarettes or even adopt a dog from an animal shelter. But as of today, in nine states, including Louisiana, they are automatically handled as adults, rather than as juveniles. In two states, New York and North Carolina, 16-year-olds are as well. Now Louisiana and several other states among those nine appear to be on the verge of raising the cutoff to the more standard age of 18 — part of a national “raise the age” movement that has won bipartisan support, a result of concern about high incarceration rates and growing neurological evidence that young people’s brains are different from adult brains.
Estate taxes reduce inequality
The Center on Budget and Policy Priorities recently published a report on the importance of state estate taxes in evening out the tax burden placed on low- and moderate-income residents. It implores states that have eliminated or reduced estate taxes to reinstate them. Only the wealthiest–2.56 percent of estates in states with the tax–pay these taxes, which help counteract heavy reliance on consumption taxes. Many states allowed their estate taxes to phase out in parallel with the federal phase out that began in 2001. Revenue from estate taxes could,
Provid[e] revenue for investments that promote a strong economy. In many states, revenues aren’t sufficient to cover the costs of critical services such as education, health care, and public infrastructure. Eighteen states plus the District of Columbia raise $4.5 billion a year from estate and inheritance taxes, which they use to support schools, roads, and other important public services. This revenue will likely fall in the coming years as some states phase in estate tax cuts that are already on the books. If all states without an estate tax reinstated this tax, they could raise an additional $3 billion to $6 billion a year. An estate tax will help — not harm — a state’s economy. Estate tax revenue supports services that make a state an attractive place to do business and live. Research confirms that very few wealthy individuals move as a result of an estate tax.
Number of the Day
$425,097,340 – Difference between what it cost to operate the nine public-private hospital partnerships in 2013-14 and what the hospitals requested for the 2016-17 fiscal year (Source: Louisiana Senate Finance Committee)