As the House prepares to vote on the rollback of the Affordable Care Act on Thursday, media near and far focused on how the law’s expansion of Medicaid coverage has affected the working poor. In Louisiana we meet Flora Guillory, a full-time day care worker for whom gaining coverage has been a life-altering event. The Advocate’s Elizabeth Crisp:

Before she qualified for Medicaid, she couldn’t imagine having the ability to go to a doctor four times a year, despite suffering from severe health ailments including sarcoidosis of the lungs and lymph nodes, deep vein thrombosis, high blood pressure, high cholesterol, diabetes and hypothyroidism, among others. “Those are just the major things,” she said.

The New York Times pays a visit to Defiance, a working-class enclave in the critical swing state of Ohio that turned out for Donald Trump last November but where many residents are benefiting from the ACA’s coverage expansion – which would be largely eliminated under the House bill. Abby Goodnough and Jonathan Martin:

If they push forward the House-drafted health bill, which could come to a vote as early as this coming week, Republicans may honor their vow to repeal what they derided as Obamacare, but also risk doing disproportionate harm to the older, working-class white voters who are increasingly vital to their electoral coalition.

In New Orleans, dozens of health care providers joined activists and ordinary citizens in a “second line for health care” organized by 504 Health Net to support the Medicaid expansion that now covers more than 411,000 Louisianans. Gambit’s Kat Stromquist:

“Before the expansion, my patients were often uninsured and lived in fear of a new medical diagnosis,” Jason Halperin, a doctor who works with CrescentCare, said. “I see the Medicaid expansion as much more than a card or number. … Most of all, it upholds dignity.”

But as the AP’s Melinda Deslatte reports in her weekly column, the members of Louisiana’s congressional delegation seem largely unmoved – and determined to impose deep cuts on a program that provides health coverage for more than 1 in 3 Louisianans. She quotes Dr. Ralph Abraham, whose 5th Congressional District in northeast Louisiana includes some of the poorest communities in America with the largest concentrations of Medicaid recipients.

He said while funding may drop to Louisiana, the state will have more decision-making over how the program works, and Abraham believes there’s a lot of room for improvement. He said Medicaid is a “poor insurance program” that offers “second-class service” to patients. “Like any federal program there is a lot that can be cut and not affect the patient,” Abraham said. “The state, they’re going to have to be smart about how they spend that money.”

Film subsidies in the spotlight

Louisiana has spent more than $1 billion over the past decade subsidizing TV and film productions in the state, despite a stream of studies showing the program is a money-loser for state government. Still, as Tyler Bridges reports for The Advocate, reformers are looking at ways to rein in the costs of the program instead of killing it altogether as a three-year spending cap is set to expire in 2018.

The Louisiana Budget Project recently issued a report calling for a $100 million cap on the amount of tax credits the state can issue every year along with a $150 million cap on how much the state can actually pay out each year. The group said this approach would produce a $30 million savings to taxpayers next year and more over time because the $100 million issuance cap would steadily shrink the pool of outstanding credits..

Getting lost in the justice maze

Momentum is building around the Capitol for reforms aimed at reducing Louisiana’s world-leading incarceration rate and investing more money in rehabilitation programs. But another aspect of Louisiana’s tattered criminal justice system often goes overlooked: The underfunding of public defender offices. Jacob McCarty, who oversees operations for Orleans Public Defenders Municipal Court, writes in the Lens about the ways small-time defendants often fall through the cracks.

As of 2014, the latest data available, Louisiana incarcerates nearly 40,000 people, easily making it the incarceration capital of the nation. In 2016, Louisiana spent roughly $3 billion to arrest, prosecute and jail our fellow citizens – the vast majority for nonviolent offenses – and, in 2016, just $32 million on public defenders statewide to ensure justice is done fairly and constitutional rights are upheld. With such a one-sided system, it’s a wonder anyone has a fighting chance at innocence.

Number of the Day

$305 million – Estimated 10-year savings to the state from criminal justice reforms recommended by the Justice Reinvestment Task Force. The group recommends that $154 million of that be reinvested in programs that reduce recidivism (Source: Nola.com/The Times-Picayune)