States are on the front line of the Covid-19 pandemic, and they need more federal aid to avoid severe and damaging cuts to investments in healthcare, higher education and public services. Highly restrictive federal guidance on how existing federal aid from the CARES Act can be spent and the ever-evolving nature of this unprecedented health and economic crisis has slowed spending in some states. But the need remains. Michael Leachman of the Center on Budget and Policy Priorities discusses Covid-19’s economic impact on states, and why additional aid is necessary:
Business closures and lost income and jobs — including some 1.5 million furloughs and layoffs of state and local workers — have severely shrunk states’ sales and income tax revenues. All 39 states (plus the District of Columbia and Puerto Rico) that have released new revenue projections are reporting shortfalls, generally very large ones. Nationwide, we estimate, these shortfalls total about $615 billion over the next three fiscal years, not including the added costs of fighting COVID-19.
Unsurprising trends in surprise medical bill
Surprise medical bills are difficult in the best of circumstances, but they can be catastrophic for families without significant savings. Nearly half of Louisiana households had no money set aside for emergencies in 2017. Now, potentially devastating medical bills are starting to hit families that have been affected by Covid-19. Insurers are required to cover treatment for Covid-19 while the nation is under the federal emergency declaration. But coverage of related conditions that arise from Covid is less clear, and the Trump administration has recently signaled that it wants to give health insurers more leniency to deny claims and push costs onto patients. Susannah Luthi of Politico reports:
Meanwhile advocates wary of costs being shifted on unsuspecting patients are watching for all the ways complications will hit Americans during the pandemic. “Having done this for 25 years, when we hear the governors say, If you need health care you can get it, it’s just not our experience,” said Michele Johnson, executive director of the Tennessee Justice Center, referring to the White House promise that all uninsured patients are covered. She noted that it’s hard for many patients to get through the door for medical treatment, including even Covid-19 testing, if they don’t have coverage.
In the absence of a federal solution, the Louisiana Legislature failed again this year to ban surprise medical bills. LBP joined community and patient groups in advocating on behalf of consumers that, regardless of how insurers and providers settle payment disputes, patients should be held harmless.
ACA critical now more than ever
The Affordable Care Act (ACA) has become a lifeline for millions of people who have lost their jobs, incomes and accompanying health insurance amid the Covid-19 pandemic. In Louisiana, an estimated 450,000 people have lost their employer-based health insurance due to Covid-19 restrictions. Since the state wisely expanded Medicaid to cover low income adults, about 330,000 of these people are eligible for Medicaid expansion and another 63,000 qualify for federal subsidies in the private healthcare insurance marketplace – another feature of the ACA. Bob Herman of Axios has the story:
The number of people who lost jobs and related health coverage and then signed up for Affordable Care Act health plans on the federal website was up 46% this year compared with 2019, representing an increase of 154,000 people, the federal government said in a new report. (…) Medicaid enrollment due to coronavirus-related job losses appears to be growing even faster than enrollment in ACA plans, according to the Georgetown University Health Policy Institute.
Meanwhile, the Trump Administration filed a brief with the U.S. Supreme Court this week to overturn the landmark legislation. If successful, the suit would mean devastating coverage loss for millions of Americans, with the largest losses to Black and brown people. Tara Straw and Aviva Aron-Dine of the Center on Budget and Policy Priorities provide analysis:
The Supreme Court will likely decide the case in the spring of 2021, when the unemployment rate is expected to still be about 10 percent and possibly amid a continuing COVID-19 public health crisis. ACA repeal was expected to cause 20 million people to lose coverage before the crisis, but millions more would likely lose coverage if the law were struck down during a deep recession, with commensurately larger impacts on access to care, financial security, health outcomes, and racial disparities in coverage and access to care. Striking down the ACA would also impede efforts to end the COVID-19 public health crisis and deal with the fallout.
Giving up privilege
The president of one of the oldest and wealthiest philanthropic foundations in America wants wealthy people to think about what they’d be willing to give up to advance racial equity in our nation and communities. Ford Foundation President (and Louisiana native) Darren Walker shares his personal journey from the bottom 1% to the top in The New York Times’ series, The America We Need. He goes further to challenge some of the cherished privileges of the wealthy that keep us all from making progress:
“If we, the beneficiaries of a system that perpetuates inequality, are trying to reform this system that favors us, we will have to give up something. Here are a few of the special privileges and benefits we should be willing to surrender: the intricate web of tax policies that bolster our wealth; the entrenched system in American colleges of legacy admissions, which gives a leg up to our children; and above all, the expectation that, because of our money, we are entitled to a place at the front of the line.”
Number of the Day
16.30 – Louisiana’s grade, on a scale of 1-100, for the state’s response to Covid-19 in its jails and prisons. That’s an F+ (Source: Prison Policy Initiative)