As the Legislature heads toward a long-anticipated special session, some conservatives have tried blaming Louisiana’s Medicaid program – instead of expiring temporary taxes –  for the state’s ongoing structural budget deficits. While the overall Medicaid program has grown thanks to the 2016 coverage expansion, that growth is actually helping to save the state money. LBP’s Jan Moller explains in a letter to the editor in today’s Advocate:

“Traditional” Medicaid covers people with disabilities, elderly people in nursing homes, pregnant women and children from low-income families. For these populations, the state pays about 36 percent of the cost, with the federal government picking up the remaining 64 percent. The same match rate holds true for the medically uninsured who receive charity care. The state gets a much better deal for the 464,000 people who’ve gained coverage under Medicaid expansion. Here the state is responsible for just 6 percent of the cost, with the federal government paying the rest. The state’s 6 percent share comes from dedicated taxes paid by hospitals and private health insurers. These taxes can’t legally be used to pay for anything except the state’s costs of Medicaid expansion, so if expansion were eliminated that revenue stream would also disappear. If Louisiana were to take (The Pelican Institute’s Chris) Jacobs’ advice and start “phasing out” Medicaid expansion, people would lose their health coverage. When health problems arise they would be forced to seek charity care in emergency rooms. That “charity” care would then be paid with Medicaid dollars, with the state picking up 34 percent of the cost using general-fund tax dollars instead of dedicated funding.

Trump’s ‘dead-on-arrival’ budget

President Donald Trump unveiled his 2018-19 budget proposal on Monday, and the wise men and women of Washington promptly declared it dead on arrival. That’s a very good thing, since the president’s spending blueprint would create new hardships for millions of people who depend on the federal safety net to put food on the table, pay the rent and get basic health care services. The Center on Budget and Policy Priorities has the lowlights:

The cuts would affect a broad range of low- and moderate-income people, including parents, children, seniors, and people with disabilities.  Taken together, the cuts are far deeper than any ever enacted and would deepen poverty and hardship and swell the ranks of the uninsured. The budget also scales back efforts to promote opportunity and upward mobility, such as by cutting both job training and programs that make college more affordable.  These cuts fly in the face of the Administration’s rhetoric about expanding opportunity for those facing difficulties in today’s economy and helping more people work.

The president is getting plenty of headlines for his plan to strip consumer choice from some recipients of Supplemental Nutrition Assistance Program (SNAP) benefits by converting part of the grant to a monthly box of pre-selected food. Glenn Thrush of the New York Times explains why it’s mostly a red herring:

(T)he idea, according to two administration officials who worked on the proposal, was a political gambit by fiscal hawks in the administration aimed at outraging liberals and stirring up members of the president’s own party working on the latest version of the farm bill. The move, they said, was intended to lay down a marker that the administration is serious about pressing for about $85 billion in other cuts to food assistance programs that will be achieved, in part, by imposing strict new work requirements on recipients. “I don’t think there’s really any support for their box plan. And, I worry that it’s a distraction from the budget’s proposal to cut SNAP by some 30 percent. That’s the real battle,” said Stacy Dean, vice president for food assistance policy at the Center on Budget and Policy Priorities, a progressive Washington think tank. “The dangers are these other proposals to cut benefits. But all anyone is talking about today are the boxes.”

About that Louisiana Checkbook

Conservative activists and their allies in the business community are really excited about an Ohio  website that tracks spending by state government and some local governments. The Louisiana Checkbook coalition wants a similar website for Louisiana, and have made it a top priority for the upcoming special legislative session. The Advocate’s Lanny Keller reports that while an easy-to-use website could help keep government honest, it is not a panacea for the state’s budget problems.

Gov. John Bel Edwards said he likes the idea of more transparency in spending, but he and Commissioner of Administration Jay Dardenne noted that the state is a long way from digitally together: Another $26 million — on top of $100 million or so spent mostly over the course of former Gov. Bobby Jindal’s administration — is needed to get state government networked, much less local governments and most public colleges in the state, which are now not on LaTRAC. One of the lessons of LABI’s presentations should be that if you’re going to run government like a business, it’s not just about cutting taxes. The budget crises and short-term thinking of the past decade have resulted in a lack of investment in one of the most basic functions of an organization, its computer networks.

The newspaper’s editorial board agrees with LABI President Stephen Waguespack that the Ohio Checkbook model represents a step forward for a state that already enjoys a strong national ranking for government transparency.

LaTrac had some deficiencies, though, partly because budget problems have always hampered Jindal’s good intentions of greater use of technology in state government. Now, the state of Ohio has leapfrogged Louisiana by developing the Ohio Checkbook, a more comprehensive and user-friendly website that can give the public access to spending down to the level of pencils and office equipment. The site was demonstrated at the annual meeting of the Louisiana Association of Business and Industry, which is helping lead a coalition of business and public interest groups seeking creation of a similar model in our state. We second that motion.

‘Well-being’ nosedives in Louisiana

Another day, another list from a national publication that ranks Louisiana near the bottom. The latest comes from Gallup, which surveyed more than 160,000 people across the country to see how they felt about their lives and the communities in which they live. The result? Louisiana slipped six spots in 2017 from the year before, to 49th overall. The Business Report’s Sam Karlin:

In particular, Louisiana ranked last in community well-being category, or “liking where you live, feeling safe and having pride in your community.” The Bayou State was next-to-last in financial well-being, defined as “managing your economic life to reduce stress and increase security.” The U.S. South fared poorly in this year’s rankings, with Mississippi, Arkansas placing in the bottom 10, and Alabama, Georgia and South Carolina ranking worse than average. Texas, on the other hand, ranks No. 13. Nationally, the overall well-being score for Americans dropped from 2016, and declined in 21 states represented the largest year-over-year decrease in the study’s history. “Not a single state showed statistically significant improvement compared to the previous year, which is also unprecedented in Well-Being Index measurement,” the report says.

Number of the Day

$115 billion – Estimated annual cost of the ongoing opioid crisis in 2017. Most of the cost is due to lost earnings and productivity from overdose deaths. (Source: Altarum via Axios)