Louisiana could lose 37,000 jobs and $640 million in state and local tax revenue if Congress follows through on its threat to repeal the landmark 2010 health-care reform law. So says a new report from the Milken Institute School of Public Health at George Washington University that predicts widespread economic disruptions if the tax credits that help low-income people buy health coverage are wiped out along with the expansion of Medicaid coverage to low-income, working-age adults. Elizabeth Crisp of The Advocate reports:
Nationally, the repeal would mean a $2.6 billion loss in jobs in 2019 and a $1.5 trillion drop in gross state products between 2019 and 2023, according to the report. “Repealing key parts of the ACA could trigger massive job losses and a slump in consumer and business spending that would affect all sectors of state economies,” the report’s lead author, Leighton Ku, said in a news release.
The Advocate notes in its lead editorial that the “repeal-and-delay” strategy advocated by some in Congress would have devastating effects on health care providers that serve the poor.
If the ACA is repealed without a “replacement,” whatever that might look like, the institutions serving the working poor will continue to get patients, except that many of those working-age adults won’t be able to pay. That is why hospitals and clinics across the state should also be alarmed at the prospect of precipitous legislative action on Capitol Hill. For every urban clinic worried about its customers, there is a rural hospital or doctor’s office where a large number of new insured patients have come in with a Medicaid card, courtesy of the ACA.
After weeks of silence, Gov. John Bel Edwards joined the fray this week with a letter to members of Congress asking them to keep Medicaid expansion in place. His health secretary, Dr. Rebekah Gee, told Nola.com’s Kevin Litten that efforts by some in Congress to kill the Medicaid program by transforming it into a federal block grant would be disastrous for Louisiana.
Gee said she disagrees with portraying the block grant funding as a flexible approach. In fact, she said it would do the opposite. “In a block grant scenario it would be a rationing — we’d have to ration care and who do we provide care to,” Gee said. “It’s a really severe approach, and when they talk about flexibility, it’s flexibility to cut services. We have tremendous flexibility now. We do not need more flexibility. We’re very happy with the flexibility.”
Republicans on Capitol Hill have pledged to come up with an alternate plan that lets people keep their coverage, but there is no consensus on what that will look like. The Washington Post’s Catherine Rampell notes that while polls show many people oppose “Obamacare,” they also support many, if not most of its individual components. So she has a novel solution:
(Donald) Trump may have little interest in policy, experts, numbers, details. But he is undoubtedly a marketing genius. One possible outcome of the current repeal-and-replace free-for-all is that congressional Republicans decide to keep essentially the existing system in place, with some reforms, improvements and hole-plugging, and Trump slaps a shiny new name on the whole thing. Welcome to the revolutionary, gold-plated “Trumpcare.”
Flood aid plan coming today
Nearly five months after flooding devastated much of the Baton Rouge region, Gov. John Bel Edwards’ administration will outline its plan for distributing the first $438 million in federal aid. As Nola.com’s Richard Rainey reports, it comes amid frustration and bickering among state officials that the money hasn’t reached flood victims quickly enough.
Congress had set aside $500 million on Sept. 29 for several states dealing with presidentially declared flood disasters, and the Department of Housing and Urban Development decided in October that $438 million of that should go to Louisiana. That agency set aside another $1.2 billion for Louisiana on Dec. 23 after Congress approved a second downpayment on relief for disasters that occurred across the country last year — including hurricanes Matthew and Hermine. None of that money has reached Louisiana. Instead, it rests with HUD, waiting for the state to apply for it under the federal community development block grant program. Enter Edwards’ plan, the latest step toward that goal. The public and HUD can comb through it over the next few weeks, and the administration hopes to have its plan approved by Feb. 20 and cash in hand shortly afterward.
We’re 49th (again)!
A report released this week by Education Week found that Louisiana continues to rank near the bottom nationally for public school achievement. As The Advocate’s Will Sentell reports, the Quality Counts report ranks states for academic achievement, students’ chance for success, and financing.
The latest findings come as state officials are preparing to revamp public school policies to comply with a federal law called the Every Student Succeeds Act. Sydni Dunn, press secretary for the state Department of Education, said in a prepared statement that the agency “is happy to see that the state’s high school graduation gains were reflected in an increased score in that category, just as we are disappointed that stagnating funds in years of growing enrollments have combined to decrease our funding score.’
588,230 – Louisiana adults who have health insurance coverage thanks to the Affordable Care Act (Source: LBP research)