The important story out front about the state’s efforts to increase government assistance for the poorer to obtain health care insurance remains largely ignored by Louisiana media and certain political elites, because of a backstory of agenda-setting and hypocrisy that puts politics before people.
Earlier this spring, Republican Gov. Bobby Jindal proposed his America Next Freedom and Empowerment Plan that would address this provision under national law, envisioning in it the repeal of the Patient Protection and Affordable Care Act (“Obamacare”). That’s about all a governor can do in this regard, put it out there and hope others take it up. So far, nothing has happened at the federal level but at the state level he found an unlikely ally in Democrat state Sen. Ben Nevers who wanted to pursue this plan adapted to the state level.
Nevers originally favored measures taken straight out of Obamacare that would expand eligibility in the existing Medicaid system, but Jindal opposed these as they could cost the state as much as over $2 billion through 2023 and at a minimum hundreds of millions of dollars more (and states cannot opt out once they accept it under Obamacare terms) for care shown statistically producing worse outcomes than if uninsured. Thus, Nevers turned to the politically possible in taking as many of Jindal’s ideas that could be and putting them into a state-level version, with Jindal’s blessing.
These include health savings accounts, wellness incentives, and premium support (with a high-risk pool to subsidize those individuals) for those earning between a quarter and a half the federal poverty level to purchase insurance with no co-payments while those from half up to the FPL may contribute co-payments and cost sharing. This use of Medicaid dollars for premium support, which essentially expands Louisiana’s Bayou Health program that covers adults at a quarter of FPL or below to cover the 25-100 percent FPL range, would require the federal government to grant waivers to allow use of federal funds in block grant format for premium support and for the high-risk pool funding. The plan anticipates savings (such as the $135 million in fiscal year 2013 from Bayou Health) would pay for increasing coverage.
Simply, the bill expands health care insurance as does Obamacare, but not by using the existing Medicaid fee-for-service paradigm (which actually likely will drive down premiums for all because it would expand the covered base in private markets). That bill, SB 682, has moved out of the Senate into the House. But if you depended upon large metropolitan daily newspapers and television stations in Louisiana outside of Baton Rouge, you’d never know this. Only that area’s television stations and the Baton Rouge/New Orleans Advocate even have reported about the bill and its progress.
Nor have any Democrats who championed publicly the idea of expanding health insurance provision through Obamacare, with the exception of Nevers, spoken in favor of his bill. In fact, predictably enough, the only vote so far against the bill either in committee or on the floor came from state Sen. Karen Peterson, also the chairwoman of state Democrats, demonstrating that in turning down a chance to expand insurance coverage for the indigent she’s more interested in empowering government than in helping people.
But perhaps a bigger hypocrite than Peterson is the New Orleans Times-Picayune. In the span of a year it editorialized 12 times favoring Medicaid expansion, dodging the facts that this would cost more money for worse care. Then comes Nevers’ new bill built on Jindal’s model that expands subsidized health insurance availability, just not utilizing the Medicaid fee-for-service paradigm … and then nothing. Not a single story appeared in the T-P about the bill or its progress, nor any editorial supporting the legislation concurs with the very goal the T-P led its readers to think it backed.
Then last week, it ran an article, about week after the actual announcement, that Indiana Gov. Mike Pence had proposed “Medicaid expansion” in his state. The Republican Pence’s plan also would employ health savings accounts, wellness incentives, and premium support requiring federal government waivers – in concept, close to what Jindal had proposed nationally and Nevers had translated to the state level.
So the next day on the editorial page appeared an editorial in favor of Pence’s plan and imploring Jindal to emulate it! Not only do the T-P’s capitol reporters appear blind, deaf, and dumb for not covering SB 682, but also its editorial writers look entirely ignorant and unsophisticated in not even understanding that if they like what Pence has done, Jindal basically already has delivered that to them.
Such obvious selectivity in publication choices about this issue, as more generally with Democrat politician and liberal special interest reactions, happens for one or both of two related reasons: to them, any plan with Jindal’s name on it automatically becomes anathema and any workable solution that fails to empower and grow government when such an option exists cannot be acknowledged. As such, responses of those like Peterson’s and the T-P’s show they really do not care about helping the poor but only want to use them to score political points to further a political agenda based upon expanding government and its power.