Health priorities show why state does not have a revenue problem

On the new tax issue, since the legislative session Gov. Kathleen Blanco has shown an amazing ability to talk out of both sides of her mouth. Before the session, she said there needed to be a tax on hospital for health care funds and a tax on cigarettes to fund teacher raises; otherwise, there would be no money for either. Presto, revenue estimates soar around $360 million, so there’s no need for any new taxes, right? Wrong, Blanco still insists on them.

She finally wins the hospital battle by getting a new tax on their revenues which largely will be passed along to consumers and ratepayers. So no more new revenues are needed for health care now, right? Wrong, Blanco now says the cigarette tax should go to health care, too (while winking and saying it’s really going to teacher raises).

For Blanco, she acted this way not just on new taxes, it’s also been the fiscal situation of Louisiana’s health care system. At the beginning of the session, she was saying she would bring more efficient use of health care dollars to the system, the major part of this a proposal that nursing homes not receive their long-standing favorable budgetary treatment that would save $60 million, receiving plenty of backing from Legislative Auditor’s reports that showed if Louisiana had similar standards as other states, almost $100 million a year could be saved.
Yet when the new revenue estimates came out, she suddenly backed off this.

To her credit, she has provided verbal backing to HB 697 which would allow reduced utilization of nursing homes in favor of more community-based care for the many users who could have needs met at a far less expensive per patient rate to the state. At least she’s not trying to reverse it like state Sen. Sherri Smith Cheek who also has provided some verbal gymnastics in the area of health care financing.

Cheek, who sits on the Senate Health and Welfare Committee and on the Joint Legislative Committee on the Budget, giving her large influence over health care spending, in her campaign and first year in office talked a great game about reform. But this session, she has done things that suggest rather than a commitment to taxpayers and patients that she would rather carry water for nursing home interests.

She got her committee to pass SB 253 which would enshrine into law the very formula that inefficiently uses Medicaid dollars to reimburse nursing homes, which would require a majority of the legislature to change. Fortunately, it looks dead for the session as since Blanco wisely said she would not support the bill without changes.

Then Cheek tried to throw nursing homes another bone concerning HB 697 by proposing an amendment in Health and Welfare to take much of the de-institutionalizing aspect out of it. Fortunately, other senators who have shown greater commitment to reform this session raised enough ruckus to get even nursing home owner and panel chairman Sen. Joe McPherson to back down with Cheek.

With health care taking up the largest single portion of the state operating budget, as long as we continue to have legislators with Cheek’s mindset on this issue in Baton Rouge, somebody with the mindset of Blanco’s on taxes is going to keep pushing them, successfully. It’s not a revenue problem we have in this state, it’s a spending priorities problem.