Lowering the cost of care

Lowering the cost of care

Health care in America is more expensive than anywhere else in the world. For people without insurance, who frequently have low incomes and no access to employer-sponsored health insurance, this often means delaying or foregoing care completely. Eventually, this often means trips to the hospital where care is particularly expensive. When un- or under-insured patients can’t pay, the hospital’s cost for this uncompensated care is passed to the state; that’s why states like Louisiana that have expanded Medicaid have seen a dramatic decrease in these costs. A recent study takes a closer look at the Bayou State, and the lessons it holds for the remaining 12 non-expansion states. Gideon Lukens of the Center on Budget and Policy Priorities explains how Medicaid expansion has helped stabilize our state budget and hospital finances: 

Like Louisiana, most non-expansion states are located in the South. They are also similar to Louisiana in per-capita income. And before Louisiana’s expansion, its uninsured rates for the non-elderly population and trends in uncompensated care costs were similar to those of the remaining non-expansion states. Louisiana’s expansion of Medicaid in 2016 was associated with a 33 percent reduction in uncompensated care costs as a share of total operating expenses among hospitals, the authors of the Health Affairs study estimate. The impact was particularly large for rural hospitals, for which expansion was associated with a 55 percent decrease.

The public weighs in on the budget
Legislators have spent weeks poring over the details in Gov. John Bel Edwards’ $36 billion budget request, hearing testimony from cabinet members and their lieutenants. On Wednesday, it was the public’s turn to weigh in on the state’s spending priorities for the 2021-22 fiscal year. As The Times-Picayune | Baton Rouge Advocate’s Blake Patterson notes, it’s an unusual year in that there are no major cuts being contemplated. But there still are plenty of needs that aren’t being met. 

Andrew Muhl, associate state director with AARP Louisiana, asked lawmakers to allocate $5.8 million to bolster the state’s home- and community-based programs for senior citizens and the physically disabled. The request would fund 500 new slots for the Community Choices waiver, a Medicaid program that serves as an alternative to nursing facility care. There are currently 11,500 residents on the wait-list for the waiver program, down from a high of around 17,000 residents several years ago. Muhl said some have waited nine years for the waivers and “many of them don’t live long enough to receive these services.”

Sports betting advances
Louisianans in 55 parishes voted to legalize sports gambling last year, but the regulatory framework is still a work in progress. The Legislature is considering a pair of bills this session to tax and regulate the industry, including House Bill 628 by Rep. John Stefanski and Senate Bill 202 by Senate President Patrick Cortez. As lawmakers consider the details, childrens’ advocates are pushing to have the tax revenue dedicated to early care and education programs. Wesley Muller of the Louisiana Illuminator has the story: 

While Stefanski’s bill handles taxation, Senate President Patrick Cortez, R-Lafayette, has a companion bill focusing on regulation. Cortez’s bill, as of Wednesday, would offer 20 licenses to land-based casinos, river boat casinos and race tracks. It would also offer mobile-app licenses to those gambling facilities. Stefanski’s bill would establish fees to go along with those licenses.

Higher revenues from legalized pot
Among the many changes in the state tax system that Louisiana legislators are debating this session – some good and many bad – is one that would provide a new source of revenue: taxes from legalized cannabis. Several proposed bills would change Louisiana law around cannabis, including House Bill 637, which would add Louisiana to the list of states where recreational marijuana is available for retail sale. Harsh and disproportionate policing of marijuana have long harmed Black and Brown communities. That’s one reason that racial equity considerations should be an essential part of policy around legalization of and allocation of revenue from cannabis. In a letter to the editor in The Advocate, Rep. Candace Newell, the bill author, and Peter Robins-Brown of Louisiana Progress make their case, including the need for revenue for our state’s still unfunded priorities: 

On the other hand, those states have experienced a cannabis-fueled economic boom. The industry has created hundreds or even thousands of jobs in each state. Oregon, with a total population similar to Louisiana, brought in $12.5 million per month in combined state and local cannabis tax revenue last year. That’s money we can use for early childhood care, education, and infrastructure, while the business profits can help fuel economic growth in communities across our state.

Number of the Day
48% – The share of nonunion workers who said they would join a union in their workplace if they had the chance. (Source: Economic Policy Institute)