The American Health Care Act has 17 percent public approval, which may explain why U.S. Senate leaders are debating the measure in secret, without a single committee hearing or opportunity for public input. As Majority Leader Mitch McConnell pushes for a vote by the end of this month, healthcare leaders are pushing back hard against the hundreds of billions of dollars in cuts to the Medicaid program contained in the bill. In an interview with Bob Herman of Axios, the head of the Children’s Hospital Association laid out the harmful consequences of the Medicaid cuts that are the central feature of the bill.
Roughly half of the money a children’s hospital collects, on average, comes from Medicaid. More than 30 million kids are on Medicaid, and another 6 million are on the Children’s Health Insurance Program. … It is a catastrophic bill for children’s hospitals and really any hospital that’s a high-Medicaid hospital. You take a category with 30 million kids — 40% of all the kids in the country — with an inadequately funded program, and then you reduce it. It just does not compute.
In a letter to Senate leaders, the country’s internal medicine physicians are also speaking out about the flawed legislation and legislative process:
We remain strongly opposed to the AHCA and urge the Senate to completely put aside this inherently flawed and harmful bill. The non-transparent process and pace of the Senate has made it difficult for ACP and other health advocacy groups to provide meaningful input to the Senate.
And in an op/ed in The Washington Post, former Medicare and Medicaid official Andy Slavitt writes that there is a better way:
Not long ago, Republican Sens. Bill Cassidy (La.), Susan Collins (Maine) and [Sen. Shelley Moore] Capito [W. Va.] talked about finding solutions that would lead to more people covered, not fewer. That’s an approach that could bring many Democrats to the table. Given the Senate’s narrow margins, by voting no, the three of them or others have the power to change the course we’re on and put health-care reform on a path to long-term political stability.
Sen. Cassidy once was an outspoken opponent of the AHCA, but has talked about it more favorably of late.
House back in today
Members of Louisiana’s House of Representatives return to the state Capitol today to re-start the process of passing the state operating and construction budgets. Will anything have changed since they failed to agree to a budget last week? The Advocate’s Elizabeth Crisp explores:
“There’s a billion dollar fiscal cliff a year away,” said Rep. Barry Ivey, R-Central. “It blows my mind that we get caught up in the rhetoric acting like we are being so responsible right now because we’re not going to spend 100 percent.”
The AP’s Melinda Deslatte reports that Senate President John Alario is calling on the House to put aside political games in favor of service to the people of Louisiana:
Both Edwards and Republican Senate President John Alario said it appeared that some Republicans in the House are determined not to give any victories to the governor. “If their idea is simply just to hurt the governor, it’s a big mistake because all they’re doing is hurting the people of this state,” Alario said.
Regular session recaps
The reviews are in from the 2017 regular session, and they’re not kind to a Legislature that failed in its most basic duty of passing a balanced budget.. As Gambit’s Clancy DuBos writes in his annual legislative wrap-up, that the biggest losers are Louisiana workers who are struggling to make ends meet in a state where the budget process and tax structure are badly broken.
As one senator told me early on, “There’s just no appetite for fiscal reform.” Really? Do our elected leaders think taxpayers hunger for what we have now? A bill to raise the minimum wage in Louisiana — and only minimally at that — was beat down by business interests and conservatives. Senate Bill 153 by Sen. Troy Carter (D-Algiers) would have increased the state’s minimum wage from $7.25 to $8.50 over a two-year period.
The Lake Charles American Press’ Jim Beam recounts the final chaotic minutes of the session:
The session ended in a circus atmosphere after Rep. Walt Leger, New Orleans, got a majority vote on his motion to allow a full House vote on the budget. The House couldn’t do that without Leger’s motion because (House Speaker Taylor) Barras and (Appropriations Chairman Cameron) Henry refused to sign a conference committee report on the budget. Barras got tangled up in a parliamentary quagmire questioning Leger’s proposal and that ate up precious time. Few will ever know whether that was a GOP delaying tactic, but the session came to its required 6 p.m. adjournment without an approved budget.
The Advocate’s Tyler Bridges reports that the final-hours meltdown happened because House Speaker Taylor Barras failed to sell his own GOP colleagues on a compromise plan that won support in the Senate.
He said the House would agree to the Senate’s version of the budget to spend all of the money anticipated to be available next year, but the executive, legislative and judicial branches of government would be directed to withhold a total of $50 million to cover any revenue shortfall that might develop. Barras’ idea satisfied senators, LaFleur said in an interview an hour after the meeting with Barras, because it would provide the spending they sought. It also won Edwards’ support, his aides said, because the governor had carried out a similar move during the current fiscal year, asking state agencies to set aside 5 percent of their money as a contingency. Senators held out hope that Barras’ idea would win favor among enough Republicans in the House to pass. The House Republicans caucused in the State Capitol basement at 10 a.m. Barras presented it not as his plan but as a potential idea. The conservatives rejected it, saying they wanted less spending and calling for a “win” against the Democratic governor, according to four lawmakers who were present.
The Advocate’s Lanny Keller looks ahead to next year, with the $1 billion-plus fiscal cliff, and wonders if it’s fair to expect anything beyond the current stalemate.
As a Democrat in the cross-hairs of the GOP leadership, Edwards can decide that the mess in the cafeteria is just too much to clean up and stumble along with a decision to renew the sales tax. Even that is dicey, as it takes the same two-thirds “tax increase” vote as real reform bills. Still, some conservatives believe a sales tax fairer, because “everybody pays.” This is a legacy of the old racist notion that black folks pay sales taxes but don’t have property like the whites do. It was economic insanity even in the old days, more so now, but a do-nothing Legislature this year is implicitly voting for keeping the sales tax as it is.
Number of the Day
466,000 – Number of children in Louisiana insured through the Medicaid program. (Source: Children’s Hospital Association & American Academy of Pediatrics)