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.
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