Expanded Medicaid enrollment begins today

It’s a landmark day for health-care eligibility, as more than 400,000 low-income Louisiana adults can begin signing up for private coverage through the Affordable Care Act. In a first-of-its-kind plan, the state will use information gathered through the SNAP food assistance program to identify people who qualify for Medicaid coverage under expanded income requirements. Using SNAP data during the rollout will keep the government from having to hire more new employees and will ultimately save the state money. Kevin Litten, writing for Nola.com/The Times-Picayune, has more:

Ruth Kennedy, the DHH official who is leading enrollment efforts, said in an interview Tuesday that although the task of enrolling so many people into the federally funded Medicaid expansion sounds daunting, the department has taken an “all hands on deck approach.” She added that state officials have prepared for months to enroll Medicaid recipients, and workers are positioned across the state to aid in the effort. “I am confident, and I am ready, and this is not my first rodeo,” said Kennedy, who has gained attention nationally for leading previous Medicaid expansions that included getting children into the program. “The governor, you’ll remember, said at a press conference that people would have cards in their hands on July 1. That’s a big difference from starting enrollment on July 1. Well, we won’t have 375,000 cards in people’s hands, but I’m absolutely certain we’ll be more than halfway there.”

To mark the start of enrollment, Gov. John Bel Edwards will be on hand at University Medical Center in New Orleans.

The “Healthy Louisiana” tour, which draws its title from the renamed Bayou Health program, is aimed at getting information to people about what they need to do to sign up for Medicaid. The event will begin at 11:30 a.m. at University Medical Center, 2000 Canal St., Conference Center Room C.

 

Cleaning up a messy budget

Thee Legislature shows no sign of reaching an agreement on next year’s state budget, with the Senate and House still far apart on what the state’s spending priorities should be as Louisiana faces a $600 million shortfall. The budget negotiations will likely continue beyond the regular session’s June 6 adjournment date and into the 18-day special session that begins that same day. As The Advocate’s Elizabeth Crisp reports, Edwards met with the newspaper’s editorial board to stress that new revenues are needed to pass a balanced budget that protects critical services:

“(Legislators) were always hoping there would be this money that materializes the way it always has in the past,” he said. “We’re in a difficult place, but I’m optimistic by the end of the second special session we’ll be in a better place.” … Edwards said he thinks the process of cobbling together a budget during the regular session has demonstrated to legislators that more money is needed. “We have now put together a House Bill 1 that I don’t think anybody is happy with,” Edwards said. “That process is an educational process.” … House Appropriations Chairman Cameron Henry, defending his own version of the budget, has repeatedly stressed that he believes there is additional room for cuts. He said he believes there is a disconnect between what agencies want and what they need to keep government running. “We’re spending more than we did last year,” he told the Senate Finance Committee on Monday. “No one wants to be cut.”

Edwards has proposed a plan that he hopes will raise enough revenue to meet the needs of state government next year. But he also hopes lawmakers join him in working to improve Louisiana’s tax code:

Edwards said he has offered legislators a “menu of options” to consider during the second special session that adds up to more than the estimated $600 million shortfall. Among the big-ticket items, Edwards has called on legislators to adjust the state’s income tax brackets, which could bring in an estimated $324 million; reduce the amount of excess itemized deductions, bringing in $130 million; and approve a change in health insurance premium taxes, for $125 million. The administration has backed a proposal that would lower the threshold on the middle and upper brackets of income taxes, which means middle and upper income residents likely would wind up paying more in taxes. One such proposal failed to pass the House during the first special session.

 

Budget uncertainty threatens medical education

Wary of Louisiana’s constant budget crises, young medical school graduates are increasingly choosing to do their post-graduate residency training outside of Louisiana – a trend that could exacerbate an existing shortage of medical providers as doctors tend to settle in the cities where they completed their training. The AP’s Melinda Deslatte has the story:

For new doctors who will spend three to seven years training in residency programs, choosing Louisiana can be a gamble. … Only a few years ago, LSU ran a statewide charity hospital system that primarily took care of the poor and uninsured patients around Louisiana. That provided the bulk of training sites for medical students. Former Gov. Bobby Jindal began privatizing that system in 2013, handing the facilities over to private managers, shuttering some hospitals and moving safety net services to other private hospitals. … Few dispute the system has improved, with expanded services, shorter wait times and a broader mix of patients with which medical students train. But that comes with rising costs. … Hospital managers say without enough money, they could walk away from their contracts, leaving not only patients but also the doctors who train with them in the lurch. … If Louisiana has fewer residency slots, doctors go elsewhere. Once a state loses the federally-allocated slots, other states scoop them up, making it almost impossible to recapture them. Louisiana Department of Health and Hospitals Secretary Rebekah Gee, a medical doctor, outlined the risks to lawmakers: If the state loses some of its 1,900-plus residency positions, “we permanently lose capacity to train doctors in the state.”

 

Reducing recidivism is good public policy

Lawmakers in D.C. have brought renewed attention to criminal justice issues this year, as discussions of prison and sentencing reform continue in Congress. High rates of recidivism and ways to reduce them through better prison reentry efforts should be a part of that discussion, according to commentary from experts at The Brookings Institution. Authors William A. Galston and Elizabeth McElvein explain why a research-based approach to reform would pay off, and how it could be good politics for members of Congress mired in partisan gridlock:

According to estimates by the Bureau of Justice Statistics, over a quarter of individuals released from state prison are rearrested within six months. …  Numerous studies have shown that identifying and targeting individuals at greatest risk of re-offending based on key factors such as criminal history, employment prospects, and familial relations can have a significant impact on recidivism reduction. Once at-risk inmates are identified, research indicates that prioritizing these individuals for programming can positively impact rehabilitation, reduce recidivism, and improve public safety. … Expanding debate on the reform bill to include the evidence-based recidivism reduction provisions in the Sentencing Corrections and Reform Act may prove to be good politics. By highlighting the urgent need to contain astronomical recidivism rates, the Majority Leader has the opportunity to showcase his party’s commitment to public safety and to demonstrate that the GOP is capable of working with Democrats on an issue of great public concern.

 

Correction: Tuesday’s Daily Dime incorrectly reported that Bell Helicopters “will not be building a factory in Lafayette.” The company has announced that it will not be building its new Jet Ranger X helicopter in a Lafayette facility that was built with the help of state incentives.

Number of the Day:

81 – percent of Louisiana that is federally designated as a health professional shortage area for primary health care (Source: LA Health Department via The AP)