Members of the general public have one chance every year to testify in the House about the state budget. That day was Tuesday, but the House Appropriations committee kept citizens waiting for four hours before they began hearing testimony from college students, parents of children with disabilities, seniors and others on how the looming budget shortfall will impact their lives. The state faces a $700 million funding gap starting July 1, and while some lawmakers want to raise enough revenue to address the shortfall, others favor spending cuts to balance the budget. The AP’s Melinda Deslatte was there.

Nina Savoie, of Ascension Parish, told lawmakers her son John Harris died at age 5 last year without ever receiving state-financed services to help with care for disabilities stemming from a premature birth. “He’s not waiting on the list anymore,” Savoie said. Private insurance would cover some treatments, she said, but not the full list of services and equipment needed. “It doesn’t have to be like this, and we were not the only family on the list with a terminal illness,” Savoie said. “I can’t help but wonder what could have been.”

The Advocate editorial board takes a look at the state’s safety-net “partner hospitals,” several of which have said they will walk away from their state contracts if their funding is cut.

What is different is some of the blunt language from (Lafayette General Hospital). “Zero funding simply makes it fiscally irresponsible. It actually endangers the future of our organization to stay in this agreement,” said David Callecod, president of Lafayette General. He called the loss of hundreds of jobs and the suspension of care for thousands of patients an irresponsible path for the state. Callecod is exactly right. These are real-world consequences of the tax deadlock. … This is not a phony crisis. For patients, it’s a real consequence of a budget impasse at the State Capitol.

New Medicaid study confirms benefits of expansion

A new report from the LSU Public Administration Institute spells out how the federal health care funding flowing into Louisiana as a result of Medicaid expansion is creating jobs and economic activity in every corner of the state. The report shows that Medicaid expansion has created and retained jobs, has more than paid for itself and has decreased Louisiana’s reliance on state general fund dollars to provide health care for low-income adults, a welcome relief given the chronic budget woes of state.

Last, these economic gains are in addition to the broader gains from people having appropriate healthcare throughout their adult life. Improved healthcare access can also have a positive effect on the labor force participation rate, defined as the number of persons in the work force who are 16 years of age or older. Improved labor force participation rates should be one long-term result of the Medicaid expansion program, and rising labor force participation rates will allow further employment growth from in the state.  

While the report shows the positive impacts of expansion, a new report from the Center on Budget and Policy Priorities shows how imposing onerous work requirements on Medicaid recipients could cause many people who are already working to lose coverage.

Less understood, many working people also will likely lose coverage due to work requirements. Most non-elderly adult Medicaid enrollees work, but in low-wage jobs that generally do not offer health insurance and are often unstable, with frequent job losses and work hours that can fluctuate sharply from month to month. As a result, our analysis finds that 46 percent of low-income workers who could be affected by Medicaid work requirements would be at risk of losing coverage for one or more months under a work requirement policy like Kentucky’s. Even among people working 1,000 hours over the course of the year — about 80 hours per month, meeting Kentucky’s standard on average — 1 in 4 (25 percent) would be at risk of losing coverage for one or more months because they would not meet the 80-hour requirement in every month.

Senate Bill 77 by Sen. Sharon Hewitt and House Bill 46 by Rep. Lance Harris would impose a work requirement in Louisiana’s Medicaid program. Neither bill has been scheduled for a committee hearing to date.

In defense of progressive taxation

The concept of progressive taxation – that those at the top of the income pyramid should pay a higher tax rate than those at the bottom – arrived in America with the Puritans and is older than the country itself. But Louisiana seems intent on going in the opposite direction, becoming increasingly reliant on sales taxes that are currently the highest in the nation and hit low-income families harder than the rich. The Advocate’s Lanny Keller looks at the logic, or lack thereof, for our current tax structure, and why some favor the regressive income tax reforms.

We have sales taxes created at different times and at different levels of government taxing different things. Even the five pennies of the state’s sales tax don’t match up. We have multiple collectors and forms, mainly so that local politicos can put their relatives on the payroll. …  On income taxes, beyond the irresponsible Jindal-era overall cuts, we give the big breaks to those at the top of the income scale. There’s a full deduction of federal income tax paid, putting us in an elite class of progressive tax-writing states like Alabama. … The politics that overrides the theory: More affluent people vote, particularly in down-ballot races like those of members of the Legislature, and if they notice their taxes going up, they’ll take it out on incumbents who have neither the wit nor inclination to explain why they’re doing the right thing.

Bill that would delay raise the age advances

A bill that would delay the implementation of a law that would stop automatically placing 17-year-olds in the adult criminal justice system advanced out of Senate committee on Tuesday, after a late morning compromise between Gov. John Bel Edwards, the state’s district attorneys and Sen. Ronnie Johns. Senate Bill 248, by Johns, postpones the shift by one year to 2019. The bill originally sought to delay implementation until 2020. Proponents of the bill say that the state does not have adequate funding to implement the changes, but critics say it’s imperative that the state acts now. Greg Hilburn of USA Today Network reports:

But Rachel Gassert of the Louisiana Center for Children’s Rights said the state has had ample time to prepare for the new law, which passed in 2016 as one of Edwards’ centerpiece justice reforms. She said the Union Parish incident illustrates the perils for 17-year-olds housed in adult prisons. … “We have reports of (alleged) rapes in three other parishes, and in three of the four case the victims were being held on non-violent charges,” Gassert said. “It’s absurd to be talking about a delay,” she said. “It’s too important to put off.”

Number of the Day

19,195 – Number of jobs Medicaid expansion has created and retained since mid-2016 (Source: Medicaid Expansion and the Louisiana Economy)