…though when the bill establishing it was being debated Louisiana’s Democrat governor John Bel Edwards was an awfully surly and vicious critic of it. Edwards wouldn’t shut up about how the state’s Attorney General, Jeff Landry, was going to put the better part of a million Louisianans with pre-existing conditions out of their health insurance by joining the multi-state lawsuit seeking to have Obamacare thrown out as unconstitutional, which was ridiculous.

Nobody believed Edwards, and the bill, which addressed the pre-existing conditions concerns in advance of that lawsuit being decided, flew through both houses of the legislature. Edwards had no choice but to sign the bill, and then he proceeded to brag about doing so in a brazen bit of spin even the state’s mainstream media types groaned about.

Since then, Edwards has gone back to whining about Landry’s role in the multi-state lawsuit and predicting doom should Obamacare go by the boards when the Supreme Court takes up the case.

But yesterday, the state’s Insurance Commissioner Jim Donelon, who helped draft the pre-existing conditions bill, sent a report to the Legislature on how the new law is performing. And in a fairly rare bit of news, this thing actually seems to have been a success. From a press release yesterday…

Today, Louisiana Commissioner of Insurance Jim Donelon delivered to the Legislature his initial report on beginning the implementation of Act 412 – the Health Care Coverage for Louisiana Families Protection Act, bipartisan legislation pushed by Attorney General Jeff Landry to protect patients with pre-existing conditions should federal courts continue to rule the Affordable Care Act (ACA) unconstitutional.

Among the key findings in the Insurance Commissioner’s Report:

• The Guaranteed Benefits Pool will reduce individual market healthcare premiums by a dramatic 35%-45%. This is a massive savings especially in light of the fact that ACA plans in Louisiana have had an overall price increase trajectory equaling 14.6% per year – on average – from 2015-2019, including nearly 33% in 2017 alone.
• The average health insurance premium reduction will be $300 per month less than current ACA rates. This is a savings of $3,600 per year – on average – for those with current individual ACA plans.
• The premium reductions will result in encouraging a portion of Louisianans, specifically those currently unsubsidized, to return to the individual market and become insured. This will increase the rate of insured in Louisiana.
• Access to coverage for Louisiana patients with pre-existing conditions is guaranteed along with other essential health benefits.
• More young people will enroll in coverage with the change in age rating, again increasing the number of insured.
• With a likely flattening of the age curve with full implementation and the dramatic savings resulting from the pool, older citizens could – and should – see savings.
• The cost to implement the Guaranteed Benefits Pool is less than half of current federal taxpayer-funded ACA subsidies being sent into Louisiana.
• Utilizing the ACA-budgeted subsidy money currently sent to Louisiana as a federal block grant would cover not only the cost of the Guaranteed Benefits Pool but also likely provide enough funding to subsidize or provide healthcare benefits for current low-income ACA enrollees.

“This report confirms what we believed when the Legislature, almost unanimously, passed Act 412: this bi-partisan law will protect individuals with pre-existing conditions while lowering health insurance premiums,” said General Landry.

“Louisianans currently in ACA plans will save thousands each year in their healthcare premiums,” continued General Landry. “This report details savings are possible not only in premiums but also in federal taxpayer overhead needed to administer the ACA from Washington. We can accomplish this without a so-called ‘age tax’ or a ‘giveaway to the rich’ as critics would falsely claim.”

“The Maine model, on which Act 412’s foundation was based, saw premium savings for older citizens; we expect the same in Louisiana due to the dramatic overall average monthly premium savings,” added General Landry.

It is important to note that Act 412 was designed as a state-based solution for those enrolled in current ACA plans. “Like the ACA, Act 412 does not at all impact senior citizens who rely upon Medicare. It is critical for senior citizens to know their Medicare benefits are not impacted at all by the ACA or Act 412; they remain protected and untouched,” concluded General Landry. “Also, those who receive insurance from their workplaces are also not impacted.”

Act 412 prohibits the denial of healthcare insurance for pre-existing conditions; eliminates lifetime limits on the dollar value of benefits and prohibits annual limits on the dollar value of essential benefits; allows for healthcare coverage on parent policies for any child until the age of 26; and ensures that any healthcare plan provide for essential health benefits including ambulance care, emergency services, maternity and newborn care, hospitalizations, pediatric care, and prescription drugs among others.

To address the needs of those who are low or moderate income and receive coverage subsidies under the current ACA, Commissioner Donelon and General Landry both support a variety of possible solutions. These are outlined in the Department of Insurance’s report. General Landry has suggested that one solution would be to use a portion of the cost savings of higher income individuals for those at lower incomes – in addition to the remaining federal dollars through a block grant of current ACA subsidy funds. If this limited recapture of savings occurred, those at low and moderate income would stay insured while those who are unsubsidized would still experience a significant price savings each month. The Department of Insurance summary report includes this option. Act 412 is designed to benefit all Louisianans, not just those who are unsubsidized.

Act 412 passed the Louisiana Senate 38-0 and the Louisiana House 90-9, and it cleared the House Insurance Committee and the Senate Health and Welfare Committee without opposition.

Act 412 does not address Medicaid Welfare as the welfare program has been in existence since 1965 as a federal program, only administered partly by the State. The Attorney General expects that Congress and the President will continue to support this program, post ACA. Following the ACA, it is the Attorney General’s hope this can be done with more flexibility to the states to create innovation and reduce costs. President Trump has already introduced programs that signal his desire to give states greater flexibility over providing health care to their low-income populations in a more efficient and effective way. A continued push to stop welfare fraud, part of General Landry’s responsibility in Louisiana, is also important when looking at any changes to this federal program.

Politically, the smart move for Edwards would be to shut up about Act 412 and the Obamacare lawsuit. He isn’t on the right side of the issue, and frankly health care is going to be a bigger and bigger problem for him as time goes along and Medicaid becomes a worse and worse financial burden on the state.

But Edwards can’t accept defeat on anything, so he’s unlikely to keep his mouth shut. The problem is, he’s increasingly an outlier on this issue. It’ll be interesting to see how he chooses to snipe at Landry and Donelon going forward.