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Legislators must reject back door Medicaid expansion

Maybe the front door may seem closed, but the back door now is wide open for Louisiana health insurance ratepayers, out-of-pocket payers for hospital services, and taxpayers to see their health care costs increase as a result of Medicaid expansion by another name in the state.

HCR 75 by Speaker Chuck Kleckley, introduced on the final day of the session for such instruments, would establish a “hospital stabilization formula” by making an assessments on hospitals, which then in essence would be paid back through increased reimbursements. The need for these would come from an increased patient load under Medicaid expansion, with the assessment supposed to pay for the state’s portion under expansion, which begins at 5 percent in 2017 and then makes its way to 10 percent by 2020. The formula would begin on or before Apr. 1, 2016 if expansion is accepted by then, meaning for the first half of fiscal year 2017 there would be no assessment. Rural, small, and specialty hospitals, all of whom together don’t see much in the way of Medicaid business, would be exempt from the assessment.

Of course, there’s no free lunch, so somebody must pay for the assessment that matches the federal funds. And that would be you emptying your pocketbook for that. The amount owed by the state 2017 and after would end up from increased insurance premiums, increased retail costs to out-of-pocket payers, and from Louisiana taxpayers who fund insurance programs for state and local government employees and from the portion they pay in federal taxes that’s the federal match, because to afford their assessments hospitals simply will raise their costs of services and pass them along to insurers and others. The state estimates that in the FY 2017-26 period this would cost an extra $2 billion, even after removing out the alleged savings in reduced uncompensated care costs.


Legislators keep giving film industry its taxpayer fix

The only real conclusion observers could draw from the Louisiana Legislature’s initial attempt to reform its wasteful Motion Picture Investor Tax Credit is that it seems sacred and bound to continue keeping hooked its crack baby to the detriment of the state and its people.

The House Ways and Means Committee yesterday passed out three bills concerning the tax credit, which has crept up steadily in payout over the $200 million level in the past couple of years and has drawn concern because it returns less than a quarter of each dollar in taxpayer subsidies. The most ambitious and sensible bill of the bunch was state Rep. Lance HarrisHB 276, which would have capped the amount paid out to $50 million this calendar year and then reduce it annually to sunset in four years.

This one took the most fiscally sound approach by weaning the industry off taxpayer subsidization. The whole program sold over a decade ago on the idea that state support would last long enough to allow the industry to build a foothold that then allowed its natural advantages to flourish, such as more industry-friendly attitudes and lower human resources costs in Louisiana as opposed to Hollywood, and then wean away public money.


Limiting Caddo constable deputies appropriate

Legitimate questions about government waste and redundancy collide with electoral politics concerning the expanded ability of Caddo Parish constables to appoint and pay for deputies, all wrapped up in a bill authored by state Rep. Jim Morris.

HB 118 by Morris would reverse the authority granted to constables, who are elected, one each to one of 10 districts (one is the Shreveport City marshal position treated somewhat differently by statute) to appoint multiple deputies, provided as a result of legislation in 2012 by state Rep. Alan Seabaugh that passed the Legislature unanimously. Constables execute court orders by their district’s justice of the peace (City Court in the case of the marshal) and as a result of these duties, including things such as serving summons, executing writs, and taking bonds, do not have to have the required peace officer training that law enforcement officers in the state have generally, yet are allowed to make arrests and to have firearms.

Hatfield amazingly has 18 deputies (Caddo is only one of three parishes whose constables are allowed to have any at all) for his district of about 10,000 registered voters. While the law makes clear that these are part-time employees, some are full-time employees in other judicial agencies and some are constables from other districts (deputies do not have to reside in the district, unlike the constable), and Hatfield terms them as full-time employees. Morris questions the need for so many, and Caddo Sheriff Steve Prator feels unease with so many officers without required certified training out there, which would make for the third largest local law enforcement force in the parish.


Grand LA budget bargain seems increasingly elusive

As the regular session of the Louisiana Legislature continues, it seems more and more likely that worlds will collide concerning resolution of the fiscal year 2016 budget.

Last week, the Senate Finance Committee passed SB 177 by Sen. Robert Adley, which would put forth a constitutional amendment that would eliminate the state’s inventory tax credit by eliminating inventory’s taxation, as a result raising over $500 million that could go to reducing a shortfall in the $1.6 billion range. The problem is that this would cost local governments almost 80 percent of that and business the remainder, although Adley assured local governments that some way would be concocted to allow them to recapture that revenue but provided no details.

Gov. Bobby Jindal supports eliminating the credit that is refundable, but not the portion that is used to offset corporate income and franchise taxes. However, as it is a constitutional amendment, he has no direct impact on the bill’s passage, which requires a two-thirds vote in each chamber. He has promised retaliation on a strategy of suspending tax exemptions, which the Legislature can do by resolutions that he can’t veto by a two-thirds vote, by vetoing a budget that relies on them, but they can override that by a two-thirds vote.


Beneficial TOPS reform bill may not hurdle veto threat

Turns out that state Sens. Jack Donahue and Conrad Appel are cleverer than they look. The question is whether that’s enough to get Taylor Opportunity Program for Students reform past a doubting Gov. Bobby Jindal.

Donahue is the main author, with Appel, of SB 48, which would lock in TOPS awards at their academic year 2017 levels, after which the Legislature would have to affirm increases in that rate. This means that, under the 10 percent maximum now allowed annual increase in tuition for schools that meet performance targets and/or any future removal of legislative control over the raising of tuition beyond this level, tuition levels at schools can increase without the award level following suit, as now is the law. This effectively would cap TOPS costs at the level of next year’s costs for each school or substitute (such as a weighted average for nonpublic schools) that would vary only by the mix of students attending what schools.

Reading the bill in isolation, it would appear that instead of this outcome, it would create a gap between award and tuition that the student would have to cover through other means. But the interpretation above holds because of the way the law is written and the promulgated code associated with it. R.S. 17:3048.1(N) states that if insufficient money is present to fund all awards that then the Louisiana Student Financial Assistance Commission would establish criteria that decided who got awards, subject to the statute’s mandating usage of scores on the American College Test and expected family contribution (a federal government formula computed through the standards Free Application for Federal Student Aid process) as part of that. In other words, eligible applicants either get or do not get an award if not enough money is appropriated.