Court overturns work requirements for Medicaid

Court overturns work requirements for Medicaid

A federal waiver that allows Arkansas to force some Medicaid recipients to report their working hours to keep their health coverage is “arbitrary and capricious” and goes against the clear intent of the federal health care program, a federal appeals court panel ruled last week. The AP’s Ricardo Alonzo-Zaldivar and Jill Bleed report that the ruling is a major setback for the Trump administration, which has been encouraging states to emulate the Arkansas model. 

The court found that it is “indisputably correct that the principal objective of Medicaid is providing health care coverage” and that work requirements for “able-bodied” people lack specific legal authorization. Moreover, the court ruled that administration officials failed to thoroughly examine the risk that some Medicaid recipients would lose coverage in approving Arkansas’ experiment with work requirements. 

Nearly 20 states had been considering adopting some type of work reporting requirement in response to the administration’s guidance. More than 18,000 low-income people in Arkansas lost their health coverage as a result of reporting requirements, many of them due to paperwork snafus.  


Unions rip Jeff Landry
Attorney General Jeff Landry has defended his foray into the Mexican labor market by claiming there were no Louisiana workers available to fill the welding and pipefitting jobs he was trying to hire for at the Cameron LNG project in southwest Louisiana. Labor officials told a very different story to WWL-TV’s David Hammer, claiming union workers were shut out from helping build the $15 billion natural gas export facility.

(United Association representative Lance) Albin said his pipefitters and welders union could have filled 500-600 skilled positions on the Cameron LNG project if the builders — formerly CB&I and now McDermott International — had been willing to hire any UA members. … “We did a lot of work to get ready because we knew that work was coming. We built a new training center in Lake Charles, La., to the tune of about $4.5 million,” Albin said. “We have the facility there and the infrastructure to flip the switch and get more folks there if we need them. But the demand just hasn’t been there for us since we did that investment because we have not gotten (hired) on these projects.”

The Advocate’s editorial board says Landry needs to come clean about his dealings with felon Marco Pesquera, who is in federal prison for defrauding the immigration system.  

The federal visa program is designed to overcome temporary labor shortages, and the visas Landry’s business secured were legal, if they were obtained truthfully. But if Landry were a real gumshoe, he might have noticed that his firm was doing business with a fake company. That it was paying cash to mail FedEx packages. And that it was claiming it “operates year round providing a range of industrial and commercial construction services,” despite not being registered with the contractor licensing board.


Edwards defies a trend on teacher pay
Public school teachers and their union leaders are disappointed that Gov. John Bel Edwards’ budget proposal did not explicitly call for a teacher pay raise – although the $39 million funding increase earmarked for school districts could be used for salary hikes. The Advocate’s Mark Ballard writes that Louisiana appears to be standing still while other states are investing in educators. 

A Louisiana teacher makes an average of $50,359 per year compared with $52,178 in the 16-state region, according to 2017-18 tabulations, the latest available. That’s about what a manager at McDonald’s makes. But managers also get cash bonuses, profit-sharing and stock options. Plus, teachers need a college degree. And the average college student graduates with a debt of $29,800. Relying on public school math, it cost Louisiana taxpayers about $101 million for last year’s raise, meaning another $200 million is needed to bring this state’s teachers up to the regional average of 2018. But that’s a moving target. Texas boosted salaries by up to $9,000. Teacher pay rose by $3,000 in Georgia and $2,000 in Florida, according to the Southern Regional Education Board.


The truth about ‘surprise billing’
The issue of “surprise billing” – large, unexpected health care bills resulting from treatments by doctors and others who are not part of a person’s insurance network – is getting a lot of attention on Capitol Hill by members of both parties who want to curb the practice. Dr. Elizabeth Rosenthal, writing in The New York Times, explains how the problem originated and why it’s so hard to stop.  

Typical scenarios: A patient having a heart attack is taken by ambulance to the nearest hospital and gets hit with a bill of over $100,000 because that hospital wasn’t in his insurance network. A patient selects an in-network provider for a minor procedure, like a colonoscopy, only to be billed thousands for the out-of-network anesthesiologist and pathologist who participated. And yet, no one with authority in Washington has done much of anything about it. Here’s why: Major sectors of the health industry have helped to invent this toxic phenomenon, and none of them want to solve it if it means their particular income stream takes a hit. And they have allies in the capital.

Number of the Day
3.4% – 5.9% – Decrease in the suicide rate among working-age adults (age 18-64) with a high school education or less when the minimum wage is raised by $1. The effect is most dramatic during periods of high unemployment (Source: Journal of Epidemiology and Community Health)