U.S. Sen. Bill Cassidy of Louisiana joined three of his colleagues on Monday in laying out a plan to replace the federal Affordable Care Act with an alternative that represents a partial retreat from earlier promises to repeal the landmark law in its entirety. The Associated Press reports that Cassidy’s “Patient Freedom Act of 2017” would allow states to keep the ACA mostly intact should they choose, including Medicaid expansion, or switch to an alternative plan that relies on federal tax credits and health savings accounts that could be used to buy coverage.
“I’m not saying that it’s perfect, but it’s important that we put specific proposals on the table,” (cosponsor Sen. Susan) Collins (of Maine) said on the Senate floor about the plan. Repeal without replacement or repeal with a delay, as some lawmakers have suggested, would send insurance markets into a tailspin, she said.
It’s one of several proposals GOP leaders have floated as they scramble to come up with a suitable replacement for a law that has provided health coverage to more than 20 million Americans. Sarah Lueck of the Center on Budget and Policy Priorities writes that, because of the broad discretion given to states, Cassidy-Collins could leave low-income people and those with pre-existing conditions with less access to care than they have under the ACA.
That’s partly because the bill punts major decisions about how to respond to ACA repeal to the states but then scales back the federal support available to cover people. Cassidy-Collins would repeal the ACA’s marketplace subsidies, eliminate the individual and employer mandates, and drop or roll back most market reforms and consumer protections — with all changes set to take effect after one year, though the sponsors indicated they would likely extend the effective date by perhaps three or four years.
Edwards budget plan due on Friday
The Associated Press reports that Gov. John Bel Edwards will unveil his recommendations Friday for how to cut $304 million from the state budget to make up a mid-year budget shortfall. The plan will be unveiled to a House-Senate budget committee and is expected to include tapping the state’s rainy-day savings account for $119 million, plus cuts to healthcare and education services. Melinda Deslatte reports:
The Edwards administration says constitutional limits on the governor and the joint budget committee’s ability to cut spending leave public colleges and health services with the brunt of the cuts. A special session would allow lawmakers to cut more broadly across agencies. Republican House leaders want the governor to offer a proposal for closing the gap without a special session, saying such a session carries costs for the state. “Why would we come back when we’re already in a money pinch?” said Rep. Lance Harris, head of the House Republican delegation.
Subsidies and unintended consequences
Gov. Bobby Jindal’s administration offered $12.7 million in state subsidies as part of its efforts to get GE Capital to build a new technology center in New Orleans. On top of that, the state put up $5 million over 10 years for high-tech training at state universities. In return, GE Capital promised to create 300 high-paying jobs. But as Stephanie Riegel details in the Baton Rouge Business Report, the headline-grabbing deal hasn’t worked out as planned. Those “new jobs” ended up being filled by people poached from GE’s competitors with state-subsidized wages.
While LED ponders how to compel companies that got sweet deals under the Jindal administration to honor the spirit of the law that enabled those deals, it’s also trying to make sure they adhere to the actual letter of the law. In GE’s case, that’s been an issue on both fronts: Despite the millions of dollars in incentives it received and all the talent raiding it has done, the company still failed to meet its payroll obligations to the state last year. According to LED’s most recent performance report released last March, GE was more than 20% short of the 12-month 2015 payroll obligation outlined in its agreement with the state.
The charter school conundrum
Kevin McGill of the Associated Press follows up on last week’s report from Tulane’s Education Research Alliance for New Orleans, which found that charter schools in New Orleans are spending more money on administrative costs than public school systems in similar parishes, and less money on classroom instruction. McGill asks how long the Crescent City can rely on relatively young, inexperienced teachers who do not participate in the state pension program.
“There are signs that interest in New Orleans is abating among younger teachers and growing concern about the constant churn of teachers who do not plan to stay or make teaching a career here,” the report said. “The state government is also in dire financial straits and may eventually have to either reduce spending or force charter schools to pay into the state pension system.”
Number of the Day
63.4 – Percentage of Louisiana’s Medicaid expansion population that is comprised of women. (Source: Louisiana Medicaid Forecast, December 2016).