The suit seeking to overturn the Affordable Care Act (ACA) is scheduled to be heard by the U.S. Supreme Court on Nov. 10. If the court overturns the landmark health care law, it will trigger the end of health care coverage for millions of low-income Americans insured through Medicaid expansion, including about half a million Louisianans. This loss in coverage has widespread ripple effects, including reduced access to care, increased premature deaths and increased financial hardship through medical debt. Aviva Aron-Dine of the Center on Budget and Policy Priorities has the numbers: 

Twelve million people had Medicaid expansion coverage as of mid-2019, and the figure likely is significantly higher now due to the economic downturn: expansion enrollment rose almost 13 percent between February and July in states with available data, equivalent to 1.5 million people nationwide. The overwhelming majority of them would likely become uninsured if the Court strikes down the ACA. 

States that expanded Medicaid have also significantly lowered hospitals’ costs for uncompensated care, according to analysis by Matt Broaddus of the Center on Budget and Policy Priorities of Medicaid and CHIP Payment and Access Commission’s annual report:

As a share of hospital operating expenses, uncompensated care costs in 2017 were 26 percent lower than in 2013, equating to more than $14 billion in savings in 2017 alone. While uncompensated care costs fell in all states, they fell much more in Medicaid expansion states: by 45 percent, on average, compared to 2 percent in non-expansion states. Expansion states also saw much bigger gains in health coverage.

Maternity care “deserts”
Thirty-five of Louisiana’s 64 parishes have little-to-no access to maternal care, endangering the lives of mothers and children according to a new report by the March of Dimes. An estimated 1 in 4 pregnant women in Louisiana may need to travel outside of their home parish for medical care during their pregnancy, including ultrasounds, blood tests, specialist appointments and delivery. Emily Woodruff of Nola.com | The Baton Rouge Advocate reports on the burden this places on expectant mothers: 

Dr. Rahul Gupta, the nonprofit’s chief medical officer, said that the inconveniences of distance can make it hard for expectant mothers to get the care needed to keep them healthy. “Transportation becomes an issue,” said Dr. Gupta. “Time becomes an issue, it becomes a money issue. You have to take a day off, go and wait in a practitioner’s office. A lot of times pregnant people have other kids they need to take care of. They have to then find child care. These things accumulate in maternity care deserts.”

Rebuilding Louisiana
As the nation faces the daunting challenge of rebuilding its economy and helping those who have lost their livelihoods due to the economic fallout from Covid-19, a new report by Robert E. Scott, Zane Mokhibe and Daniel Perezthe of the Economic Policy Institute shows a path forward. The report outlines a two-pronged strategy, including trade and industrial policies to dramatically boost U.S. exports and eliminate the U.S. trade deficit and a $2 trillion investment in infrastructure, clean energy and energy efficiency over four years. The Greater Baton Rouge Business Report summarizes how their proposal would impact Louisiana: 

By rebalancing trade and investing in infrastructure, clean energy and energy efficiency, Louisiana could gain a net 91,400 jobs by 2024, according to a recent report from the Economic Policy Institute, representing some 4.5% of the state’s employment. Every state as well as Washington, D.C., would benefit from the investment stimulus, the report shows, with Louisiana seeing the 28th-largest increase in jobs. Of the estimated 91,400 jobs the stimulus would create in the state, about 27,500 would go to infrastructure and 12,900 would go to clean energy and energy efficiency. Meanwhile, rebalancing trade would support 51,100 jobs.

Race and work amid Covid-19
Covid-19 has disproportionately harmed Black and Brown communities, with workers and their families facing disproportionate physical and financial harm from the virus. Black and Brown workers are overrepresented in the hardest-hit occupations and industries. And the nature of their jobs – and the larger household sizes these workers often return to – puts them and their families at greater risk, according to analysis by Katy Reckdahl of NOLA.com | The Advocate. This latest installment of “The Deep Dive,” an occasional series on the impact of Covid-19 on Black Louisianans, highlights how racial disparities show up in how work gets done: 

Nearly 26% of White men and nearly 20% of White women who were characterized as essential could work remotely, compared with 14% of Black women and 13% of Black men. On top of that, when looking at workers overall, 25% of all Black women worked in the high-risk health sector, versus 17% of White women, 7% of Black men and 4% of White men. And even those estimates don’t capture the full picture, since most such studies don’t include cash-business workers who may not be deemed “essential” but can’t afford to stay home, said Alfred Marshall, an organizer for STAND With Dignity. Though little data exists, Marshall says this group is disproportionately Black and Latino. “If you add the… guys who wash cars or sell food from trucks, the count of at-risk workers goes up significantly,” Marshall said. “These guys are frontline workers and they can contract the virus, without a doubt.”

Number of the Day
42% – The share of children nationally living in households that reported it was somewhat or very difficult to cover expenses such as food, rent or medical expenses. (Source: Center on Budget and Policy Priorities analysis of Census Household Pulse Survey covering Sept. 16-28)