Twelve years ago today, President Barack Obama signed the Affordable Care Act into law. Since then, the law has dropped the national uninsured rate to below 10%, protected millions of people with preexisting conditions and helped narrow long standing disparities in health coverage and access to care for people of color. In Louisiana alone, 550,000 adults enrolled in Medicaid coverage between July 2016 and August 2020 after eligibility was expanded. But as the Huffington Post’s Jonathan Cohn explains, the law could look very different in year 13 as Congress decides whether to make ACA improvements included in the American Rescue Plan permanent. 

The American Rescue Plan, the COVID-19 relief bill that Democrats passed and President Joe Biden signed in March 2021, ramped up the financial assistance available to people buying coverage on their own through HealthCare.gov or state-run exchanges such as Covered California. That boost made a big difference, reducing premiums by hundreds or even thousands of dollars a year. But the extra financial help ends at the end of 2022, when premiums will go back up for millions of insurance buyers unless Congress makes the increase permanent or at least extends it for a few more years.

New analysis by Bloomberg shows that states that refused to expand Medicaid as part of the Affordable Care Act, lag in job-market strength and income growth.

By 2020, before the coronavirus pandemic ended the longest period of U.S. growth in modern times, the job market in states initially refusing and subsequently implementing the Medicaid expansion outperformed states opposed to it, according to labor participation data compiled by Bloomberg. Labor participation measures the proportion of people in the working-age population who have jobs or are seeking work. Excluding recent transplants during the pandemic, the trend continues unabated because the Covid-19 pandemic weighed heavily on mothers without child care, especially low-wage women, whose recent employment significantly lags behind men. From April 2020, when the U.S. started to recover from the worst employment collapse since the Great Depression, through Jan. 31 of this year, the number of U.S. jobs grew by 14.3%. That’s 1.4 percentage points greater than the average for the 12 states refusing the Medicaid expansion and 0.6 percentage points less than the average for the states accepting it, according to data compiled by Bloomberg.

Unexpected hurricane relief
The federal government is sending Louisiana an unexpected $1.7 billion to help with its ongoing recovery from the deadly hurricanes that struck in 2020 and 2021. Southwest Louisiana will get $450 million of that amount, with the rest going to southeast Louisiana to help with recovery from Hurricane Ida. The announcement by Gov. John Bel Edwards and Sen. Bill Cassidy was welcome news after Lake Charles was left out of a major spending bill approved earlier this year. Mike Smith and Mark Ballard report for The Advocate:

The surprise announcement holds particular importance for the state’s southwest, which has fought an uphill battle to be noticed since Laura – one of the most powerful storms to ever hit the state — struck more than a year and a half ago. … But given the state’s stark needs, federal officials decided to grant additional money to Louisiana out of a previously approved amount set aside for disaster relief nationwide. Ida aid was expected to eventually come from that, but at a lower amount.

A toll bridge for Baton Rouge? 
Gov. John Bel Edwards’ plan to sock away $500 million of surplus cash for a proposed new bridge across the Mississippi River in Baton Rouge has become one of the key flashpoints in the annual budget debate. Legislative leaders think the money would be better spent on other priorities, and argue that the $2 billion bridge project is too early in the planning stages to commit that much cash when Louisiana has plenty of other pressing needs. The latest controversy, as The Advocate’s Will Sentell reports, is whether drivers will be forced to pay a toll to cross the new bridge: 

Reps. Brett Geymann, R-Lake Charles and Aimee Freeman, D-New Orleans, voiced concerns about charging motorists to use the structure. Geymann, who is most interested in construction of a new Interstate 10 Calcasieu River bridge in Lake Charles, told (Transportation Secretary Shawn) Wilson lawmakers would prefer that tolls not be placed on either bridge. … The idea is that, to cover part of the financing, the state would enter into a partnership with a private firm to help pay for part of the costs in exchange for a long-term source of revenue — tolls.

Local governments should have say about their own taxes 
A 2016 executive order by Gov. John Bel Edwards gave local governments more control over generous property tax exemptions from industrial corporations. Legislation filed for the current lawmaking session would enshrine the changes to Louisiana’s Industrial Tax Exemption Program (ITEP) in the state’s constitution, to make sure the next governor doesn’t go back to the old blank-check approach.  St. James Parish sheriff Willy Martin, assessor Glenn Waguespack and parish president Pete Dufresne, in a letter to The Advocate, explain why local governments should have a say in their own affairs. 

We have continued to work closely with industry since the 2016 rule changes. We believe industry wants to work with us and understands we deserve a seat at the table when the discussion is about millages our voters approved. SB 151 would not do away with ITEP. It would keep in place what is still one of the most generous incentives in the country, while protecting local authority over a program that directly impacts law enforcement, schools and basic services. How is this a bad thing?

Number of the Day
$195 billion – Cumulative amount of student loan payments avoided by 37 million borrowers since payments were frozen at the start of the Covid-19 pandemic. The moratorium is scheduled to end on May 1 (Source: New York Federal Reserve via Wall Street Journal)