Promises by President-elect Donald Trump and congressional Republicans to repeal the Affordable Care Act are unpopular with healthcare groups and the general public. A new Pew Research Center survey found 54 percent of Americans think Congress should expand the law or keep it as is, compared to 39 percent who support repealing the law. The American Medical Association along with the American Hospital Association, the American College of Physicians, AARP and other patient advocates, also oppose repeal without an adequate replacement. Noam Levey reports for the Los Angeles TImes:

“Any new reform proposal should not cause individuals currently covered to become uninsured,” cautioned Dr. Andrew W. Gurman, president of the American Medical Assn., the nation’s largest physicians’ group.“ When people get cancer, they have to know that they are going to have insurance,” said Chris Hansen, president of the American Cancer Society’s advocacy arm. “There have been and are problems with the ACA, but we have to make sure that what is done and the way it is done is not going to leave people who have cancer or who may get cancer … in the lurch.” The American Cancer Society Cancer Action Network last week sent a letter to congressional leaders urging them not to repeal large parts of the healthcare law without first developing replacement legislation that guarantees patients the same protections.

The American Academy of Actuaries warned House lawmakers that any repeal measure without an immediate viable replacement will disrupt the private marketplace and lead to insurer flight. NOLA.com/The Times-Picayune’s Kevin Litten talked to LBP’s Jan Moller on the implications for Louisiana.

States such as Louisiana rely far more heavily on federal funds than states with smaller low-income populations, Moller said, and have much more to lose. “Under most of these replacement scenarios, you’d be getting fewer federal dollars for indigent and low-income populations, and I think that’s extremely dangerous and would put additional strains on an already very strained state budget.” Reducing federal funding for health care “would create chaos for health care providers, and health insurers both offering policies through the exchange and Medicaid,” Moller said.

EITC could fix income woes

It’s a familiar story: The American economy has grown considerably since the 1970s. But only  a tiny slice of that growth has accrued to those at the bottom of the income ladder. While Economic growth has outpaced income growth since the 1970s. Per-capita GDP is up 78 percent since 1979, yet the bottom quintile of earners has realized only a 7 percent increase in income. The New York Times’ Neil Irwin says a boost in the Earned Income Tax Credit could help fix the gap and create more wealth for people who’ve been largely left behind by the economic upheavals of  recent decades. President-elect Donald Trump’s tax plan makes the misguided assumption that massive tax breaks for businesses and the wealthy will spur investment and production. Irwin’s plan, modeled by the Center on Budget and Policy Priorities and the Tax Policy Center, would increase production and growth through boosting demand:

The first step was to design a tax credit expansion that would raise the income of the bottom 20 percent of families to where they would be if they shared equally in the gains since 1979. That meant figuring out a tax change that would put an extra $2,889 in the pockets of a family of three that in 2013 made $20,420. An increase in benefits also helps families with somewhat higher incomes. For example, a family of four making $40,000 would receive about $6,000 a year in this expanded E.I.T.C., compared with the $2,142 they get now. The benefits wouldn’t completely phase out for a family of four until they hit nearly $70,000 of income. If [the working class] had extra cash in their pockets from an expanded E.I.T.C., they would be more likely than millionaires to spend the money, many economic studies suggest. That means that including help for the working class in any tax overhaul would add a “demand side” source of economic growth.

More money = better education

A recent judicial ruling in Connecticut found the state wasn’t funding schools equitably, which contributed to poor outcomes for children in the state’s poorest districts. An overhaul of performance standards, teachers’ training and evaluation, and graduation requirements is now underway to reverse the damage and fulfill the state’s duty to educate all of its children. Kevin Carey and Elizabeth Harris write for The New York Times’ Upshot blog about new research affirming the importance of adequate and equitable K-12 funding.

They found a consistent pattern: In the long run, over comparable time frames, states that send additional money to their lowest-income school districts see more academic improvement in those districts than states that don’t. The size of the effect was significant. The changes bought at least twice as much achievement per dollar as a well-known experiment that decreased class sizes in the early grades.

Coming up short on flood relief

Congress has agreed to give Louisiana just shy of $2 billion to fund recovery efforts from the August flooding – or less than half of that state leaders have sought. Julia O’Donogue at NOLA.com/The Times-Picayune says that House Majority Whip Steve Scalise of Metairie has the most power to bring the money home, but doesn’t seem terribly interested in using his influence to help the capital region.

Scalise’s district wasn’t personally affected by the flooding, but he is the most powerful member of the state’s congressional delegation and the Louisiana congressman with the best access to Trump. As a member of the House Republican leadership, he’s talked to Trump at least a few times since the presidential election. But it’s not clear that Scalise thinks more flood recovery funding is needed either. His staff said the Majority Whip is “open” to seeking more money for Louisiana, but only after the money that has already been allocated has been distributed to flood survivors.

Number of the day

54 – Percentage of Americans who want to expand or keep the ACA as is. 39 percent favor expansion and 15 percent want to keep it as is (Source: Pew Research Center).