Last week, state Sen. Ben Nevers vacated his SB 107, which, as several similar bills introduced in the Legislature this session had sought to do in different ways, had preached for the expansion of Medicaid as by the Patient Protection and Affordable Care Act – commit states to a costly new entitlement that, at best, unlikely would improve outcomes for those families with incomes in the ranges of 25-100 percent of the federal poverty line, who presently don’t have access taxpayer-funded insurance. In its place, he substituted SB 682, built on an entirely different philosophy.
That’s because it mirrors, best it can, the “America Next” (titled the “Freedom and Empowerment”) plan forwarded earlier this year by Gov. Bobby Jindal. SB 682 calls for state study to create a framework this summer that follows the Jindal national plan. It intends to provide through tax breaks and premium support no-cost insurance to those in the 25-50 percent FPL range, to those above that range cost-sharing and copays only, also including Medicare recipients with cost-sharing and premium assistance, and would enact measures to lower the cost of health care provision, leading to lower rates, such as by establishing portability among states, tort reform, and pooling. Combining this with greater discretion in using federal funds, such as by using them to pay premiums for private insurance for qualifiers as along the lines of the current Bayou Health program (but for a different population) that already saves the state money over the fee-for-service model on which previous attempts at Medicaid expansion were based, extra state expenditures would not be expected.
Of course, because some of this depends upon federal government action, principally in allowing for portability (requiring a legal change) and in granting block grant authority (which probably cannot be done by waiver but also may need Congress to act), any such review by DHH probably would come back admitting such a plan could not be implemented until this happened. Unless Pres. Barack Obama undergoes and extraordinary ideological transformation and he decides to graduate from illegal waiving of laws to actually promulgating them on his own, this won’t happen anytime soon.
Still, the fact remains that with cooperation this is a workable plan that anyone who cares about providing health insurance to the indigent not now covered can lobby for, if not push into law. Yet those who had been so vocal about the one-expensive-size-fits-all-badly version, instead of praising lawmakers – including all but Nevers himself – suddenly went almost entirely silent. For example, not one tweet came from the Democrats’ official Twitter account where just days and weeks before dozens championing the less effective measure flew around, including from party chief state Sen. Karen Peterson or from its only declared 2015 gubernatorial candidate state Rep. John Bel Edwards.
Nor did the media cover this bill, aside from just a couple of television stations and just one daily newspaper. The New Orleans Times-Picayune, which no fewer than seven times last year editorially called for the less effective version’s implementation and again this year, ran neither a news story nor editorial, supportive or otherwise, on the matter. Only the Baton Rouge/New Orleans Advocate bothered to run a news story on it, and editorially its ever-reliable stenographer for the left Stephanie Grace chose to regurgitate some talking points that the trendily progressive Louisiana Budget Project passed out on the national version of Jindal’s plan, which she summarized by writing it probably wouldn’t expand coverage to the low income.
Naturally, she didn’t bother to check the LBP’s disingenuous effort, which set up a straw man for criticism of the state version as it did not reflect the content of the bill but guesswork on the national version. While it did this prior to the bill’s introduction, thereby providing a partial excuse for its treatment, days after the bill’s text became public as this column went to press no LBP correction or revision about the plan has come through, so as far as its analysis goes applied to SB 682, garbage in, garbage out.
And that’s the sum total, Nevers obviously excluded, of the response of these presumed cheerleaders of expanding health insurance to many of the poor and of the mouthpieces for their views – almost total indifference, with the remainder offering up tepid deferrals. Which leads to wondering about just how genuine their commitment is to provision of health insurance to this segment of the population, and whether they have a greater commitment to expanding government’s and their cadre’s power at the expense of disempowering people.
Listen to the deafening silence on supporting this bill from so many of those who like to present themselves as all-concerned about the welfare of citizens with few resources. That’s the roar of their sanctimonious hypocrisy you hear.