The trouble with repealing the ACA

The trouble with repealing the ACA

Attorney General Jeff Landry is suing to overturn the Affordable Care Act, imperilling coverage for more than 800,000 Louisianans with pre-existing health conditions. Facing the terrible prospect of actually winning his suit, Landry has thrown his weight behind a proposal to preserve the most popular parts of the law, such as the protection for people with pre-existing medical conditions (Gov. John Bel Edwards is backing a similar proposal in the House). But as The Advocate’s Sam Karlin reports, preserving the coverage protections without the federal subsidies that make such coverage affordable would jack up insurance premiums by up to $650 million per year, leaving thousands of patients in the lurch. Both bills stalled in committee.

The proposals would only go into effect if Landry and several other Republican attorneys general are successful in repealing the health law, commonly called “Obamacare.” Landry has joined a lawsuit that seeks to declare the health law unconstitutional, now that Republicans in Congress have repealed the law’s penalty on people who don’t buy insurance. However, both Mills and Brown had to amend their legislation after state officials estimated consumers would be hit with hundreds of millions of dollars in higher premiums if the health law was killed and the state tried to offer the law’s more popular protections. Without the subsidies that help offset the costs of insurance and effectively pay for the health law, Edwards said “there’s no way the state of Louisiana can support” the bill to protect people with pre-existing conditions.


#MakeLa38 – America one step closer to Equal Rights for Women
The committee on Senate and Governmental Affairs voted 4-3 on Wednesday to move a resolution ratifying the Equal Rights Amendment (ERA) to the full Senate. This vote is long in the making—the ERA was first proposed in 1972—but represents a historic opportunity for Louisiana to become the final state needed to secure passage of a change to the Constitution that would guarantee equal protection under the law regardless of gender. As Kaylee Poche reports in The Gambit, the proposal faces significant hurdles now that it’s out of committee, both political and legal:

Chairwoman Karen Carter Peterson, D-New Orleans, who is the only woman on the nine-person Senate and Governmental Affairs Committee, said that the resolution was a chance for Louisiana to make a positive change for women in the state and across the country. “I do recognize — and I hope all of the members recognize — the importance of this, albeit a long time coming.” Peterson said. “Louisiana can certainly make a huge impact by passing this resolution and helping to ratify the amendment.” If the resolution passes, it would make Louisiana the 38th state to ratify it, the final state needed to add the amendment to the U.S. Constitution. However, possible legal hurdles include a expired 1982 deadline for ratification, and five states who have rescinded their ratification in the years since.

Reminder: According to the National Conference of State Legislators, Louisiana has the fourth lowest percentage of women serving in the Legislature of any state, at 15.3 percent.


Cash assistance reduces child abuse and neglect
Child abuse and neglect not only puts children at immediate risk, it also sets them up for a lifetime of difficulties. That’s why Louisiana spent $267 million last year on efforts to combat the terrible problem of child mistreatment. But new research suggests a significant gap in our state’s approach to the problem: While we crack down on parents who neglect their children, our policies fail to offer the assistance that stops child abuse before it happens. Giles Bruce at USC Annenberg’s Center for Health Journalism reports on studies that show how raising the minimum wage and providing direct cash assistance to struggling families saves children from neglect.

For every $1 increase in the minimum wage, neglect reports decline by 9.6%, according to a 2017 study by Raissian and Lindsey Bullinger of the Georgia Institute of Technology. The decrease was concentrated among children 12 and younger. Meanwhile, upping the earned income tax credit reduces child neglect and the chances a family becomes involved with child protective services, particularly among low-income single mothers, according to a 2017 study by researchers at the University of Wisconsin, University of Texas and Columbia University. And increasing child support payments also lowers the risk of child maltreatment, according to research at the University of Wisconsin and Louisiana State University in 2013. This can be done by allowing parents who receive cash help — known as Temporary Assistance for Needy Families — to get all of their child support rather than letting states keep some of it to reimburse itself for that aid. “If you really take a hard look at most forms of neglect, you move upstream and it’s … economics, it’s housing, it’s health care stresses,” [said] Peter Pecora, managing director of research services for Casey Family Programs and a professor of social work for the University of Washington.

Louisiana gives less money to poor families with children than any other state. For every 100 families living in poverty, only 4 receive a cash benefit through the Family Independence Temporary Assistance Program, our state’s version of cash welfare.


Medicaid expansion improves racial equity
Medicaid expansion may be a political football (albeit a very popular football) but the results of expansion are clear: better health outcomes, reduced costs to the state for emergency care, and greater security to families working hard but earning less than they need. Now, new research shows that Medicaid expansion not only benefits the state as a whole but specifically reduces racial disparities in infant mortality. Howard Bauchner, MD and Karen Joynt Maddox, MD, MPH report on new research documenting this finding in the Journal of the American Medical Association:

The future of health care coverage in the United States remains uncertain. The current administration has continued to make it more difficult for individuals to obtain health care coverage, and in 2018, the number of uninsured individuals increased for the first time in 7 years. Opponents of further Medicaid expansion argue that the program is too expensive or that it fails to improve health outcomes. The former critique is the source of ongoing policy debate, but the latter is increasingly proving false. In fact, as the study by Brown and colleagues highlights, Medicaid expansion may be helping to reduce racial disparities in one of the most important health indicators of a society—birth outcomes related to infant mortality.


Didja Know? Podcast: Episode 2
In this episode we talk to Davante Lewis about Invest in Louisiana, a proactive policy campaign that recently launched. Next, we discuss what a paid leave policy would look like in Louisiana with Stacey Roussel. Lastly, Jan Moller recaps the first two weeks of the legislative session and previews what’s on the horizon. Click here to listen.


Number of the Day
22 percent – The “weekly wage penalty” for teachers in Louisiana compared to other college graduates in the state. Nationally, teacher pay has remained stagnant, in real dollars, since 1996, while wages for other college graduates have risen. (Source: Economic Policy Institute)