Advancing health and racial equity in Medicaid

Advancing health and racial equity in Medicaid

Lifting administrative burdens in Medicaid would expand eligibility and advance racial equity in the program, according to a new paper by CLASP and the Center on Budget and Policy Priorities. While Medicaid provides crucial access to health care for millions of people, administrative burdens, which are rooted in racism, continue to harm eligible people, especially people of color. CLASP’s Suzanne Wikle, and CBPP’s Jennifer Wagner, Farah Erzouki and Jennifer Sullivan explain how state efforts can lower the bureaucratic hurdles that keep eligible people from accessing health care and that are particularly likely to harm communities of color. 

A concerted effort to streamline Medicaid is vital to increasing the ability of eligible people to participate in the program and access health care coverage and services they need, and it is critical to addressing racial health inequities. People of color face systemic racism in areas like education and employment that makes them likelier both to work in jobs with low wages and no employer coverage and to face Medicaid’s administrative burdens, such as the extra documentation required of those working multiple jobs. “Administrative burden exacerbates inequity,” the Office of Management and Budget recently said of economic and health assistance programs. That is because burdens “do not fall equally on all entities and individuals, leading to disproportionate underutilization of critical services and programs, as well as unequal costs of access, often by the people and communities that need them the most.”

Treasurers mobilize against climate action
Louisiana Treasurer John Schroder is among nearly two dozen Republican state treasurers who have sought to punish companies that are trying to reduce greenhouse gas emissions. The treasurers have coordinated tactics and talking points, met privately and cheered each other on as part of an effort to protect the fossil fuel industry. The New York Times’s David Gelles explains that the effort includes pulling state funds from the investment firm BlackRock, which has been outspoken about moving away from fossil fuels. 

In March, the Arkansas treasurer, Dennis Milligan, pulled $125 million from BlackRock. And in April, the treasurer of Louisiana, John Schroder, emailed [West Virginia Treasurer Riley] Moore and Marlo Oaks, the Utah treasurer, and boasted about withdrawing more than $600 million from BlackRock accounts. Mr. Schroder said he had also blocked Citibank, Bank of America and JPMorgan from almost $1 billion in bond financing. “That’s excellent, John!!!” Mr. Moore replied, according to emails reviewed by the Times. “Great work!!!”

These actions go against common sense, especially for a state like Louisiana that is on the front lines of climate change, and are contrary to the role of a state treasurer. Gelles explains:

The Republican treasurers skirt the fact that global warming is an economic menace that is damaging industries like agriculture and causing extreme weather that devastates communities and costs taxpayers billions in recovery and rebuilding. Instead, they frame efforts to reduce emissions as a threat to employment and revenue, and have turned climate science into another front in the culture wars. 

Sinema OKs IRA 
Senate Democrats have (tentatively) secured Sen. Kyrsten Sinema’s support for their modified climate, tax and health care package. The Arizona senator gave her thumbs-up to the Inflation Reduction Act on Thursday night after leaders agreed to scale back a number of tax proposals that were included in the initial draft of the bill. Politico’s Burgess Everett and Marianne Levine report

The Arizona Democratic centrist announced that she’s signed off on the legislation after winning tweaks that include the removal of a narrowed loophole for taxation of certain investment income, a provision known as carried interest. In a statement, Sinema said she’s also won changes that would “protect advanced manufacturing, and boost our clean energy economy.” It was a big, early win for Majority Leader Chuck Schumer’s caucus, even as some of the bill’s specifics are still clouded in uncertainty. 

The Senate plans to hold a Saturday vote on the bill. But first, the Senate parliamentarian must rule whether the bill meets the strict qualifications to evade a filibuster. Sinema stated that she would wait for a final parliamentary review before voting to support the bill. 

Louisiana’s youth prison crisis
Nearly 20 years ago, a generation of state leaders set out to transform Louisiana’s antiquated and brutal juvenile justice system into one that would treat kids like kids, not prisoners. While the effort saw some early promise, Hurricane Katrina and subsequent draconian budgets cuts during Gov. Bobby Jindal’s  administration severely hamstrung efforts to move the system to a more therapeutic model. The Advocate’s Jacqueline DeRobertis details how a decade of broken promises led to the state’s deepening youth prison crisis.

In fiscal year 2009, the office’s budget was $182 million; that fell to $111 million in fiscal year 2014. By fiscal year 2022, it has increased to $150 million — still about 17% less than it received in 2009. [Mary] Livers, the former head of the Office of Juvenile Justice between 2008 and 2016, said the Jindal years were “extremely lean” and sacrifices were made to keep staff and teens safe. Programs that served as alternatives to incarceration deemed inefficient or lagging were axed — but Livers said the dollars supporting those services were returned to the state’s general fund, rather than redirected to the juvenile justice system. In the meantime, with finances so strained, the youth facilities continued to deteriorate.

Number of the Day
528,000 – Number of jobs the U.S. economy added in July. This is the fastest monthly job increase since February (Source: U.S. Bureau of Labor Statistics