Going backwards on children’s health coverage

Going backwards on children’s health coverage

In 2019, the United States and Louisiana continued a disturbing trend: a steady increase in the number and share of children without health insurance. For Louisiana, this trend resulted in a child uninsured rate of 4.4% in 2019, leaving more than 50,000 kids without coverage. Nationally, the uninsured rate for children climbed to 5.7% in 2019 – an increase of about 320,000 more uninsured children nationwide. These coverage losses took place prior to the Covid-19 pandemic and during a year of low unemployment after a decade of economic growth. LBP’s policy director, Stacey Roussel, has the details in a new report: 

The erosion in coverage comes after years of significant gains in coverage for children, including accelerated gains after the Affordable Care Act was enacted in 2014.1 After a decade of bipartisan support and sustained effort, the Pelican State hit an historic low in both the number and rate of uninsured children in 2017 – the reference year for this report – with 36,000 children (or 3.1%) going without health insurance coverage. 

The New York Times’ Margot Sanger-Katz and Abby Goodnough zoom out to look at the national picture, using data compiled by the Georgetown Center for Children and Families. 

In recent years, falling enrollment in Medicaid and CHIP drove the overall changes, according to the report. Although those programs for low- and middle-income children are primarily managed by state governments, Trump administration policies could be playing a role: The administration has encouraged states to check eligibility more often, which advocacy groups say has caused many families to lose coverage because of paperwork errors and missed deadlines.

On the constitutional amendments
Louisiana voters, as usual, will see numerous constitutional amendments on their Nov. 3 election ballots. The ballot measures cover everything from abortion to property taxes and the state budget. While the Legislature’s appetite for amending the state’s governing charter is nothing new, this year’s batch comes with an unfamiliar twist: the virtual absence of public debate. A Nola.com | Baton Rouge Advocate editorial explains

The public is absent, in part because of coronavirus restrictions and in part because a newly elected Legislature is increasingly run by party caucuses. … Government-by-amendment has never worked particularly well. It’s even worse when effective public comment only came when different types of businesses were at odds over legislation; then lobbyists dueled among themselves. 

The newspaper made its recommendations on the first four amendments, taking a particularly dim view of No. 4 – which would force the Legislature to cut public services even in years when the state has enough revenue. 

This is another version by anti-government legislators who have been unable to convince their peers that drastically cutting services — the result of budget limits — is a good idea in a poor state that needs more spending on education, health and other needs, not wants. We want to see wiser spending, but we don’t want to see arbitrary limits on the budget. 

An analysis of the amendments by the Council for a Better Louisiana is here, and the Public Affairs Research Council of Louisiana’s report is here. LBP will release its analysis of this year’s amendments later this week. 


St. James Parish takes a stand
A $247 million hydrogen plant under construction in St. James Parish is expected to create 15 new, permanent jobs and another 62 “indirect” jobs. In exchange for that, the company sought a 10-year property tax break worth $24 million – money that could otherwise be used to support public schools, libraries, police and other services. But as Nola.com | The Advocate’s David Mitchell reports, parish authorities rejected the tax break, marking a rare occurrence where all three local taxing jurisdictions have turned away an Industrial Tax Exemption Program request. 

Before (Gov. John Bel) Edwards changed the rules, companies could get 100% exemptions for five years with an option for a five-year renewal that was almost always granted by the state. Under the latest version of the new Edwards rules, companies get exemptions on 80% on the new investment value for up to 10 years. Local governments get taxes on 20% of the new value, but local taxing agencies also have a vote.


Who’s the tax cheat?
A lot of attention has been paid, rightfully, to the federal tax laws that allowed Donald Trump to pay just $750 in federal income taxes in 2016 and 2017 – thanks in large part to heavy financial losses and questionable deductions, including $70,000 for hair styling. In the meantime, Tanya McDowell was given a five-year prison sentence in 2012 for, in part, using her babysitter’s address to get her son enrolled in a better school. The New York Times’ Nicholas Kristof writes that the cases of Trump and McDowell highlight the grotesque inequities in the way America’s tax laws are enforced: 

The proper reaction to the revelations about Trump’s taxes is not to fume at the president — although that’s merited — but to demand far-reaching changes in the tax code. … The five counties with the highest audit rates in the United States, according to Tax Notes, are all predominately African-American counties in the South. Meanwhile, zillionaires claim enormous tax deductions for donating expensive art to their own private “museums” located on their own property. That’s the kind of scam that works if you’re a billionaire, but not so well if you’re my old friend Mike, who is homeless and once gave his food stamp card to a friend to buy groceries for him. The government responded by suspending Mike’s food stamps.


Number of the Day
$1 trillion – Estimated amount of revenue that could be raised over a decade through tougher enforcement of existing federal tax laws. (Source: Natasha Sarin and Lawrence Summers via The New York Times)