Aug. 5: A national perspective on Medicaid expansion

Aug. 5: A national perspective on Medicaid expansion

More than 265,000 low-income Louisianans have enrolled in Medicaid since the program was expanded on July 1 under the executive order Gov. John Bel Edwards signed on his first full day in office. As Noam Levey of the Los Angeles Times reports, Louisiana isn’t the only state where Medicaid enrollment has surpassed expectations.

There is growing evidence nationally that Medicaid coverage is affecting patients, as previously uninsured Americans like Jackson begin to get recommended medical care and more routinely take their medications. After Kentucky and Arkansas expanded their Medicaid programs in 2014, for example, researchers found poor patients there skipped fewer medications and were more likely to get regular care if they had a chronic illness such as diabetes. By contrast, the researchers found little improvement in Texas, which continues to oppose the Medicaid expansion. In Louisiana, Edwards and other state official say they are looking for even longer-lasting results. “This isn’t just about getting health insurance,” the governor told a group of reporters visiting Baton Rouge recently. “You get people health coverage for a reason. You want better health.…  We want healthier people.”

Income and race in East Baton Rouge
Louisiana’s capital city suffers from large income gaps between white and black residents and low-quality public schools. At least according to new data commissioned by the Baton Rouge Area Foundation from the LSU Public Policy Research Lab.  The Advocate’s Andrea Gallo has more on this year’s findings from an annual survey tracking public opinion on local  and national  issues:

The median household income for the parish in 2014, the most up-to-date year in the survey, was $63,558. White households slightly lost ground in earnings from 2013 to 2014, saw a median of $88,901. Asian households also saw their household incomes drop during the two years, with a median incomes of $57,823 in 2014. Hispanic and black households did not lose or gain any extra household earnings from 2013 to 2014, the statistics show, and still lagged behind. Hispanic households had median incomes of $51,404 in 2014 while black households saw the lowest incomes in the parish at $41,029 that year. The City Stats report concludes that for every dollar earned in white households in 2014 in East Baton Rouge parish, Asian households earned 65 cents, Hispanic households earned 57 cents and black households earned 46 cents.

The safety net in Louisiana
New fact sheets released by the Center on Budget and Policy Priorities show the impact of the safety net on American lives. Isaac Shapiro explains that, in addition to immediate poverty reduction, safety-net programs produce long-term gains for people struggling the most:

Safety net programs not only reduce immediate deprivation but also have long-term benefits for children…The findings suggest, for instance, that SNAP [Supplemental Nutrition Assistance Program] and the EITC [Earned Income Tax Credit] help reduce infant mortality and low birthweight, and improve children’s reading and math test scores, high school completion, college entry, and expected future earnings. The findings also indicate that housing assistance that helps low-income families move to safe, low-poverty neighborhoods with better schools can enhance their children’s long-term prospects. Further, people eligible for Medicaid coverage in childhood miss fewer school days due to illness or injury, are likelier to complete high school and college, and earn more as adults.

The fact sheet for Louisiana highlights some of the immediate impacts for the state.

Federal and state safety net programs lift an estimated 790,000 Louisianans above the poverty line each year, reducing the poverty rate from 32.2 percent (before counting government benefits and taxes) to 14.4 percent. Many are children: the safety net lifts roughly 220,000 Louisiana children above the poverty line, reducing the child poverty rate from 33.0 percent to 13.8 percent.


Mental health treatment vs. jail
East Baton Rouge residents may have the opportunity to vote in December for a tax measure that would pay for a new mental health center. The Baton Rouge Area Foundation and newly-tapped initiative leader, Rob Reardon, are gearing up for a campaign to advance the project. The nonprofit Bridge Center is envisioned as an alternative to jail for those suffering from mental health and substance abuse issues. Steve Hardy from The Advocate has more on the purpose of the proposed center.

Metro Councilman and mayoral candidate John Delgado has been a proponent of the Bridge Center and plans to sponsor the motion to put its funding on the ballot. Delgado called attention to a recent case in which a 71-year-old man was arrested for masturbating in a street and put in jail on $50,000 bond. Delgado wondered if the septuagenarian was a criminal, or if perhaps he had dementia or another mental health diagnosis. “(Police) can’t leave him on the street naked and masturbating,” Delgado said. “Hopefully BRPD would send someone like this to the Bridge Center.” The facility could also help when a member of a family is having a psychiatric emergency and may be a danger to himself or others but relatives want the person to get help, not wind up in jail, Reardon pointed out. “Jails are not designed to hold mentally ill people. … (But most jails) are the de facto mental health hospitals,” Reardon said.

Number of the day

63  – Percentage of polled East Baton Rouge residents who said they strongly agree that money should be shifted from incarcerating people to treating low-risk people with mental illness. (Source: Baton Rouge City Stats 2016)