Mr. Cassidy goes to Washington

Mr. Cassidy goes to Washington

By most accounts, the GOP’s efforts to replace the Affordable Care Act with something that covers far fewer people is dead, at least for the moment. But someone forgot to tell Louisiana Sen. Bill Cassidy, who flew back to the nation’s capital on Monday for a White House meeting with beleaguered President Donald Trump.

Number of the Day

34 percent - Decrease in federal health-care funding, compared to current law, by 2026 under a block-grant proposal being pushed by Louisiana Sen. Bill Cassidy (Source: Center on Budget and Policy Priorities).

By most accounts, the GOP’s efforts to replace the Affordable Care Act with something that covers far fewer people is dead, at least for the moment. But someone forgot to tell Louisiana Sen. Bill Cassidy, who flew back to the nation’s capital on Monday for a White House meeting with beleaguered President Donald Trump. Cassidy was there to push his “Graham-Cassidy” plan, developed with South Carolina Sen. Lindsey Graham, as an alternative to the three measures that were defeated last week. So what’s in the latest plan? As Judith Solomon and her crack team of researchers at the Center on Budget and Policy Priorities report, it would make deep cuts to Medicaid, shift money from expansion states to non-expansion states and transform the program from an entitlement into a federal block grant.

(T)he text of the amendment alone makes clear that — contrary to Senators Cassidy and Graham’s claims — the proposal would cut federal funding for Medicaid and marketplace subsidies by hundreds of billions of dollars over ten years, and by trillions over two decades.  The proposal would block grant and sharply cut federal funding for Medicaid expansion and marketplace subsidies (with funding ending altogether after 2026), while retaining the Senate bill’s damaging per capita cap on federal funding for the rest of Medicaid.  Many millions of people would lose coverage, just as under both the House-passed health bill and the Senate bill (the Better Care Reconciliation Act, or BCRA).

While there is always a chance the Senate could hold another health-care vote, Utah Sen. Orrin Hatch and others say the upper chamber is simply too divided to reach the required 50-vote threshold. As The New York Times’ David Leonhardt reports, that’s largely due to the work of everyday people who rose up to defend a law that has provided crucial health coverage for millions of Americans.

If one of the Senate or House health care bills had become law, millions of people would have lost their coverage. Ultimately, many would have been denied medical care. Birth defects, cancer, diabetes and other conditions would have gone untreated. And it came depressingly close to happening. But it didn’t — because of a lot of hard work from a lot of people. Today, I want to give them their due. They are the people who have helped save decent medical care for their fellow citizens. They are an antidote to cynicism in this often cynical time.

 

Budget crisis hamstrings higher ed

Years of budget cuts to Louisiana’s public colleges and universities has lowered faculty morale, driven top-performing students out of state and harmed the state’s future economic competitiveness. That’s the takeaway from the Chronicle of Higher Education, which looks at higher education in Louisiana after a legislative session when universities received a rare reprieve from cuts. Nell Gluckman reports:

A morale survey of faculty members at Louisiana’s public institutions, released in May, showed that many are ready to leave the state. Of the 575 professors who responded, roughly two-thirds said they were looking for positions outside Louisiana. Nearly 52 percent said they would leave for a lower-paying position if it came with the possibility of a raise. Most said they did not think their positions were secure and would not expect them to be filled if they left.

 

Capital outlay threatened by fiscal cliff

With more than $1.2 billion in temporary taxes due to expire on July 1 – creating the so-called fiscal cliff – the threat to state health-care and education services is well known. But as the AP’s Melinda Deslatte reported over the weekend, the fiscal uncertainty caused by the Legislature’s failure to stabilize the state budget could also affect state construction projects. That’s because the state will bump up against a self-imposed debt limit, which restricts the amount of money the state can borrow to pay for roads, buildings and other capital construction projects.

“The reality is that if we don’t choose to do something next year because of the fiscal cliff and because of the limit on the debt, (Louisiana) is going to have to start slowing down projects,” (Commissioner of Administration Jay) Dardenne said. As the bond commission readies for a September bond sale to generate $341 million to keep dollars flowing to construction projects, state officials learned that the expiring taxes will make for some tricky choices ahead.

 

Keeping an eye on loved ones

Louisiana’s powerful nursing home industry has long had a stranglehold on the state Legislature, having used its political clout to ensure that its Medicaid reimbursements are protected by constitutional fiat as other services get cut. Now the industry is fighting efforts to shine a light on the care they deliver. As Jeff Sadow detailed in Sunday’s Advocate, a Louisiana family’s effort to install a camera in their mother’s room in a Slidell nursing home is the subject of a lawsuit.

In reality, nursing homes fear that cameras will expose employee misbehavior that creates legal liabilities, increase state corrective actions, and affect the bottom line by hiking personnel costs — through paying higher wages and dealing with staff turnover. The industry will fight any attempt to make camera installation a legal right. Regardless, at the next available opportunity Louisiana policymakers should change state law to allow cameras in rooms of nursing home clients. If they won’t protect taxpayer resources, they at least need to allow families to protect vulnerable citizens.

 

Number of the Day

34 percent – Decrease in federal health-care funding, compared to current law, by 2026 under a block-grant proposal being pushed by Louisiana Sen. Bill Cassidy (Source: Center on Budget and Policy Priorities).