The House is expected to vote later today on the American Health Care Act, which would gut the Medicaid program and shift hundreds of billions of dollars in health care costs from the federal government to the states. A new policy brief by LBP senior policy analyst Jeanie Donovan breaks down how the GOP’s health insurance plan would affect Louisiana.
Between fiscal years 2020 and 2023, an estimated $2.6 billion in Medicaid costs would be shifted from the federal government to the state. In fiscal year 2023 alone, the AHCA would increase the costs to the state by $1.1 billion, which is 27 percent more than estimated $4.2 billion the state would spend on Medicaid in 2023 if no changes are made to federal law. The growing costs to the state likely would force state leaders to jettison the Medicaid expansion, which would severely limit coverage options for low-income Louisianans, eliminate jobs in the healthcare sector and related fields, and worsen health outcomes for the state.
A new report by Josh Bivens of the Economic Policy Institute finds that the GOP bill would raise out-of-pocket costs through higher deductibles and co-pays, which is the opposite of what Republicans have promised.
The American Health Care Act (AHCA) would cost Americans roughly $33 billion a year in higher out-of-pocket costs by 2026. That means the Republican claim that they want to repeal the ACA and replace it with the AHCA because they want to relieve Americans of too-high OOP costs is a demonstrable lie.
On the New York Times’ Upshot blog, Margot Sanger-Katz explains how the 24 million Americans who would lose health insurance under the AHCA is more than would be uninsured if the Affordable Care Act were simply repealed without a replacement:
Getting rid of Obamacare would cost 23 million Americans their health insurance, according to another recent C.B.O. report. In other words, one million more Americans would have health insurance with a clean repeal than with the Republican replacement plan, according to C.B.O. estimates. The current bill would cause more people to lose employer insurance, while a straight repeal bill would most likely cause more people who buy their own coverage to become uninsured. A simple repeal would be worse for Americans with preexisting conditions, but the current bill would be worse for older Americans who are relatively healthy. Both approaches would lead to major reductions in the number of Americans covered by Medicaid.
Moderate Republicans are starting to worry, including Rep. Charlie Dent of Pennsylvania. Cristina Marcos with The Hill:
Dent had previously expressed concerns about the bill’s rollback of the Medicaid expansion. His formal opposition could open the door to more centrists voting against the GOP leadership’s proposal. “After careful deliberation, I cannot support the bill and will oppose it. I believe this bill, in its current form, will lead to the loss of coverage and make insurance unaffordable for too many Americans, particularly for low-to-moderate income and older individuals,” Dent said.
Frank LoBiondo, a moderate Republican from New Jersey also announced Wednesday that he would not vote for the bill, citing concerns for the most vulnerable in his state and opposition from providers:
“Under the current proposal, many South Jersey residents would be left with financial hardship or without the coverage they now receive. Our seniors on Medicare already struggle to make each dollar stretch. Three South Jersey counties have more than 30 percent of their residents receiving Medicaid assistance. Medical professionals – our hospitals, doctors, nurses – are opposed.”
Senators intervene to save child health program
Mid-year budget reductions made during February’s special session led to difficult decisions by department officials about what programs and services to cut. One such cut by the Louisiana Department of Health was the subject of an emergency hearing in the Senate Health and Welfare Committee Wednesday. The cut would have eliminated a program that provides psychosocial rehabilitation to 47,000 at-risk youth in the state. Ultimately, the senators decided the department must find other places to trim spending. The AP’s Melinda Deslatte:
The Edwards administration planned to close the program April 1, to save Louisiana more than $2 million this year. The plan came in response to cuts levied by lawmakers on the Department of Health in last month’s special session to close a budget deficit. Senate Health and Welfare Committee members said they couldn’t support balancing the budget by eliminating services that help children with behavioral health and emotional problems to remain in their homes and function in school. Several senators blamed House Republican lawmakers for forcing deeper cuts by refusing to use more “rainy day” fund money to fill gaps. “I understand the dilemma that the administration has,” said Sen. Jay Luneau, D-Alexandria. But he added: “I can’t do this to kids.”
The elderly at Angola
Two controversial recommendations by the governor’s Justice Reinvestment Task Force would reduce the state’s prison population by offering geriatric and medical parole to individuals who have served decades in prison and are unlikely to commit a crime if released. Although the Louisiana District Attorneys Association has said the recommendations are a non-starter, Julia O’Donoghue with Nola.com/The Times-Picayune interviewed staff and prisoners at Angola who are supportive of the idea:
Darrel Vannoy, the acting warden at Angola, said lifers, in particular, are among the least troublesome prisoners, despite being here for the most serious offenses. He’s supportive of the geriatric parole and medical parole proposals, even for violent offenders. Louisiana has 4,850 lifers in prison, and 4,300 of them are at Angola. “They may have had a few adjustment problems with they came into prison, but over time, they adjusted. They’ve got a job. They go to work,” Vannoy said in an interview in January. “You get older. You mature.”
If implemented, the recommendations also could result in cost savings for the state’s prison system:
Older people who have been locked up for decades are more likely to need medical care than a person who is the same age but not in prison: They go to the doctor about five times more often, according to the Vera Institute of Justice. If the Legislature approves geriatric parole and loosens the rules on medical release, some of these offenders might leave Angola. They’d still rack up expensive medical bills, but not on the state’s dime. That’s because their medical expenses would be covered by Medicaid, even if they only left prison temporarily on furlough, Corrections Secretary Jimmy LeBlanc said. When treated in prison, they are not covered by the federal program, so the state must pay for all of their expenses.
Investing in our children
The Louisiana Partnership for Children and Families begins its annual series of regional meetings next week that will provide updates on legislation affecting children and families. LBP is partnering with the Partnership and will discuss the urgent need for tax reform in the upcoming session. All are invited.
Number of the Day
$11.2 billion – Financial losses in Louisiana as a result of continued coastal erosion and loss of wetlands over the next 50 years, unless the $50 billion coastal protection and restoration master plan is implemented. (Source: Mark Schleifstein, Nola.com)