Unless lawmakers can agree on a revenue package by July 1, the Louisiana Department of Health is facing more than $650 million in cuts next year – an amount that would swell to $2.8 billion with the loss of matching federal dollars. This means cuts to substance abuse, mental health and other public health services, but most of the cuts would come from the Medicaid program. Tulane University Medical Center’s Celeste Newby, writing in The Advocate, explains.
As a provider working at UMC, I am deeply concerned about what this means for patients and our community. Cuts to health care, especially to a public-private hospital like ours impact our ability to care for patients as services and programs are cut. Wait times increase and patients have to stay in the hospital longer because they’re not able to get placed in a timely manner. This impacts everyone who receives services at the hospital, including the privately insured. We cannot afford to decrease the already limited and badly needed mental and substance abuse services, particularly in the middle of an opioid crisis. People who are sick need to be treated, and I do not want to see them needlessly suffer as a result of state funding cuts.
The House Health & Welfare Committee is hearing testimony today on bills that would impose out-of-pocket costs on low-income Medicaid recipients and take away coverage from people who don’t comply with a proposed work requirement. LBP’s Jeanie Donovan explains why premiums and copay requirements are a bad idea, and why work requirements don’t work.
Rather than saving the state money, the Medicaid proposals would actually add to the state’s cost at a time when Louisiana is confronting a $1 billion fiscal cliff. The Legislative Fiscal Office lays out the details about work requirements here and explains why forcing low-income Louisianans to pay premiums would actually raise costs to the state.
Black Caucus vs. GOP on revenues
The Legislature’s efforts to replace nearly $1 billion in expiring tax revenue stalled on Wednesday in the House Ways & Means Committee, after a leader of the Legislative Black Caucus made it clear that Democrats will not support a partial renewal of the sales tax without an agreement to also raise revenue from the personal income tax. The move by Rep. Ted James shows that while Republicans have a large majority in the House, they will need broad cooperation from Democrats to move a revenue package. Nola.com/The Times-Picayune’s Julia O’Donoghue has the details:
The question is who is going to bend in the end. Will the Black Caucus let the sales tax hike get through, or will the Republicans have to compromise and approve some other type of tax hike in order to get the Black Caucus’ support? If the sticking point for the Black Caucus is a change in the income tax deduction for people who itemize deductions at the federal level, some Republicans could be open to change. Harris said he wouldn’t personally vote for that type of legislation, but he isn’t actively working to scuttle the proposal either. The proposal would only take 53 votes in the House, not the 70 needed for most tax bills. Some GOP members have already indicated they would vote for if it made it to the House floor for a full vote.
No support for SNAP boxes
President Donald Trump’s plan to replace part of the federal food assistance program with monthly boxes of government-selected food is already being tried on a small scale. The Commodity Supplemental Food Program provides food boxes for about 630,000 low-income seniors around the country. But as Caitlin Dewey reports in The Washington Post, boxes often go unclaimed by elders who cannot reach distributors and dietary restrictions cause significant food waste.
“[The senior food-box program] is an important program but serves far fewer people than SNAP,” said Elizabeth Wolkomir, a senior policy analyst at the Center on Budget and Policy Priorities. “The proposal would require operational capacity that neither USDA nor states have.” The Trump administration’s 2018 budget proposal blindsided the food industry and anti-hunger advocates. Many said they had never even heard the idea discussed before — not even during more than a dozen congressional hearings on the future of SNAP.
Financing paid sick and “family” leave
The White House is researching a policy change that would allow some parents to draw from their Social Security accounts when they need to take time off for the birth of a child. Critics say that Social Security is already inadequate for its cash assistance to the retired, while others appreciate that it does not mandate a new fund or payroll tax. Tara Siegel Bernard and Claire Cain Miller have the story in The New York TImes Upshot Blog.
“This is a significant philosophy shift that doesn’t look at it like an insurance program where we are all in it together, but an individual asset you can tap to pay for your individual needs,” said Kathleen Romig, senior policy analyst at the liberal-leaning Center on Budget and Policy Priorities. The proposal would also begin to reshape Social Security into something more akin to 401(k) accounts: Account holders can borrow against their 401(k), or even drain it in a financial emergency (albeit with a penalty), leaving them with less savings for retirement.
The proposal covers new parents, but not sick leave for family members or workers recovering from illness. As debates for making paid sick and family leave universally accessible continue, Richard V. Reeves at The Brooking Institution explores how current laws define the “family” qualifier.
Right now, the attempts to define a family member in paid sick and paid family leave laws fall between two stools. They are too broad to be sensibly enforced, but still prescriptive enough to exclude some worthy cases. Why should I not be able to use some of my sick leave to care for my oldest, dearest friend from my church?
Number of the Day
8.3 percent- Black unemployment rate in Louisiana at the end of 2017, compared to 3.1 percent for whites and 4.7 percent overall. (Source: Economic Policy Institute)