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Medicaid expansion enrollment is outpacing expectations

Posted on February 12, 2019

Low-income adults continue to enroll in Louisiana’s expanded Medicaid program, with more than 500,000 participating in the state-federal health insurance program as of January. That’s more than Gov. John Bel Edwards’ administration was expecting, as the AP’s Melinda Deslatte reports. But higher enrollment doesn’t necessarily mean higher costs to the state.

Louisiana is expected to have 1.7 million people 37 percent of the state’s population, enrolled in Medicaid through the expansion and non-expansion programs by June. The federal government is paying most of the Medicaid expansion cost. Louisiana is paying a share that eventually increases to 10 percent. Lawmakers passed financing tools to help cover the state’s costs, including a tax hike charged on health maintenance organizations.

While Louisiana’s enrollment is booming, legislators in Utah voted to put the brakes on expansion, defying the will of voters in the Beehive State. Amy Goldstein of the Washington Post:

On Monday, the legislature gave its answer: It enacted a Medicaid plan that would cover tens of thousands fewer people than what voters called for, despite demonstrations by people carrying signs saying, “Respect democracy, our vote matters.” Within hours, Gov Gary R. Herbert (R) signed the measure into law, saying that it “balances Utah’s sense of compassion and frugality.”

 

Childcare is not a perk
The Louisiana Legislature has long been dominated by men. Even today, women only hold 15 percent of the seats in the chambers, one of the lowest percentages in the country. And as women leaders are ascendant around the country, the Louisiana Board of Ethics is making it harder for female candidates in Louisiana to seek office by refusing to allow campaign funds to cover child-care expenses. The Advocate’s Stephanie Grace shares why this issue is indicative of a larger problem:

Child care is a modern-day necessity. There’s no Big Babysitting lobby looking for favors, only families trying to balance home and work, just like most of the people they seek to represent. That’s true for candidates of both sexes but often more so for women, who frequently bear not only the primary responsibility for making arrangements but also the skepticism of those who can’t seem to understand why they don’t just stay home. And this attitude has a broader effect on the very notion of representation. It can wind up restricting who participates in the process, and that in turn restricts what policies lawmakers address. The Louisiana Legislature, where women hold a shockingly low 15 percent of seats, is a case in point. Just listen to the clueless comments you sometimes hear from the dais the next time a committee considers some issue that affects working families.

The Ethics Board will take up the matter again on Friday, as Elizabeth Crisp reports for The Advocate.

Morgan Lamandre, an attorney who is running for a Baton Rouge-area House seat next year, was advised by state Ethics Board in November that she could be penalized if she uses her campaign fund to pay for child care. Her appeal of that ruling is slated for Friday. If the Ethics Board rejects Lamandre’s appeal, it would set a higher standard than candidates have been held to in the past. The earlier vote made national headlines and has been used to highlight issues that women face in politics.

 

Revenue blocked once again
Louisiana is projected to collect more tax revenue in the current and upcoming fiscal years than economists were projecting last spring. But the extra revenue cannot be plugged into Gov. John Bel Edwards’ executive budget, due next week, because House Speaker Taylor Barras continues to block the Revenue Estimating Conference from updating the official forecast. Without a unanimous thumbs up from the REC, the governor’s budget blueprint is likely to call for budget cuts that are unnecessary. The AP’s Melinda Deslatte has more:

The Edwards administration calls the move political, aimed at making it difficult for the governor to include the public school teacher raise in his budget proposal for next year. He releases that plan to lawmakers Feb. 22. Commissioner of Administration Jay Dardenne, Republican Senate President John Alario and LSU economist Jim Richardson — three of the four members of the Revenue Estimating Conference — said economists for the Legislature and the Edwards administration have made the case for rewriting the numbers, based on tax collection data and economic modeling. Richardson described the proposed forecast changes as “very cautious.”

Refusal to recognize the revenue has also thrown a wrench in the this year’s budget.

The deadlock has kept Edwards and lawmakers from enacting $43 million in spending plans for this year, largely on public safety programs.

 

Seniors and SNAP
Food insecurity is not limited to children and families. Seniors, especially if living alone, are quite vulnerable to food insecurity. This is often caused by increasing healthcare costs, and using what little resources they have to help even less fortunate friends, family members or even pets. Mark Ray of WNET in New York and Next Avenue, “a national journalism service for America’s booming older population,” has more:

In the United States, 4.9 million people age 60 and older are food insecure, which equates to 1 in every 12 older adults (that’s a 45-percent increase over 2001), according to a 2016 report by Feeding America, a nonprofit with a nationwide network of more than 200 food banks. And while poverty is an obvious contributing factor (more than 30 percent of older adults below the poverty line are food insecure), a surprising 20 percent of those above the poverty line face food insecurity as well. “If the poverty line were the only issue to address, that would be simple,” says Keri Ann Lipperini, who directs the Office of Nutrition and Health Promotion Programs within the U.S. Department of Health and Human Services. “Even seniors living above the poverty line can experience food insecurity as they face life challenges such as increased health care as they age.”

 

Number of the day
560,000  – The anticipated number of Louisiana adults who will have health coverage due to Medicaid expansion by June 2020 (Source: The Associated Press)

 

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