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14.4.16

Expand TOPS to voucher to stay an entitlement

Last week, Louisiana’s Commissioner of Higher Education Joseph Rallo echoed a remark investigated on several occasions in this space and which provides an alternative formulation in how to deal with the state’s schizophrenic Taylor Opportunity Program for Students currently under budgetary fire.

TOPS, with its extraordinarily mediocre standards, does not operate as a true scholarship program because of that but instead mimics an entitlement. For that reason, it features a high default rate and uses taxpayer dollars inefficiently. Modest enrollment increases over the years since its institutionalization almost two decades ago and substantial tuition increases that brought up Louisiana from close to the bottom of senior institution average tuition among the states about a dozen places, although still lagging the national average by over $1,500 annually, have swelled TOPS’ cost, making it a target to cut in times of budgetary stress.

Democrat Gov. John Bel Edwards has proposed that – not as a sincere means to cut the cost of government but as a cudgel to scare lawmakers into a tax hike. As currently defined in statute, that reduction would have the effect of raising dramatically TOPS’ standards and, as touted in this space, would have the beneficial impact of making it a genuine scholarship program, eliminating most of its inefficiency in resource use.

13.4.16

Revised budget offers transformational opportunity

Because it goes against the grain of Louisiana’s political culture, more than ever legislative Republicans should take the budget deal Democrat Gov. John Bel Edwards has offered.

In his fiscal year 2017 budget version 2.0, Edwards performed some considerable slashing to erase a projected nearly $800 million shortfall from current spending levels. In doing so, it picked up a particular Janus-like quality: both a serious document and a political one, designed to accomplish Edwards’ long-term goal of growing government through tax increases, in that it concentrates cutting in areas that challenge the prevailing populism still a part of the state’s ethos.

A little over half of reductions came in health care, centered on the possibility of “closing” four of the nine charity hospitals still in the state’s portfolio. More precisely, that would mean the state dissolves contracts with operators that pay them above Medicaid rates for care delivered to individuals with family incomes of less than 200 percent of the federal poverty level.

12.4.16

LA needs to elicit client responsibility in Medicaid

Louisiana need not abandon the idea of asking Medicaid patients for some reimbursement to arrest wildly increasing costs, but must design the program with an understanding of the inculcated culture of poverty in order to make it effective.

The insurance industry for decades has designed coverage where a user of health care makes small payments at the time of service, but only recently has that crossed over from private to government insuring. The goal remains the same regardless of sector: create a disincentive for the consumer to access health care frivolously while lowering the insurer’s exposure slightly. With that in mind, legislators filed a number of bills for the regular session of the Louisiana Legislature, requirements in Medicaid co-payments both to put a dent the huge cost increases coming from program expansion and to inspire increased personal responsibility from clients.

However, in the case of public-backed insurance, unlike with private insurance where overuse turns back the inefficiency onto the ratepayer utilizing the service with an increase in premiums, the exposure falls on the taxpayer, not the user who pays little or no taxes. Thus, policy-makers eye the co-payment requirement not just as a method to connect the client’s demand to the cost of the service in the hopes of limiting consumption for trivial reasons or in inefficient ways, but also as a way to raise some funds to ameliorate the impact of the transfer of wealth forced to fund the program.

11.4.16

Privatization presents large LA prison savings

Louisiana’s Department of Corrections might want to rethink its budgetary poormouthing strategy, especially when there exist realistic solutions to cuts costs that take only the political will to implement.

Last week, Secretary of Corrections Jimmy LeBlanc – the only holdover selected by Gov. John Bel Edwards to continue in the same cabinet job from former Gov. Bobby Jindaltestified to a House of Representatives panel that a projected cut of 10 percent in his department’s budget would lead to any or all of closing prisons, releasing prisoners early, or cutting across the board. He described the aftermath of this as potentially deleterious to both public safety and prisoners, calling it “dangerous.”

While policy-makers always should go alert in judging validity of information when hearing such drastic claims – LeBlanc threw out numbers such as releasing over 5,000 of the state’s over 37,000 incarcerated about equally distributed between state and local facilities and closing five of the state’s nine prisons to make up the roughly $65 million – even milder protestations would draw some deserved skepticism given the recent controversy over some suspicious personnel practices in DOC. Former Louisiana State Penitentiary head Burl Cain, a former business partner of LeBlanc’s, and one of his relatives engaged in wasteful, if not fraudulent, practices apparently legal only because of the exceptional laxness of internal DOC policies. Additionally, Cain will receive extensive retirement benefits that in a minor way would have alleviated the contemplated budget cut.