Sen. Bill Cassidy’s ACA repeal and replace proposal is the center of attention on Capitol Hill this week. As the Senate barrels toward a possible vote next week, it’s becoming increasingly clear how harmful the bill would be for Louisiana. On Monday, Dr. Rebekah Gee, Louisiana’s Secretary of Health, tweeted out a letter she sent to Cassidy, which blasts the rushed, closed door process he’s using to try to pass the bill and explains how his legislation “gravely threatens” health care access in the state:
The combined effects of the per capita caps and eliminating expansion would result in a projected loss of $3.2B in Federal funding through 2026 – making Louisiana the 8th biggest loser of those states affected by the Legislation and by far the poorest and sickest state affected by these cuts. All seven of the states with larger nominal cuts, including NY, TX, and CA, are far larger and wealthier. The cuts would threaten critical access and care for our most vulnerable Medicaid populations including the disabled, children, and pregnant women.
Cassidy’s bill would redistribute funds from states that have expanded Medicaid to those that haven’t – a shrewd strategy to garner support from Republican governors and votes from Republican senators. In a guest column for The Times Picayune/Nola.com, LBP senior policy analyst Jeanie Donovan calls out Cassidy for playing politics with people’s health care:
Americans deserve quality, affordable health care regardless of the state they call home. Cassidy’s latest bill would make some states winners and others — including Louisiana — would be losers. He has taken this approach simply as a strategy to muster up enough votes to pass the bill by a Sept. 30 deadline –not because it would improve our nation’s health care system or lead to better health outcomes. This is not the way sound health care policy is developed, and Cassidy should know better. The public, experts across the political spectrum and groups representing patients, hospitals, physicians, seniors, people with disabilities and others have forcefully and repeatedly rejected this misguided approach.
The Congressional Budget Office won’t have time to do an analysis of how many Americans would lose coverage under the Cassidy-Graham bill or what impact the bill would have on premiums. Jacob Leibenluft with the Center on Budget and Policy Priorities explains how the same rushed process was used by the House to pass the American Health Care Act, in an attempt to hide many of the bill’s major flaws:
Yet Senators Cassidy and Graham and their counterparts appear set to take the exact approach they criticized, precisely in order to hide the bill’s damaging impact on coverage, consumer costs, and consumer protections … That means senators (and later, House members) would vote on the bill without a complete examination, by CBO or experts in an open hearing process, as to what it would actually do. Such a CBO report would likely illustrate the ways that the bill’s cuts — $239 billion through a block grant and another $175 billion through a per capita cap to Medicaid between 2020 and 2026 — would shrink health coverage.
Workforce study at child welfare agency
A recent review of the Department of Children and Family Services (DCFS) by the Louisiana Legislative Auditor revealed how staffing cuts, high turnover and increasing caseloads at the agency were leading to poor performance and putting children at risk. On Monday, the leader of the department, Marketa Walters, announced DCFS was selected to participate in a workforce improvement initiative that could improve outcomes for Louisiana’s most vulnerable children and families. The Advocate’s Elizabeth Crisp reports:
DCFS has recently been named one of eight states to work the next five years with the national Quality Improvement Center for Workforce Development to address issues staffing issues that affect vulnerable children. According to a release on the efforts, “QIC-WD will work with the selected sites to address and study potential solutions to their specific workforce issues.” “Ultimately, a stronger workforce with less turnover and more supportive organizational environments should improve the outcomes of the vulnerable families and children served by the child welfare system,” said QIC-WD director Michelle Graef, a research associate professor at the UNL Center on Children, Families and the Law.
Underestimating racial inequities
LBP’s State of Working Louisiana 2017 report revealed a significant gap in wages between white and black workers – a gap that had widened since 1979. Still, many Americans believe that racial inequities are decreasing and that our country is making progress toward becoming the egalitarian meritocracy it aspires to be. A group of researchers at Yale recently measured the difference between what Americans perceive about progress toward racial equity and the reality. Emily Badger for the New York Times’s Upshot Blog:
“I’m a person who studies inequality, who should really know how inequality looks,” said one of the psychologists, Michael Kraus, who researches the behaviors and beliefs that help perpetuate inequality. “And I look at the black-white gap, and I’m shocked at the magnitude.” Black families in America earn just $57.30 for every $100 in income earned by white families, according to the Census Bureau’s Current Population Survey. For every $100 in white family wealth, black families hold just $5.04. If Mr. Kraus, of all people, is taken aback by these numbers, what are the odds that most Americans have a good understanding of them? The answer, he and his colleagues fear, has broad implications for how we understand our society and what we’re willing to do to make it fairer.
Hurricane recovery hardest for the poor
As residents of Texas and Florida begin the recovery process in the wakes of Hurricanes Harvey and Irma, some households will be better equipped and better positioned to bounce back from the damage caused by the storms. Researchers Eleanor Krause and Richard V. Reeves at the Brookings Institution found that, as in New Orleans, families in Houston with lower-incomes were both more likely to live in low-lying, flood-prone areas and less likely to have flood insurance:
Second, poorer families are less well insulated against the economic shock that often accompanies the physical one. In the eight counties most severely-affected by Hurricane Harvey, only 17 percent of homeowners held flood insurance policies, which are more commonly held by wealthier households. Even with FEMA assistance, poor households affected by storm damage will likely confront the consequences for years to come. Ten years after Hurricane Katrina, residents whose homes flooded during the storm had lower credit scores and rates of home ownership than their neighbors who were spared the worst.
Number of the Day
$5.04 – Amount of wealth the average black family in America accumulates for every $100 in wealth accumulated by the average white family. (Source: U.S. Census Bureau’s Current Population Survey via The Upshot Blog)