Louisiana’s Medicaid program has grown considerably in recent years – from less than $8 billion five years ago to more than $12 billion in the current budget cycle. Most of that growth is due to an influx of federal funding associated with Medicaid expansion, and it’s buying something very important: secure, portable health coverage for more than 400,000 low-income adults. But as the AP’s Melinda Deslatte reports, Republicans have zeroed in on the health care program as they look for ways to cut the state budget – despite ample evidence that it’s been healthy for the state budget.  

Medicaid spending grew by $1 billion this year alone, driven largely by the expansion. Again, there’s a nuance: State general fund spending on the program actually dropped by nearly $400 million. The federal government is paying most of the Medicaid expansion cost. Louisiana is paying a share that eventually increases to 10 percent. Lawmakers also passed items to help cover the state’s costs, including a tax hike charged on health maintenance organizations known as HMOs. Louisiana also is saving millions by tapping into enhanced federal financing for coverage it already provided to the poor and uninsured that is now available because of Medicaid expansion. State spending growth on Medicaid over the past 15 years actually is below the national average, about 6.7 percent compared with 7 percent nationally, according to a nonpartisan House Fiscal Division analysis. The analysis said Louisiana’s per capita state general fund spending on Medicaid also is less than the national average.

With Louisiana facing a massive $1.5 billion shortfall next year, a bipartisan group of House members met last week for a series of closed-door briefings and to begin searching for common ground. Jim Beam of the Lake Charles American-Press reports that consensus remains elusive:

Legislators can approve new taxes, cut the budget or try a combination of the two. They have already refused to reform the state’s budget and tax systems, which is the preferred approach. Sen. J.P. Morrell, D-New Orleans and chairman of the tax committee in the upper chamber, described the current climate in blunt terms. “There is no tax solution,” he told the Times-Picayune last month. “No one has suggested anything we haven’t already tried, so I don’t know why anyone thinks there are new ideas. I don’t think the Legislature is going to solve this problem before we go off the cliff.” The conservative powerhouses are ready to pounce on anyone — particularly Republicans — who even think about voting for taxes. GOP lawmakers, primarily in the House, live in constant fear of being attacked by Americans for Prosperity, the organization funded by the billionaire Koch Brothers.

IBM and the problem with business incentives

State and local officials were downright ecstatic four years ago when IBM announced it was coming to downtown Baton Rouge, and bringing 800 technology jobs to the capital region. Four years and $57 million of incentive payments later, many of the promised jobs have yet to materialize, and state officials are forced to explain why they’re not enforcing penalty provisions that allow them to recoup some of the money that was given to the company. The Advocate’s Ted Griggs looks at the troubled deal, and the problem of luring technology jobs to a region that doesn’t produce many of the graduates that high-tech firms seek.

Jan Moller, head of the Louisiana Budget Project, a nonprofit that advocates for low- to moderate-income families, said the failure of IBM to hit its job mark here points to the problems with government offering financial incentives to lure companies. “Everyone shares the desire to bring high-tech jobs, but I tBhink this speaks to the folly of simply trying to pay companies to locate in a particular place as opposed to the much harder work of developing the kind of workforce that’s needed to attract these companies organically,” he said. … In 2015, Louisiana had 365 computer science graduates and 2,165 open computing jobs — roughly six times as many open jobs as there were graduates, according to figures compiled by Code.org, a nonprofit dedicated to increasing women’s and minorities’ participation in computer science. Brandon Reeves, CEO of EtherMon, a Baton Rouge-based cybersecurity firm, said skilled workers are being pulled to high-tech centers on the West Coast, as well as to Austin, Texas, and Nashville, Tennessee.

Racism and political indifference
The major problems that plague Louisiana – child poverty, environmental degradation, mass incarceration and predatory lending, to name a few – disproportionately affect people of color. Columnist Bob Mann, writing for Nola.com/The Times-Picayune, thinks that’s a major reason why they often are ignored by most people, and, consequently, by elected officials.

There is a term that describes this collective indifference to poverty, disease, discrimination and suffering: institutional racism. “There are many ways to talk about racism as a political issue, a sociological phenomenon [and] a cultural divide, but at its deepest level, racism is a soul sickness,” says Father Bryan Massingale, a professor of theological and social ethics at Fordham University. “It’s a profound warping of the human spirit that enables human communities to create communities of cold, callous indifference to their darker brothers and sisters.”

Except, of course, that affluent whites are profoundly affected by injustice.

Put another way, as a wise man once said, “There is no Them. There are only facets of Us.” When any of us ignores racist laws and policies, we are complicit in that racism. When we when profit from the economic inequalities visited upon others, we are also complicit. In fact, cold indifference to injustice may be our society’s most serious sin.

The cradle to prison pipeline
Research has shown conclusively that trauma experienced in childhood – from divorce and parental drug use to deep poverty and sexual abuse – has negative consequences that can last a lifetime. The more Adverse Childhood Experiences (ACEs) a person suffers, the more likely they are to be obese, go to prison or suffer from chronic diseases such as heart disease or diabetes as adults. To drive this point home, The New York Times’ Audra S. Burch brings us the story of Rob Sullivan, a 43-year-old Connecticut man whose lengthy involvement in the criminal justice system can be traced back to a traumatic childhood.

Mr. Sullivan was one of 10 newly released prisoners in Connecticut whom the PBS series “Frontline” and The New York Times followed for more than a year. The state is working to reduce its prison population and improve former prisoners’ chances of successfully rejoining society. But those convicted of crimes often have complex problems that date back to childhood. More than half, including Mr. Sullivan, went back inside. A look at their histories showed that long before they were perpetrators, many of them were victims. Seven completed a questionnaire intended to quantify childhood trauma on a scale of one to 10, including the experience of or exposure to physical and sexual abuse, drug and alcohol abuse or mental illness in the home. High scores predict a wide variety of negative outcomes. All but one of them scored four or more, indicating a substantially elevated risk of chronic disease, depression, suicide attempts, substance abuse and violence.

Number of the Day
$57 million – State dollars spent, of $147 million promised, to bring IBM to downtown Baton Rouge. (Source: The Advocate)