25.5.08

LA officials should call bluffs by passing good bills

In the past week, a couple of potential public policy losers have intimated they would sue the state of Louisiana if certain laws pass. In no way should lawmakers let this deter them from doing the right thing.

Explicit threats came from the Police Jury Association of Louisiana and the Louisiana Municipal Association as SB 807 by Sen. Ann Duplessis advanced. The bill, among other things, would grant a statewide rather than local franchising power for cable television providers. This makes it harder for local government to discriminate against potential providers, a power they use to create monopoly situations wherein they use contracts with providers to squeeze money out of ratepayers and to transfer it to the local governments themselves.

On what legal grounds this might occur remain a mystery, but it is shameful that these special interest groups would rather fight for empowering government than for citizen-consumers. But this attack on the citizenry at least is clear, transparent, and doesn’t bring questions about government’s motivation.


Oddly, an implicit threat came not from any affected party, but from the executive branch itself in the matter of health spending outlined in the state’s operating budget bill HB 1. Secretary of Health and Hospitals Alan Levine, in testimony in front of the Senate Finance Committee, gave details on cuts of increased spending he proposed to make if House reductions from the original administration budget bill stood. They totaled $134.5 million (although only about $40 million involved state money the rest being federal matching dollars) and only partially followed my suggestion of a few days ago.

Levine also announced that the $38.6 million to be sliced from a $60 million increase in nursing home reimbursements (which are among the nation’s highest per capita paid with the lowest occupancy rates and draw around 85 percent of their funding from the state) might cause those institutions to sue the state. It’s strange that he would plan reductions in such a way if he really believed that, however, so this probably is the time-honored scare tactic of trying to organize cuts to produce the most serious potential consequences in order to scare legislators away from making them. In other words, Levine lacks credibility on this matter.

(Another indicator of this lack of credibility is he also said he planned to cut $19.8 million from community-based care waiver slots without also adding this might trigger, and more realistically, a suit. In its Barthelemy settlement the state promised to rapidly expand community-based programs, and a court might not believe the state has made a good faith effort in this regard when there are tens of thousands of people, some for a decade, on waiting lists to receive these services and with plans to reduce the increase in availability of those services the cuts would entail.)

It’s puzzling why Levine, and implicitly his boss Gov. Bobby Jindal, are not using this thriftiness of the Legislature to do what has been needed to be done for decades in the state to deliver health care more efficiently and effectively: shift money away from the fat and happy nursing home industry to community-based solutions. If part of that needs to be the repeal of odious Act 848 of the 2006 Regular Session which wrote nursing homes’ privileged position into law, attaching that as a rider to HB 1 can’t be all that difficult.

It bears repeating: taking away the entire projected increase for nursing homes would resolve the wished of the House and then some, would be the wisest use of taxpayer dollars, and would create a better health care system. Consumers would benefit with lower costs and more choice by passing SB 808. Lawmakers and administrators should go in these directions and call these legal bluffs by those who know their arguments cannot win the day so therefore as a last resort rely on threats against Louisianans.

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