Medicaid expansion is working

Medicaid expansion is working

When the Covid-19 pandemic shut down large parts of Louisiana’s economy, the state’s health care safety net did exactly what it’s designed to do: It ensured that people with low incomes – or no income at all – had access to health coverage, which guaranteed that an illness or injury would not result in financial catastrophe. This is largely due to the state’s decision to expand Medicaid — today, nearly 600,000 Louisiana adults are covered as part of the “expansion” population. As The Times-Picayune | Baton Rouge Advocate notes in an editorial, this has been good for patients and for hospitals’ bottom lines: 

Researchers at the Tulane School of Public Health and Tropical Medicine found that Medicaid expansion in Louisiana coincided with a 33% reduction in the share of hospital operating expenses attributable to uncompensated care, with rural and public hospitals (including those formerly under the Charity system) seeing the greatest impact. … That fits with what we know, that Medicaid expansion in Louisiana has led to sharp reductions in the uninsured population, and that the pluses were so obvious as far back as 2015 that even Edwards’ Republican opponents were prepared to take the plunge. Unfortunately, the discussion over expansion nationally and in other states has been politicized, and Republican governors elsewhere in the South have rejected expansion.

Meanwhile, the new American Rescue Plan law includes several provisions that will make health coverage more affordable for people who make too much money to qualify for Medicaid. The Advocate’s Kristen Mosbrucker reports

Winners include those covered under the Affordable Care Act, known as “Obamacare,” or who are just now signing up for it through a May 15 deadline. Self-employed people who buy their own insurance and don’t currently get federal help could be eligible for subsidies. The package also benefits laid-off workers struggling to retain employer coverage, and most anyone collecting unemployment. … The temporary premium tax credits — put into effect for the next two years, retroactive to Jan. 1 — would ensure that no individuals buying federal marketplace health insurance would spend more than 8.5% of their income on premiums — meaning some policyholders will qualify for a health care subsidy for the first time since Obamacare began. 

Businesses should pay their fair share
The ink was barely dry on the $1.9 billion American Rescue Plan when the state’s business lobbyists announced that they want to use part of the state’s $5.2 billion windfall for bailing out the unemployment insurance trust fund. But the rush to refill the trust fund obscures bigger problems with the state’s unemployment system, which pays paltry benefits and erects too many barriers for people who’ve lost their job through no fault of their own. The Times-Picayune | Baton Rouge Advocate’s Mark Ballard looks at the state’s broken system, which is supposed to help laid-off workers but instead caters to the needs of businesses. 

Over the years as the competition to attract businesses intensified, states went lower on all taxes, including minimizing the contribution to UI funds, which in turn required states to come up with hurdles that limit which unemployed workers get paid, and how much. … “If they can first fix the delivery system and raise the benefit levels, only then should they bail out the trust fund,” said Jan Moller, director of the Louisiana Budget Project, a Baton Rouge-based group that advocates for low- and middle-income families.

Exceptionalism reconsidered
Economic inequality is nothing new in American life. But the stark contrast between rich and poor – between the innovation and technological breakthroughs at the top of the economic pyramid and the deprivation faced by those at the bottom – has rarely been more apparent than in the past few weeks. A trio of Washington Post reporters looks at the issue of “American exceptionalism” and the consequences of the country’s decision to favor private wealth over public investments:

America can put a rover on Mars, but it can’t keep the lights on and water running in the city that birthed the modern space program. It can develop vaccines, in record time, to combat a world-altering illness, but suffers one of the developed world’s highest death rates due to lack of prevention and care. It spins out endless entertainment to keep millions preoccupied during lockdown — and keep tech shares riding high on Wall Street — but leaves kids disconnected from the access they need to do their schoolwork.

A major shift on safety-net policy
In the quarter century since President Bill Clinton signed a law ending “welfare as we know it,” the U.S. economy has endured three major recessions and witnessed a widening gulf between the richest Americans and everyone else. Last week President Joe Biden took a step past that era with his American Rescue Plan, which seeks to re-energize the pandemic economy by investing in the families that need help the most. The New York Times’ Jim Tankersley and Jason DeParle explain the political realignment it represents: 

Rising inequality and stagnant incomes over much of the past two decades left a growing share of Americans — of all races, in conservative states and liberal ones, in inner cities and small towns — concerned about making ends meet. New research documented the long-term damage from child poverty. … Concerns about deficit spending receded under Mr. Biden’s Republican predecessor, President Donald J. Trump, while populist strains in both parties led lawmakers to pay more attention to the frustrations of people struggling to get by — a development intensified by a pandemic recession that overwhelmingly hurt low-income workers and spared higher earners. … Whether the new law is a one-off culmination of those forces, or a down payment on even more ambitious efforts to address the nation’s challenges of poverty and opportunity, will be a defining battle for Democrats in the Biden era.

Number of the Day
$2.6 billion – Amount of new federal funding for Louisiana public schools included in the American Rescue Plan. Among other things, the money is expected to pay for summer-school programs to help students overcome learning loss during the pandemic. (Source: The Advocate)