Jan. 13: The faces of Medicaid expansion

Jan. 13: The faces of Medicaid expansion

Gov. John Bel Edwards celebrated the one-year anniversary of his executive order expanding Medicaid coverage by introducing the public to three of the 378,000-plus Louisianans who’ve gained coverage since July 1.

Gov. John Bel Edwards celebrated the one-year anniversary of his executive order expanding Medicaid coverage by introducing the public to three of the 378,000-plus Louisianans who’ve gained coverage since July 1. The event was designed to celebrate the policy achievement and defend it from threats in Congress. The AP’s Melinda Deslatte reports:

Ricky Miles, 51, of Metairie, enrolled in the Medicaid expansion in July. A month later, abdominal pain sent him to a doctor, and a colonoscopy diagnosed cancer. The expansion program pays for medicine and chemotherapy. “I’m doing a lot better,” Miles said. “I’ve got Medicaid. I’ve got great health insurance.” Calderon and Miles stood with the Democratic governor at University Medical Center to praise the Medicaid expansion — even as Congress took the first steps this week to repeal the law championed by President Barack Obama.

New Orleans Mayor Mitch Landrieu also spoke at the event, cautioning that repeal of Medicaid expansion or converting Medicaid into a “block grant” would mean devastating cuts for the state. Gambit Kevin Allman has more:

“If their idea about Medicaid is to keep it, but to block-grant it,” Landrieu continued, “essentially means they’re going to start rationing health care. A block grant means they’re gonna give you a set amount of money — which is generally less than they give you now — and then tell you, ‘You decide what to do with it,’ well, then, they’re basically giving you less money and expecting you to do more than you’re doing right now with it.”

 

Moving toward special session

It’s becoming increasingly clear that a special legislative session will be needed to stabilize the state’s current fiscal year budget. The Advocate’s editorial board wrote in favor of a special session:

Why? Because the budget isn’t fixed, not by a long shot, and more mid-year budget cuts loom for state agencies as well as colleges and universities. Gov. John Bel Edwards says he has authority, with approval of the Joint Legislative Committee on the Budget, to deal with most of the anticipated shortfall. But as a matter of the constitution and law, the governor’s authority to cut is limited. This year, as in the past, most of the cuts would fall on health care and higher education. With sharp cuts in state support for colleges and universities during the administration of former Gov. Bobby Jindal, we don’t see how institutions are going to serve students well and retain key faculty with yet another round of reductions. If the Legislature can come into session and spread the pain around, colleges will still be cut, Edwards told the editorial board of The Advocate this week.

 

Saving TOPS

Investments in higher education are crucial, especially for low-income and first generation college students. But TOPS is at risk due to the Legislature’s continued unwillingness to raise sufficient revenue to make key investments. The inimitable Jim Beam of the Lake Charles American Press explains why raising revenue is so important:

TOPS scholarships have definitely proved their worth, and hard-pressed colleges and universities need the funds the scholarships provide. They have experienced 16 budget cuts over the last nine years. State funding was at 66 percent six years ago, and it has dropped to 30 percent. Citizens need to let their legislators know how they want them to either change TOPS  or come up with the necessary revenues to fully fund the program. Lawmakers should also find revenues to improve state funding for all public institutions of higher learning. Louisiana will never meet its increasing demand for highly qualified and skilled workers until legislators make higher education one of their top priorities.

The Legislature should work to fully fund TOPS and, at the very least, TOPS should be maintained for students from low-income families.

 

Why health reform is hard

As Congress moves to repeal the Affordable Care Act, Americans still have not seen details of a replacement plan, despite promises of expanded coverage and lower out of pocket costs for insurance. Trying to limit federal spending and consumer out of pocket costs, while still expanding coverage is hard to do. The Wall Street Journal’s Anna Wilde Matthews and Louise Radnofsky detail the challenges:

The range of approaches under consideration includes a return to special insurance plans that states once used to cover high-risk patients, and a fresh rule that could penalize consumers who don’t maintain coverage continuously. All will draw opposition and could create new costs or leave some uninsured…“There’s no easy answer to any of this,” says Scott E. Harrington, a health-care-management professor at the University of Pennsylvania’s Wharton School, who has been critical of aspects of the ACA. “People want low premiums, they want guaranteed access to insurance at rates that don’t reflect their health status…when you try to figure out how to make it work, people don’t like the solutions.”

The Advocate’s Stephanie Grace writes that these tradeoffs may be the downfall of Republicans’ health care scheme, epitomized by former Gov. Bobby Jindal’s empathy gap:

In fact, you don’t get the sense Jindal gives much thought to the people affected at all. You never did. Empathy has been Jindal’s Achilles Heel all the way back to his days at the state’s health and hospitals secretary, a fact that Kathleen Blanco skillfully exploited when she beat him in the 2003 gubernatorial race… But here’s the interesting part: While Jindal’s side won the election and now has the chance to dismantle the health care law, Edwards’ side threatens to win the argument. Republicans who control Congress are pushing hard to repeal the law quickly, and while Senate GOP leaders narrowly passed a key procedural step in the wee hours Thursday morning, there’s clearly nervousness in the ranks about the backlash that will hit them if Americans — including those who voted for GOP members of Congress and incoming President Donald Trump — lose benefits they’ve come to take for granted.

 
Number of the Day

$7 million – Average size of tax cut for each of the 400 wealthiest U.S. households under ACA repeal. Low and moderate income earners would see tax increases. (Source: Center on Budget and Policy Priorities)