Seven states — including Louisiana’s northern neighbor, Arkansas — have imposed rigid work requirements on some adults as a condition of obtaining Medicaid health coverage. The results have been predictable: coverage has been taken away from people who don’t meet the new rules. And it also has led to the unintended consequence of stripping coverage from people who should be exempt. As Judith Solomon of the Center on Budget and Policy Priorities explains in a new report, more than three-fourths of those who lose coverage do so because of red tape, not because they didn’t meet the work requirement:
Work requirement policies can’t be fixed for several reasons. First, any work requirement will have the unintended consequence of taking coverage away from people who are already working or should be exempt due to illness, disability, or other factors. That’s because rules for reporting and claiming exemptions increase paperwork and red tape, which cause eligible people to lose coverage and become uninsured. … Second, work requirements are ineffective in promoting employment because they don’t accurately identify those who can work but aren’t working (often for reasons beyond their control), nor do they assess their needs or provide them with supports. And they can undermine work when people can’t get the health care they need to work or look for a job.
Small towns, big problems
The residents of Clarence, in Natchitoches Parish, may soon be without drinking water, and local police officers are being laid off. It’s a similar story in Jeanerette and St. Joseph, Bogalusa and Sterlington — small Louisiana municipalities with shrinking tax bases that are having increasing trouble providing basic services to their residents. Many are at risk for state takeover, but a state fund that’s supposed to finance such interventions was raided by the Legislature during the state’s budget crunch. And even handing a city’s purse to a state-appointed financial administrator — as was the case in Flint, Michigan — won’t solve what is increasingly a structural problem. As The Advocate’s Mark Ballard reports, the problems the state’s small municipalities have in paying for necessary services are only expected to escalate due to demographic change:
Census figures show that folks are leaving small towns for the south Louisiana metropolises along Interstate 10. Those left behind tend to make less money and are less educated. The USDA Economic Research Service reported that the annual income for residents in rural areas of Louisiana was $35,170 in 2017 compared to $42,298 in urban areas. About one in five, or 21.2 percent, hadn’t graduated high school compared to 15.2 percent in urban areas in 2016. Once a thriving agricultural community with shops and retailers lining its main street, St. Joseph has lost half its population since 1980. Among those remaining the unemployment rate hovers around 12 percent — roughly three times higher than the state average — and a median family income of about $29,000 — more than 40 percent below the state as a whole.
A light legislative session?
In most other states, legislatures have already started meeting and the election season is in the rearview mirror. Not so in Louisiana, where the April 8 session start is the latest in the country and every seat in the House and Senate is on the October primary ballot. The AP’s Melinda Deslatte writes that the election-year dynamic, combined with the hangover from three years of brutal battles over the state budget and taxes, means this year’s two-month lawmaking period is likely to see few major accomplishments.
That’s not to say some people won’t try to be ambitious. A few lawmakers are talking about trying to rewrite Louisiana’s tax laws. Chatter continues about trying to raise the gas tax to address a multibillion-dollar backlog of road and bridge work. Others want to overhaul Louisiana’s method of collecting sales taxes. Some want to revisit additional hot-button topics of years past. … The governor will revisit his failed proposals to increase the state’s minimum wage and to enact new equal pay provisions, but their chances of passage seem slim. He’ll push state-level legislation to prohibit health insurers from refusing coverage to people because of their medical conditions — aimed at duplicating a provision of the federal health overhaul that is threatened by litigation. Edwards’ top priority is a $1,000 teacher pay raise, the start of an effort to return salaries to the Southern average.
The inimitable Jim Beam, who has seen more legislative sessions than just about anyone, isn’t giving up on the idea of tax reform — though he suspects it will take a public uprising at the polls to make it happen.
If tax and budget reform doesn’t take place soon, Louisiana will be back in fiscal trouble like it was when Edwards took office in 2016. That temporary sales tax passed last year will be off the books in just over six years, and the tax turmoil we saw last year will be back again. Not much is going to change unless voters elect legislative candidates who are willing to upset the status quo and reform the state’s tax and budget systems. Taxpayers would benefit from lower taxes, and state government could adequately fund higher education and health care and build and repair some roads and bridges that are in terrible shape.
Tourism dollars in the crosshairs
The New Orleans economy is heavily dependent on tourism dollars. And the tourism industry spends lavishly to promote the city as a destination for vacationers, conventions and big-ticket sporting events. Sales and hotel taxes bring in $160 million a year, which goes back to the well-heeled entities that help promote the city. But with the city’s infrastructure in dire need of an upgrade, Mayor LaToya Cantrell wants some of that money redirected to help city residents. She faces an uphill fight, since any such changes will require legislative approval. The Advocate’s Tyler Bridges explains:
Since October, Cantrell has been saying that the Sewerage & Water Board needs a chunk of that money every year to maintain and replace rickety equipment and to invest in projects to prevent flooding during major rainstorms. Making the city better able to avoid flooding and boil-water advisories will make New Orleans more attractive to tourists, not to mention its residents, Cantrell has said. … In recent years, Convention Center officials have been doling out money with little public scrutiny for everything from a $250,000 annual subsidy for the London-New Orleans flight offered by British Airways to a one-time $9 million payment to help the Audubon Nature Commission acquire the Gov. Nicholls and Esplanade Avenue wharves, as part of a land swap involving the Port of New Orleans.
So far Gov. John Bel Edwards and Senate President John Alario of Westwego are siding with the tourism industry. Nola.com/The Times-Picayune columnist Tim Morris wishes everyone would just get along:
Mass shootings and boil-water advisories are not good for business. To the tourism and hospitality industry’s credit, representatives did pitch a plan to raise $81 million in one-time money for repairs and upgrades to drainage and other city infrastructure. Cantrell said it wasn’t enough. To the mayor’s credit, she does seem open to negotiating. “I’m not saying that we want it all,” she has said. “All I’m saying is that we need a little bit more of what we generate. And I don’t believe it’s pie-in-the-sky. I believe we can do it.”
Number of the Day
4 million – Number of Americans who could potentially lose Medicaid coverage if work requirements were implemented in every state. (Source: Center on Budget and Policy Priorities)