The American Health Care Act (AHCA), approved narrowly Thursday by the U.S. House of Representatives, is the most damaging piece of legislation for low and middle-income families in modern American history. If this bill is passed by the Senate and signed into law, an estimated 466,500 Louisianans will lose their health care over the next decade, our state will be forced to cope with over $800 billion in cuts to the Medicaid program and individuals with pre-existing conditions could be forced to pay higher premiums or be left without any type of health insurance, all while providing billions of dollars in tax cuts for millionaires. Although the opposition to the bill was bipartisan, Louisiana’s delegation voted on party lines with Rep. Cedric Richmond as the lone no vote; although Rep. Garret Graves insisted he had concerns with the bill up until the vote. Reed Abelson and Katie Thomas from the New York Times outlines the bill’s damaging effects:

The bill’s impact is wide-ranging, potentially affecting not only the millions who could lose coverage through deep cuts in Medicaid or no longer be able to afford to buy coverage in the state marketplaces. With states allowed to seek waivers from providing certain benefits, employers big and small could scale back what they pay for each year or reimpose lifetime limits on coverage. In particular, small businesses, some of which were strongly opposed to the Affordable Care Act, could be free to drop coverage with no penalty.

Virtually every healthcare organization and patient advocacy group in the country opposed the bill. Here’s a sample of the statements condemning this harmful bill.

More here from the Louisiana Budget Project.

Center on Budget and Policy Priorities:

I have been in Washington, D.C. for 45 years.  But I have never seen members of Congress vote to so deeply hurt so many of their own constituents.

American Medical Association:

The bill passed by the House today will result in millions of Americans losing access to quality, affordable health insurance and those with pre-existing health conditions face the possibility of going back to the time when insurers could charge them premiums that made access to coverage out of the question.

American Hospital Association:

Despite last-minute changes, the proposal eliminates essential protections for older and sicker patients, including those with pre-existing conditions, such as cancer patients and the chronically ill. It does little to help the 24 million Americans who would be left without coverage following repeal and makes deep cuts to Medicaid, which provides essential services for the disabled, poor and elderly people in this country.

AARP:

The bill will put an Age Tax on us as we age, harming millions of American families with health insurance, forcing many to lose coverage or pay thousands of dollars more for health care.  In addition, the bill now puts at risk the 25 million older adults with pre-existing conditions, such as cancer and diabetes, who would likely find health care unaffordable or unavailable to them.

State budget bill moves to Senate

In a 63-40 vote, mostly along party lines, the state House approved a budget bill that fully funds TOPS scholarships but shortchanges virtually every other area of state government. The bill hits health and social services providers especially hard, due largely to the GOP’s decision to leave $235 million in available funding on the table instead of allocating it to programs. Making matters worse, House leaders refused to specify where the cuts should be made. The AP’s Melinda Deslatte has the story:Ju

Most of the money cut from the governor’s budget proposal was stripped from the health department. Dollars also were removed from education programs, prisons, the child welfare agency and state police. Federal matching dollars would be lost…“It’s a transparent attempt to cut the budget deeply and hide that fact by telling the Division of Administration to do the dirty work,” (Walt) Leger said.

Gov. John Bel Edwards expressed his frustration with House’s plan, a plan that is drastically different from the one he proposed. The Advocate’s Elizabeth Crisp:

“We can’t move Louisiana forward if we’re standing still,” Edwards said. “Their budget guts health care, children’s services and veteran services to levels that endanger the health and welfare of the people of Louisiana. When politicians craft policies without the input of the experts in a field, you know you’re getting a bad deal, and that’s how this budget was drafted.”

The Senate Finance Committee is expected to begin reviewing the budget bill next week and as Nola.com/The Times-Picayune’s Julia O’Donoghue reports, there is optimism that a deal will be brokered.

The spending plan now heads to the Senate for consideration. The priorities of the Senate and Edwards tend to align more closely, and it’s doubtful that the House plan will be acceptable to the Senate. More than likely, the leadership from the two chambers will end up negotiating a compromise with the governor.

Government assistance reduces poverty

Opponents of federal safety net programs often say the poverty rate hasn’t budged much since major entitlement programs were created in the mid-20th century. But the federal poverty rate doesn’t measure the impact of these programs. When they are  accounted for, studies show poverty has decreased in the last 35 years, with the safety net playing a major role. For the first time, state-level trends in poverty were analyzed in a report by the Columbia Population Research Center and the Center on Poverty and Social Policy. The report uses a measure of poverty called the Supplemental Poverty Measure (SPM). The SPM gives a more complete picture of poverty in the United States and can be used to asses the impact that government assistance has on the poverty rate. While poverty is still a devastating reality in Louisiana, the social safety net makes a significant difference. According to the report:

Taxes and transfers today reduce the Louisiana poverty rate by 13.3 percentage points. The role of taxes and transfers in Louisiana has grown from 6.5 percentage points in 1976 to 13.3 percentage points in 2014, which highlights the growing importance of government programs in reducing poverty in the state. The child poverty rate in Louisiana would have been 12.6 percentage points higher in 2014 absent government programs, but with government programs stands at 22.3%.

Lawmakers target nursing home reforms

Rep. Rick Edmonds tried unsuccessfully to add an amendment to the state budget bill that would have required the governor’s administration to solicit managed care companies to oversee Medicaid services for Louisiana’s elderly and physically disabled. Edmonds said it would save the state money and improve care.  The Advocate’s Rebekah Allen has the story:

Were it implemented, the measure would also generate significant revenue for the state, because the state assesses a 5.5 percent tax on managed-care providers. An expansion of managed care to long-term services would generate anywhere from $100 million to $500 million a year, Edmonds said. Based on projections from the Louisiana Association of Health Plans, The Advocate has reported the tax would generate $130 million the first year and $200 million a year after the second year. ..”This is smart legislation. We save money and we make money. There’s a financial benefit and the quality of care and quantity of care increases.”

Number of the Day

$20,560 – Average premium surcharge for a pregnancy for a 40-year-old living in Louisiana under AHCA (Source: Center for American Progress)