The Senate Insurance Committee has begun its review of the proposed acquisition of Louisiana’s largest health insurer – the nonprofit Blue Cross and Blue Shield of Louisiana (BCBSLA) – by Elevance Health. As part of the deal, most of the BCBSLA assets will be used to form a new charitable foundation that will become among the largest in the country. As The Advocate’s Stephanie Riegel explains, the proposed structure of the foundation and the makeup of its board are generating questions: 

Other questions have centered on the fact that the board chose to establish the foundation as a 501(c)(4) nonprofit, a type of partially tax-exempt organization that has greater latitude to engage in political activity than does a strictly tax-exempt 501(c)(3) nonprofit. Jan Moller, executive director of the Louisiana Budget Project, a left-leaning public policy organization, said the foundation could lobby or contribute to political candidates to affect health care or insurance policy. … Moller and [Michael] Johnson also criticized the make up of the founding board and its lack of diversity in a state where nearly 50% of the population is Black or Brown and 20% lives at or below the federal poverty level. “All of the directors are white men, who collectively do not reflect Louisiana’s diverse population,” Moeller (sic) wrote in a letter of opposition to the Department of Insurance.

Farm bill under pressure
When Congress returns from its annual August vacation, they will face a Sept. 30 deadline to pass a farm bill that authorizes funding and sets the rules for federal agriculture subsidies and food programs. While farm bills have often been bipartisan affairs on Capitol Hill, States Newsrooms’ Ashley Murray reports that the GOP Freedom Caucus wants to make the bill a political battleground that could include cuts to the Supplemental Nutrition Assistance Program: 

Talks to advance the funding bill collapsed before lawmakers left for August recess as far-right conservatives pushed to ban the availability of mifepristone, the abortion pill. Cutting SNAP funding in the agriculture appropriations bill is also a target for the GOP-led House. Among the Republican proposals are “right-sizing” funding to reflect pre-pandemic levels and adjusting the administration’s Thrifty Food Plan, which increased benefits to match healthy food prices. Another proposal Democrats are criticizing is limiting state waivers that allow certain adults to be exempt from work requirements because of labor market conditions. Currently 13 states, the District of Columbia and two territories have statewide waivers.

Bipartisan law to curb gun violence
Louisiana suffers from some of the highest gun violence rates in the country, and the Legislature in recent years has worked hard to make it easier for people to buy guns. So it was somewhat surprising to see Rep. Mandie Landry, a progressive Democrat from New Orleans, win passage of a bipartisan bill to incentivize people to store guns safely. The Advocate’s Sam Karlin reports:. 

“I thought, ‘I don’t know how people could be against that,’” Landry said in a recent interview at a restaurant near her Uptown New Orleans home. Remarkably, Landry got her bill through the Legislature without a single “no” vote. Gov. John Bel Edwards, a Democrat, signed it into law in June. To be sure, the bill is a small step. It provides a $500 tax credit to people who buy gun safety devices and expires in 2027. The state caps the amount of credits at $500,000 a year in total. In other words, it’s hardly the type of transformational gun legislation that Landry or supporters would like to see.

Cuts to hospital safety-net
Hospitals were caught off guard earlier this month when the Biden administration proposed a $1 billion cut to their Medicare payments for treating low-income and uninsured patients. The decrease to safety-net payments, which was much larger than what was originally proposed, was rationalized by the Centers for Medicare and Medicaid Services because of new data that shows a lower uninsured rate next year. But as Axios’ Maya Goldman reports, hospitals say the data doesn’t accurately reflect changing federal rules stemming from the end of the Covid-19 pandemic, a process known as “unwinding.” 

The uninsured rate hit an all-time low in early 2023, but more than 4.2 million Americans have lost Medicaid coverage since states began redetermining eligibility in April, according to KFF. The American Hospital Association wrote to CMS asking that it keeps the fiscal year 2023 uninsured rate in place for next year and to pause scheduled DSH cuts until the Medicaid redetermination process plays out. AHA pointed to a Congressional Budget Office report predicting that 6.2 million people will become uninsured after losing Medicaid coverage.

Hundreds of thousands of Louisianans could lose their Medicaid coverage in the coming months as these pandemic-era enrollment protections end. That loss of coverage could spell disaster for people who rely on Medicaid to get the healthcare they need. A new report by the Louisiana Budget Project explains how we got here—and what we can do to help minimize the looming coverage cliff.

Programming note: Registration is open for the Invest in Louisiana Policy Conference on Thursday, Sept. 21. Be sure to take advantage of early bird pricing, which ends on August 31. Click here to register. 

Number of the Day
53% – Percentage of Louisiana adults who have experienced physical violence in their lifetime. (Source: Tulane University Newcomb Institute)