Medicaid cuts could leave states with massive shortfalls

Republicans in the U.S. House are attempting to partially offset the $4.5 trillion cost of their proposed tax cuts for the wealthy and large corporations with an $880 billion cut to Medicaid. One proposal would eliminate the 90% federal match rate for states that have expanded Medicaid eligibility through the Affordable Care Act. The New York Times’ Noah Weiland and Sarah Kliff explain how this cost shift away from the federal government and onto states could result in massive budget shortfalls: 

If states picked up the costs from the federal government and kept their expansion populations in place, they would spend more than $600 billion to do so over a decade, an increase of almost 20 percent, according to KFF. Many states would be short more than $10 billion over a decade, and some larger states, such as New York and California, would face a shortfall of more than $50 billion.

As Weiland and Kliff note, states that have expanded Medicaid, like Louisiana, would be left with hard choices if the federal government pulls back:

They could shoulder the extra costs to preserve Medicaid coverage for millions, make cuts to coverage or look for cuts from other large government programs to offset the reduction in federal funds. Medicaid, which covers more than 70 million people, is the largest health insurance program in the nation, and the largest single source of funding for states.

Eliminating the ACA expansion match rate could reduce Louisiana’s total Medicaid enrollment population by 41%, or 782,000 people. But the health care needs of people who would lose their coverage would not change; there just wouldn’t be resources available to pay for their care.  

Louisiana DOGE adds state auditor

A new state commission aimed at probing for possible cuts to government programs is adding the Louisiana Legislative Auditor to its ranks. The “Fiscal Responsibility Program,” which met twice without alerting the public or giving citizens a chance to participate, paused its work earlier this month over concerns that the group was violating Louisiana public meeting law. The Times Picayune | Baton Rouge Advocate’s Tyler Bridges reports: 

“We do a lot of audits on state agencies that get put on a shelf,” [Legislative Auditor Mike] Waguespack said. Now, he added, “we have a group that will potentially look at our audits and take action. We’ll be the boots on the ground. I’m super excited about this.” The governor’s press release did not say whether the group will begin holding public meetings. “We will always comply with public meeting law,” [Fiscal Responsibility Program Chair Steve] Orlando texted.

LSU’s far-reaching DEI purge

LSU could remove as many as 1,300 web pages in response to a Trump administration threat to nix federal funding for schools that consider race as a factor in admissions, hiring and programming, among other things. The Louisiana Illuminator’s Piper Hutchinson explains how any mention of the words diversity, equity and inclusion are in the crosshairs of the state’s flagship university:

LSU business faculty members whose research touches on home equity, and scientists whose research focuses on diversity of species have been highlighted as potential problems. The list included biological sciences professor Kyle Harms’ webpage, which mentions his research on the topic of ecological diversity. … Two obituaries for former deans of the Manship School of Mass Communication have also been flagged. A write-up of Dean Martin Johnson’s achievements mentions his experience at The Reveille, the university’s student newspaper, and championed a weekly edition co-published with the newspaper of Southern University, a historically Black university in Baton Rouge. 

Invest in expanding early education

Last month, a guest column in the Times Picayune | Baton Rouge Advocate explained how Louisiana’s recent – and historic – education gains are linked to investments in early childhood education, particularly in 4-year-olds. Sarintha Stricklin, executive director of the Jefferson Ready Start Network, explains why the state should also prioritize education efforts on children from birth to age 3. 

Research is clear — the foundation for lifelong learning is built in the first three years of life, a period of rapid brain development that shapes future success. Yet, unlike the widespread access we’ve achieved for 4-year-olds, families with younger children face an entirely different reality. Less than 16% of children under 4 in economically disadvantaged families have access to any publicly funded program. High-quality early education for infants and toddlers is scarce and expensive, leaving many families without options. Without greater investment, too many children enter preschool already behind — a gap that can persist through K-12 and beyond.

Reality check: Unfortunately, state lawmakers cut funding for early education during last year’s legislative session. A constitutional amendment on the March 29 statewide ballot (Amendment 2) would further reduce the number of early education seats in the state. Learn more about why Amendment 2 would take Louisiana in the wrong direction. 

Number of the Day

$13.9 billion – How much Louisiana would have to spend over the next decade to maintain its Medicaid expansion population if the 90% federal match rate for states is eliminated. (Source: KFF)