The AHCA can’t be fixed

The AHCA can’t be fixed

After the U.S. House of Representatives rammed through a deeply unpopular healthcare bill, the action has moved to the U.S. Senate.

Number of the Day

77 - Percent of Louisianans who oppose cuts to hospitals. 70 percent of respondents said they wanted full funding for TOPS. (Source: Bernie Pinsonat via The Advocate)

After the U.S. House of Representatives rammed through a deeply unpopular healthcare bill, the action has moved to the U.S. Senate. As the Center on Budget and Policy Priorities explains, the bill has numerous damaging features that cannot be remedied with cosmetic changes. Instead, lawmakers should take a step back from the ledge and work in a bipartisan fashion to shore up the health system. For Louisiana, severe cuts to Medicaid, including the gutting of the popular Medicaid expansion would be particularly harmful.   

Medicaid expansion has improved access to care and financial security for enrollees — increasing the share of low-income adults who are able to see a doctor and fill needed prescriptions, while reducing the share who are dependent on the emergency room for care or burdened with medical debt. It has also cut uncompensated care costs for states and hospitals and let states treat more people coping with substance use disorders, including opioid addiction. The House bill would reverse these gains.

Nola.com/The Times-Picayune columnist Bob Mann suggests the evisceration of Medicaid could be a major factor in how Sen. Bill Cassidy is talking about health care:

Cassidy’s moderate position is not surprising. He represents a state with a large Medicaid population. Some are his former patients. Perhaps more than any member of the Senate Republican caucus, Cassidy understands the struggles of working-poor families. I suspect he does not want it on his record or his conscience that he made life harder — or more deadly — for these families.

Meanwhile, President Donald Trump remains unfamiliar with the projected impact of the bill and with health insurance more generally. Vox’s Sarah Kliff reports:

Trump makes a promise of “guaranteed coverage.” But the Republican bill doesn’t deliver on that. When the Congressional Budget Office analyzed the last version of the American Health Care Act, it estimated that 24 million fewer Americans would have coverage if the bill were to pass. … “Insurance is, you’re 20-years-old, you just graduated from college, and you start paying $15 a month for the rest of your life and you really need it, you’re still paying the same amount and that’s really insurance,” Trump says. The fact that Trump settles on $15 as the appropriate amount to pay for health insurance betrays a lack of familiarity with the actual cost of coverage. You do not have to be a health policy expert to get this — just someone who has ever purchased a health plan.

 

Medicaid cuts would hurt women

A new report on Medicaid by Hannah Katch, Jessica Schubel, and Matt Broaddus shows that women would be most affected by cuts included in the AHCA. Over 766,000 women have health coverage through the program, including 264,000 who gained coverage through expansion. 69 percent of all births in Louisiana are covered by Medicaid.

The House Republican bill to repeal the ACA, the American Health Care Act (which passed the House on May 4), would radically restructure and deeply cut Medicaid, reducing enrollment by 14 million people by 2026.  While the cuts would jeopardize care for all Medicaid beneficiaries, they would disproportionately affect women due to the higher proportion of women who rely on Medicaid and the specific services at risk of cuts.

LBP responded to the report:

“Senator Cassidy and Senator Kennedy must protect Louisiana women – and all Louisianans — by rejecting any health bill that causes people to lose coverage, caps or cuts Medicaid or ends the Medicaid expansion, or takes away critical protections,” said Jan Moller, director of the Louisiana Budget Project. “Failing to meet any of these standards would hurt Louisiana women and families.”

 

Long-term care bill goes down

A House committee shelved a bill that would have required the Louisiana Department of Health to begin implementation of Managed Long-Term Services and Supports. Proponents of the bill argued that managed care could help more people receive long-term care in a home setting. The Advocate’s Rebekah Allen has the story:

“We are disappointed to see the committee vote against the needs of their constituents and against overwhelmingly favorable public opinion that supports alternatives to nursing home care,” said Andrew Muhl, a lobbyist for AARP lobbyist, adding that the issue will not go away. “We will continue to seek an answer from the governor and our Legislature on why they think Louisiana should continue a system that does not work for the 30,000 people currently waiting for services.” … Richard Carbo, a spokesman for (Gov. John Bel) Edwards, said the administration is actively reviewing options to improve long term care services for the elderly, but stressed that managed care “is not an easy task, despite how it has been portrayed by some, nor is it a silver bullet that will solve all of our problems.” It would also require upfront investment in state resources, he said.

 

What really deters crime

Sociologist Michael L. Radelet and Ben Cohen of the Promise of Justice Initiative penned a guest column in The Advocate to rebut Jeff Sadow’s assertion that the death penalty deters crime. They point out that states without the death penalty have lower murder rates than those with it. They also suggest evidence-based ideas for deterring violent offenses:

Criminologists agree, the best way to “deter” crime is to prevent the conditions that lead to it: better education, more support from positive role models, better mental health treatment. Louisiana has to decide whether it wants to continue spending millions of dollars on a system that does not deter, that does not provide justice, and that that has a demonstrable record that it gets it wrong far more often than it gets it right. We suggest that those in favor of such system be sent the bill for it. And we also suggest that academics think twice before disseminating unsubstantiated pseudo-science, especially when millions of dollars — along with the conscience of the community — are at stake.

 

Number of the Day

77 – Percent of Louisianans who oppose cuts to hospitals. 70 percent of respondents said they wanted full funding for TOPS. (Source: Bernie Pinsonat via The Advocate)