In the final analysis, policy-makers should take Gov. John Bel Edwards’ surprising announcement in his state of the state speech that Medicaid expansion would save the state $100 million in fiscal year 2017 with a grain of salt, as well as understand it would predict costs, not savings, in future years.
Only two authoritative, publicly-released studies have occurred on this policy, both by the Department of Health and Hospitals prior to Edwards’ inauguration, and only the first, released in 2013, went into a year-by-year, component-by-component study of the issue. It presented four scenarios that depended upon the rates of enrollment of the uninsured population specifically newly eligible because of expansion, of increased enrollment in other Medicaid programs because of the publicity surrounding expansion, and of enrollment of the insured population from the private sector switching now eligible to switch to Medicaid. A second report a year later confirmed, utilizing data gathered from other states’ experiences, that the most costly scenario most closely fit reality. The extremely detailed report predicted for the last half of 2016, when Edwards wants to start the increased coverage, this would cost the state $38 million; by 2023, the state would pay an additional $373 million that year.
The public could access both reports – until shortly after Edwards took office. Echoing the communist world when a new regime would wipe away evidence from the previous, the reports mysteriously disappeared from the DHH website, and now locatable online only through other unrelated archiving sites. Two months later came Edwards’ pronouncement that alleges a positive $142 million dollar swing in the forecast impact from the first for the last half of this year.
Posted by Jeff Sadow at 13:15
Even as Democrat Gov. John Bel Edwards suffered political defeat during the recently-concluded special session of the Louisiana Legislature, legislation filed during the regular session provides him an opportunity to score some political points – or maybe demonstrate fraudulence of his asserted social conservatism.
Edwards called the session ostensibly to pursue fiscal reform, but his call defined that as extremely heavy on tax hikes and very light on spending cuts, with little emphasis on altering the practices and processes of state government that a genuine effort would entail. It ended in almost balancing the current fiscal year budget but leaving a substantial gap for the next because he refused to investigate seriously spending reductions, kicking the can down the road to his discredit.
Should the Republican-controlled Legislature come up with legislation that facilitates trimming state government – the deficit amounts to about three percent of total spending – Edwards will suffer a complete rout in his first half-year in office. Supposing he gets his wish to keep inflated government by having tax increases enacted in another special session, still he takes a political hit for both instigating higher taxes and lacking the leadership to reduce the drama produced by the necessity of a last-minute reprieve when he could have gotten the job done the first time.
Posted by Jeff Sadow at 09:55
While Louisiana’s legislators generally have turned their attention to balancing the budget in the just-commenced regular session, under the radar flies an area that deserves urgent attention and cannot afford any more reduction: that of paying for indigent defense, which if not soon resolved may prompt an influx of criminals roaming the streets.
Years ago the state supposedly solved for the chronic underfunding of indigent defense. Constitutionally, if the law defines a person as indigent, the state must provide legal representation to those accused of crimes. In the past, the system depended upon the wildly varying funding source of surcharges on convictions with a backstop of state funding doled out by need. The reform included increasing the latter component, recognizing that enforcement choices of law enforcement agencies that by definition operate independently of the system made for too much instability.
But with budgetary difficulties in the past couple of years that have reduced the state funding and with changes in enforcement patterns that have reduced the number of cases that could result in the fee payment, last year’s atmosphere that saw only a handful of the 42 (one for each judicial district) public defense agencies in difficulty and just a couple approaching a crisis point has deteriorated further. Now, before the end of the year a few agencies may have to stop taking new cases, even as currently they work with more of these per lawyer than national guidelines recommend, and many others threaten to join them in 2017.
Posted by Jeff Sadow at 12:55
Maybe he lives in a fantasy world. Maybe he’s just ticking off boxes. Maybe he’s a true believer pathologically unable to brook dissent from his prejudices. Regardless of potential explanations to understand Gov. John Bel Edwards’ State of the State speech (version 2.0, perhaps if counting his address to the Legislature prior to the just-finished special session), the clear message from it reminds Louisiana of the mistake made in his gaining the office.
In what has become nauseatingly familiar to observers, Edwards framed the presentation along the twin rhetorical principles emblazoned upon his administration to date: blaming his predecessor for every bad thing, real or imagined, under the sun; and pugnaciously defining cooperation as the endorsing of his policy preferences while conflict occurs only when others disagree with him. Expanding upon the latter, to which he also made allusions at the end, he alleged that a “Washington” politics of divisiveness interfered with getting things done (read: having his agenda enacted) and that a “Louisiana way” should prevail.
Of course, the “Louisiana way” has facilitated spending the state’s way into oblivion: in the next-to-last year data were available (2012), the state ranked 12th in spending as a proportion of state personal income. That’s high, but more remarkably growth in that measure over the previous two decades exceeded that of all states but Delaware. In Louisiana, consensus of Edwards’ type leads to overspending and a little more conflict seems in order to stop it.
Posted by Jeff Sadow at 16:05