More Louisiana residents than ever before were covered by health insurance in 2016, according to figures released Tuesday by the U.S. Census Bureau. The state’s uninsured rate dropped to 10.3 percent in 2016 from 11.9 percent the previous year – a decline that came in a year when the state expanded Medicaid coverage to low-income adults. Louisiana’s coverage gains were the third-best in the country, and continue a trend of positive health care news for the state since the federal Affordable Care Act took effect in 2014. Louisiana’s uninsured rate dropped 38 percent from 2013 to 2016, thanks mainly to the expansion of coverage under the ACA. LBP’s Nick Albares digs into the numbers and also highlights some national income and poverty trends in a blog.

Medicaid, both expansion and the traditional Medicaid program, is having a transformative impact for people struggling to get by in Louisiana. It covers around 1.6 million Louisianans – mainly kids, people with disabilities and children. That includes 434,594 Louisianans who get their health coverage through the ACA’s Medicaid expansion, which has facilitated more than 35,000 cancer screenings and more than 126,000 primary care visits. Unfortunately, many in Congress are trying to undermine this progress by repealing the federal law that made it happen. Every repeal bill put forward by Congress this year would have ended Medicaid expansion and deeply cut and capped the underlying program, putting coverage at risk. Medicaid’s costs per beneficiary are far lower and have grown more slowly than private insurance, so it’s an efficient way to provide health care to people who are struggling.

While the state is moving in the right direction on health coverage, Sen. Bill Cassidy introduced a bill today that would cap and cut health coverage. The Advocate’s Bryn Stole talked to senators about the proposal.

U.S. Sen. Orrin Hatch, the Senate’s longest-serving Republican and the chair of the finance committee, one of the likely venues to hold hearings on the bill, answered with a simple “no” when asked if the Cassidy-Graham bill would get a vote in the Senate, according to The Hill newspaper.

David Leonhardt writes in The New York Times that Cassidy’s plan should go away quickly.

While it would theoretically give states more flexibility, the bill would mostly rob states of money to pay for health insurance — and millions of Americans would lose coverage as a result. Think of it this way: Every reader of this newsletter has the theoretical flexibility to buy a private jet. Cassidy-Graham, as the bill is known, ends up looking remarkably similar to previous repeal attempts.

Bipartisan deal on children’s health insurance
Sens. Orrin Hatch of Utah and Ron Wyden of Oregon, the chair and ranking member of the Senate Finance Committee, came to an agreement on funding for the federal Children’s Health Insurance Program, which runs out of money on Sept. 30. They’ll now need to sell the deal to their colleagues in both the Senate and House, while finding a legislative vehicle for the plan. CHIP covers 120,463 children in Louisiana. Politico’s Rachana Pradhan has more:

The bitter Obamacare repeal debate for months sidelined work on extending federal funding for CHIP, which covers children in families with incomes too high to qualify for Medicaid. States have repeatedly warned lawmakers that they may have to freeze enrollment or send termination notices to enrollees if funding is not renewed by the end of this month.

La. sells bonds for construction
With the state construction account running low, the Louisiana Bond Commission agreed to $341 million in new borrowing on Tuesday that will have to be repaid over 20 years. The AP’s Melinda Deslatte reports that next year the Bond Commission could face diminished borrowing authority if policymakers don’t come to an agreement on renewing or replacing more than $1 billion in temporary taxes that expire on July 1.

The Bond Commission has been presented with options for how it could replenish the construction account if none of the expiring taxes are replaced. The state could borrow money after the taxes expire by delaying repayment and then back-loading the debt payoff — with the state paying millions more in interest over time. However, if lawmakers agree to fill even a portion of the budget gap with new revenue, that would give Louisiana more room to borrow money for projects without needing to restructure the debt.

Medicare expansion, child care bills to be released
Today, Sen. Bernie Sanders (Vt.) is releasing a health care plan along with 15 co-sponsors, dubbed Medicare for All. Sanders describes the proposal in The New York Times:

A half-century ago, the United States established Medicare. Guaranteeing comprehensive health benefits to Americans over 65 has proved to be enormously successful, cost-effective and popular. Now is the time to expand and improve Medicare to cover all Americans. … Under this legislation, every family in America would receive comprehensive coverage, and middle-class families would save thousands of dollars a year by eliminating their private insurance costs as we move to a publicly funded program.

Meanwhile, Sen. Patty Murray (Wash.) is leading the charge on an early care and education bill. Politico’s Burgess Everett has that story.

The legislation will make federal funding mandatory for lower- and middle-class families to ensure child care doesn’t eat up a disproportionate share of their budget, focus on preparing 3- and 4-year-old children for kindergarten and make new investments in the child care workforce, according to a summary.

On government spending
As Americans get older, popular and important social programs like Social Security and Medicare are going to cost more. These programs have lifted millions of people out of poverty. Lawrence Summers, professor and past president of Harvard University, shares in a Washington Post perspective piece that budget and tax policy should reflect our values – elderly people in our country have paid their dues and deserve to be cared for as they age.

First, the population is aging and the federal government disproportionately takes responsibility for the aged. … The share of the adult population over 65 will have risen from 12.5 percent in 1990 to 19 percent in 2030. … My point is not to argue about the proper size of government, only to note that if one accepts the judgments made in recent decades, the logic points to larger government in the future. … That is why leading with large unpaid-for tax cuts is dangerous and ill-advised policy.

Number of the Day
43 – percent increase in opioid addiction treatment prescriptions in Medicaid expansion states relative to non-expansion states. (Source: The New York Times’ Upshot blog)