We know that it’ll be a big political issue statewide, because it’s a big political issue nationally – and with the relatively likely proposition that all of Obamacare is going to be thrown out as unconstitutional, the one item within the previous administration’s signature policy initiative which remains uniformly popular is going to be decided, in all likelihood, at the state level.
This has crossed the Louisiana political radar because Jeff Landry, the state’s Attorney General, joined Louisiana to the lawsuit filed by some 17 other states seeking to void Obamacare altogether. Landry took that action late last year, and earned himself a good bit of griping by Democrat Gov. John Bel Edwards for his trouble.
“This was a short-sighted lawsuit, to say the least. I intend to vigorously pursue legislation to protect individuals with pre-existing conditions from losing their health insurance and ensuring the working people of our state aren’t penalized because of this decision,” Edwards squealed back in December, after a federal judge in Texas found Obamacare unconstitutional in toto.
The problem with Obamacare is that its individual insurance mandate in and of itself is constitutionally infirm – a problem Supreme Court Chief Justice John Roberts inexplicably got around by essentially rewriting the law to find that mandate to be a tax, despite a congressional record which clearly shows it was not intended to be a tax (the law wouldn’t have passed if that mandate had been presented as a tax). But the Trump administration has waived the mandate, and therefore the linchpin of the law is now gone. That’s why U.S. District Judge Reed O’Conner threw out all of Obamacare in December, and it’s expected his ruling will be upheld first at the Fifth Circuit and then at the U.S. Supreme Court.
What happens then? Probably chaos in the health care market, which won’t be all that much worse than what we have now.
In all likelihood, Congress and the White House will agree to block-grant massive amounts of health care dollars to the states, at least as a temporary solution since it’s going to be impossible to square the Democrats’ demands for Medicare-for-all, which will never get through the Senate, with GOP demands for a much more deregulated health care market that includes things like interstate health insurance sales, association health plans, health savings accounts and other market-based changes.
Which means Louisiana is going to need a solution. And there are bills in the current legislative session which would do just that. Landry is backing SB 173 by Sen. Fred Mills, called the Healthcare Coverage for Louisiana Families Protection Act, which would discourage health insurance companies from denying coverage to people with pre-existing conditions and from setting annual or lifetime limits on benefits – using incentives and disincentives more so than command economics, and would give a lot of power to the Louisiana Insurance Commission to put a post-Obamacare regime in place. He had a press conference just before the start of the legislative session to announce his support for the bill.
SB 173 goes in front of the Senate Health and Welfare Committee tomorrow morning, which is the committee Mills chairs. That committee has a 5-4 Republican majority – but it’s a very soft majority, seeing as though among the Republicans is Norby Chabert (R-Houma) – the most RINO’y of the Senate’s RINO’s. Another of the five Republicans is Dan Claitor (R-Baton Rouge), who has expressed doubts about the bill, specifically that the state won’t have the money to subsidize the coverage incentives for pre-existing conditions in the event the feds don’t block-grant the Obamacare funding to the states.
But beyond Landry the bill does have a proponent of note – that being U.S. House Minority Whip Steve Scalise (R-Jefferson), who weighed in on it last week…
As we have been working to fix serious problems with our healthcare system in Washington, I have also been following the healthcare debate in the Louisiana Legislature. We should all want a quality healthcare system that lowers costs, gives patients more choices, and protects people with pre-existing conditions from higher costs, while also improving the quality of care for everyone.
I commend Attorney General Jeff Landry, House Speaker Taylor Barras, State Senator Fred Mills, Chairman Kirk Talbot, and Insurance Commissioner Jim Donelon for working together with Members of the Louisiana Legislature who are interested in protecting people with pre-existing conditions.
There is no question that the Affordable Care Act (ACA) has not delivered what it promised: it is not affordable for families who have faced skyrocketing premiums and up to $10,000 deductibles; it has not lowered costs as promised; for millions of families across America, they were not allowed to keep their doctor; and many more had their existing private insurance plans cancelled.
On top of all of that, the ACA has added unnecessary red tape where unelected Washington bureaucrats have increasing power to make healthcare decisions for families and individuals.
I am confident, should the Louisiana Legislature move forward on a state-based solution, that the Federal government would continue to work with Louisiana officials, recognizing that state-based innovation is the best way to lower costs for patients, protect people with pre-existing conditions, and improve the quality of care for all Louisiana families.
That last paragraph should read as a prediction by Scalise that the block-grant money from Washington is coming should Obamacare fall in court. He’s probably right – they’re not going to pass a solution in Washington to succeed Obamacare, and kicking the funding and the legislative initiative back to the states is probably the only short-term fix available.
House Speaker Taylor Barras is backing Mills’ bill, and so is House Insurance Committee chairman Kirk Talbot. If they get that bill over on the House side they’ll pass it.
But we don’t know if all that’s enough to get the bill out of the Senate.
John Bel Edwards isn’t a fan, and that could well mean SB 173 gets killed on the Senate floor if it does survive the Senate Health & Welfare Committee. Here’s what Edwards said after Landry came out for SB 173…
It’s ironic that the Attorney General wants to try and take credit for fixing a problem that he himself caused by involving the state in a lawsuit that eliminates protections for people with pre-existing conditions, without having a plan in place or consulting with anyone before doing so. Let’s be clear: Jeff Landry endangered the health coverage of almost 850,000 people in Louisiana with pre-existing conditions because he was more concerned with politics than with real people.
Get past the peculiar nature of Edwards trashing Landry for upholding the Constitution, and you start to realize how tough that statement might be to defend. Edwards is backing another bill, HB 237 by Rep. Chad Brown (D-Plaquemine), which goes about protecting pre-existing conditions by kicking health insurers out of the state’s market if they deny anybody coverage as a result of a pre-existing condition. Essentially making Louisiana a guaranteed-issue market will make health insurance in the Bayou State every bit as unaffordable as car insurance. That’s why HB 237 is all but certainly dead in the House Insurance Committee tomorrow afternoon – the hearing on HB 237 was deliberately set to follow the Senate hearing on SB 173, so that if Mills’ bill gets out of committee Brown’s bill is surely headed for a violent death.
If things go the way Landry, Mills, Talbot and Barras are planning, Louisiana will have something in place to protect people with pre-existing conditions without soaking the rest of the health insurance market in the state in the event Obamacare gets blown away in court. That something will go to John Bel Edwards’ desk.
And at that point, his rhetoric attacking Landry – and that of his lickspittles in the state’s media – would go by the boards. He’d either have to sign the bill and give Landry a major legislative victory to go with the potential credit for assisting in slaying Obamacare once and for all, or he’d veto it and be directly responsible for leaving those with pre-existing conditions open to losing their health insurance without a safety net.
At some point, your political rhetoric melts away and you have to govern. Edwards is approaching that point on this issue. The question is whether Claitor and Chabert – and the other supposed Republicans in the Senate – have the sand to force him into that position.