Stung by their failure to pass legislation that guts the Affordable Care Act, House Republicans are trying a new approach. As Margot Sanger-Katz of The New York Times reports, the White House has been negotiating with the rebel House Freedom Caucus on a new plan. The latest idea is to give states flexibility to offer pared-down coverage and effectively bar people with pre-existing conditions from buying coverage.

The ability to opt out of the benefit requirements could substantially reduce the value of insurance on the market. A patient with cancer might, for example, still be allowed to buy a plan, but it wouldn’t do her much good if that plan was not required to cover chemotherapy drugs. The second opt-out would make the insurance options for those with pre-existing conditions even more meaningless. Technically, the deal would still prevent insurers from denying coverage to people with a history of illness. But without community rating, health plans would be free to charge those patients as much as they wanted. If both of the Obamacare provisions went away, the hypothetical cancer patient might be able to buy only a plan, without chemotherapy coverage, that costs many times more than a similar plan costs a healthy customer. Only cancer patients with extraordinary financial resources and little interest in the fine print would sign up.

Taxing choices on transportation

The traffic gridlock that grips Baton Rouge on a daily basis is motivating capital-area lawmakers and business leaders to take the lead in the effort to increase Louisiana’s gasoline tax for the first time since 1990. The AP’s Melinda Deslatte reports that Rep. Steve Carter of Baton Rouge is among the legislators seeking to hike the tax by as much as 17 cents per gallon during the upcoming session.

But he acknowledged the tax will be a tough sell, needing a two-thirds vote of the House and Senate. In particular, the more conservative House, which has shown a strong anti-tax bent, is expected to be a stumbling block. “We’ve got to do a salesman’s job within the House,” Carter said. He said supporters will have to show the dollars will pay for roads, bridges and ports, not whittled away by administrative costs or raided to fill other gaps. He said tax backers will have a companion bill to detail how the new tax dollars generated would be spent.

Reminder: Louisiana’s gas tax has lost 47 percent of its purchasing power since it was last raised.

Legal aid on the chopping block

Low-income people in Louisiana would have a tougher time finding lawyers to help with evictions and other civil matters under President Donald Trump’s budget proposal. As Nola.com/The Times-Picayune’s Richard Rainey reports, the president is proposing to eliminate funding the federal Legal Services Corporation to help raise enough money to finance a Mexican border wall.  The agency funnels money to Southeast Louisiana Legal Services and Acadiana Legal Services Corporation.

Southeast Louisiana, which serves New Orleans and 21 other parishes, would lose $3 million a year — just short of half its budget, said executive director Laura Tuggle. Its lawyers handle a gamut of legal cases for people who otherwise couldn’t afford representation. They include legal help with evictions, fraud, abuse, health insurance problems, disaster recovery and employment discrimination, among others.

The disability debate

The number of Americans receiving Social Security Disability Insurance payments has risen substantially in recent years – from 7.7 million in 1996 to 13 million in 2015. The increase has been especially acute in rural, working-class areas in the South and Appalachia. To explain the phenomenon, The Washington Post visited rural Beaverton, Ala., where 39-year-old Desmond Spencer is seeking disability to deal with chronic pain.   

The rise in disability has emerged as yet another indicator of a widening political, cultural and economic chasm between urban and rural America. Across large swaths of the country, disability has become a force that has reshaped scores of mostly white, almost exclusively rural communities, where as many as one third of working-age adults live on monthly disability checks, according to a Washington Post analysis of Social Security Administration statistics.

The Center on Budget and Policy Priorities offers some critical context – noting, for example, that 39-year-old applicants are the exception, not the rule.

SSDI enrollment grew as the population grew, baby boomers aged into their peak years of disability, and more women earned SSDI coverage in case of disability by participating in the workforce and paying into Social Security. Also, Social Security’s retirement age rose, so workers who become disabled remain in SSDI for longer before switching to retirement benefits. As the demographic and economic pressures on the program have eased, the number of disabled-worker beneficiaries has fallen by 150,000 over the past two years. And the share of Americans receiving SSDI is expected to remain flat over the next 20 years.

Number of the Day

0.3 percent – Growth in personal income in Louisiana in 2016 over the previous year, the fifth-slowest growth in the nation. Nationally, earnings grew 4.1 percent in 2016 (Source: Bureau of Economic Analysis)