House budget #2

House budget #2

After eight hours of testimony, the House Appropriations Committee approved a budget bill Tuesday amid the same tensions that doomed the state spending plan during the regular session.

Number of the Day

64 -  Percent of all Medicaid spending in Louisiana that goes to health care services for the elderly and disabled. (Source: LBP: Medicaid Spending FY 2018)

After eight hours of testimony, the House Appropriations Committee approved a budget bill Tuesday amid the same tensions that doomed the state spending plan during the regular session. As Elizabeth Crisp with The Advocate reports, the latest version isn’t much different than the one that House leaders were championing last week:

House Republican leaders are again suggesting that the state spend $100 million less than is projected to be available. That’s about half of what the GOP-controlled House initially wanted to leave on the table, but it’s also not far from where negotiations broke down between the House and Senate in the final moments of the regular session Thursday…Gov. John Bel Edwards’ administration voiced opposition to the latest House leadership plan before it passed on a party-line vote in the House Appropriations Committee Tuesday. Edwards has not formally called another special session but has indicated that he would if a final budget deal isn’t reached again.

The Times Picayune’s editorial board points out that the Legislature’s bickering does not bode well for the much larger and more challenging task ahead: tax reform.

After the budget meltdown on the final day of the legislative session, it’s hard to imagine this group of lawmakers working together to reform Louisiana’s tax system. They couldn’t even agree on how much money they had to spend for the next year and now are spending more of our money on a special session to complete the budget. But this is the Legislature we’re stuck with for two more years, and we ought to demand better of them. Getting a balanced budget passed is only the beginning of what they need to do. The state has more than a billion dollars in temporary taxes, which could plunge the state into a financial hole next year. Louisiana has the highest combined state and local sales tax rates in the nation. Although income and property taxes are relatively low, the economy isn’t thriving.  

 

Louisiana kids deserve better

Louisiana ranked 48th for the second year in a row on the Annie E. Casey Kids Count report released yesterday. While there were a couple bright spots and areas of improvement, overall it is still clear that the state has a long way to go before it can say it is adequately serving its youngest residents. The Advocate’s Gracey Toohey with the story:

We need to be sure that we have supportive communities, policies, programs to help children thrive,” [Agenda for Children’s Teresa]Falgoust said. “We really need to consider preserving existing programs and reversing these budget cuts we’ve seen in recent years.” Falgoust said another promising measure in the report for the Bayou State is the number of children without health insurance, which was at 4 percent in 2015, improving in the last five years from the 6 percent of the state’s children without health insurance in 2010. She said those numbers are directly linked to the state’s expansion of Medicaid.  However the state remains among the worst for the numbers of babies with low birth weight, children living in poverty, teen births and eighth graders not proficient in math.

 

The truth about Medicaid

Some Americans may think they can tune out the discussion about federal health care reform because they have private insurance. They may think the fight over cutting $834 billion from the Medicaid program in the American Health Care Act is irrelevant to them. They should think again, argue David Grabowski, Jonathan Gruber, and Vincent More in an opinion piece for the New York Times. Given the population that Medicaid serves, our parents and all of us are likely to end up relying on Medicaid services as we age:

Many American voters think Medicaid is only for low-income adults and their children – for people for aren’t “like them.” But Medicaid is not “somebody else’s“ insurance. It is insurance for all of our mothers and fathers and, eventually, for ourselves. But few people seem to know that nearly two-thirds of [Medicaid] spending is focused on older and disabled adults – primarily through spending on long-term care services such as nursing homes. In some states, overall spending on older and disabled adults amounts to as much as three-quarters of Medicaid spending. As a result, there is no way that the program can shrink by 25 percent (as under the AHCA) or almost 50 percent (as under the Trump budget) without hurting these people.

Speaking of Medicaid and the AHCA, The Brooking’s Institution put together a list of 10 questions and answers all Americans should be asking themselves about the House-passed version of the bill (which reportedly could make up 80 percent of the Senate’s bill). In one answer, authors Caitlin Brandt, Margaret Darling, Marcela Cabello, and Kavita Patel very succinctly explain how Medicaid per capita caps would work:

Currently, Medicaid has open-ended funding, meaning that the federal government covers a certain percentage of whatever costs accrue, without limit. What the AHCA proposes is a dollar limit on spending from the federal government – a capped amount of money per enrollee, based on the current average cost in the state in 2016 for each category of enrollee. So, while the CBO predicts that this will decrease federal spending, states must compensate by either increasing their contributions to Medicaid program costs spending through raising taxes or cutting other sectors of the state budget, or by reducing Medicaid spending through things like payment cuts for providers and health plans, getting rid of optional services for enrollees, or restricting enrollment eligibility.

Possibly due to the harm the AHCA would do to millions of children, persons with disabilities, elderly, and low-income families, President Trump yesterday called the bill “mean” and suggested the Senate to put forth a more generous proposal.

 

Number of the Day

64 –  Percent of all Medicaid spending in Louisiana that goes to health care services for the elderly and disabled. (Source: LBP: Medicaid Spending FY 2018)