Approximately 8.6 million people would lose health coverage over the next decade under proposed Medicaid cuts that House Republicans unveiled on Sunday. The spending reductions are being used to partially pay for tax cuts for the wealthy and large, profitable corporations, and are part of a sweeping bill to enact President Donald Trump’s legislative agenda. Margot Sanger-Katz and Catie Edmondson of the The New York Times report on where the cuts fall and who they would affect:
It also adds a work requirement to Medicaid for poor, childless adults, mandating that they prove they are working 80 hours every month to stay enrolled. That is a less flexible version of a work requirement briefly imposed in Arkansas in 2018 that caused 18,000 people to rapidly lose coverage. … But the legislation also ratchets up paperwork requirements across the program, by allowing states to check the income and residency of beneficiaries more often, and by permitting them to terminate coverage for people who do not respond promptly. The use of such strategies had been curtailed under a regulation published during the Biden administration.
The plan would also eliminate “provider” fees charged by health care providers that serve patients on Medicaid, which are a critical tool for states to raise money for their share of the health insurance program. The Times Picayune | Baton Rouge Advocate’s Mark Ballard explains how nixing these fees would affect Louisiana, where 1 in 3 residents are on Medicaid:
As Gov. Bobby Jindal’s first health care chief, [Ballad Health Chief Executive Officer of Ballad Health Alan] Levine used provider taxes in 2010 as the foundation for transitioning away from Louisiana charity hospitals, which were underfunded and couldn’t keep accreditation. … “Louisiana’s health care system would literally crash if they cut these provider taxes,” said Levine, who has advised a number of Republican governors on health care policy. “You could not tax the people of Louisiana high enough. It would destroy your economy in Louisiana,” he added.
Creating new ineffective tax breaks
Last November the Legislature eliminated a host of popular, but ineffective tax credits, including the Quality Jobs Program. The program cost Louisiana $150 million per year and only returned 11 cents in tax revenue for every $1 spent. Despite this poor return on investment, the Landry administration is pushing to enact a similar program. The Louisiana Illuminator’s Greg LaRose reports:
Jan Moller with Invest in Louisiana, a progressive fiscal policy watchdog group, told the Illuminator he expected the business-friendly legislature would eventually restore some of the incentives it targeted last year. “I’m not surprised that it happened,” Moller said. “I’m surprised that it’s happening four months after the ink dried on that tax bill.” Although Quality Jobs was among the incentive programs lawmakers eliminated, the state will continue to accept applications until its June 30 sunset date.
House Bill 507 by Rep. Julie Emerson would create a new program where state taxpayers cover up to 22% of salary costs for certain “high impact” jobs – up to $200,000 per job. The Legislative Fiscal Office estimates it would cost $347 million over five years:
Moller questions whether the High Impact Jobs Program will live up to its name. By linking the incentive to what’s already a below-average parish salary, companies won’t be required to move the needle significantly on living wages in his opinion, he said. “We are underwriting payroll of companies that we like, and they don’t even have to be particularly great jobs,” Moller said. “They just have to pay a little bit above average.” … “These kinds of subsidies end up becoming just lagniappe, but not the thing that brings a company into Louisiana,” Moller said.
Private school vouchers hurt rural school districts
Last year, Gov. Jeff Landry and the Legislature created a new program that uses taxpayer dollars to subsidize private school tuition for families. There are already concerns about the ballooning cost of the LA GATOR Program. But as The Times-Picayune | Baton Rouge Advocate’s Patrick Wall and Jeff Adelson explain, lawmakers and residents from rural areas are concerned about limited access to the program.
“In my district, those opportunities just don’t exist,” said Rep. Jack McFarland, R- Jonesboro, whose district includes Winn Parish and who, as House Appropriations chair, plays a big role in deciding how to allocate state money. McFarland said he’d rather see more funding for public schools, which anchor many rural communities but operate on shoestring budgets. “They haven’t had an increase in years,” he said.
Wall explains how the state’s private school voucher program will create a financial crunch for underfunded public schools.
In small rural districts, losing even a few extra students to private or home education would make it even harder to afford building upgrades or higher pay. And as state funding for private education expands, the likelihood of increased aid for public education shrinks. Amber Cox, a school board member whose son is in the fourth grade at Winnfield Primary, said she supports the goal of giving parents more school choices. Yet she also wants the state to invest more in public schools like the one her son attends.
USDA cuts hurt families and farmers
The Trump administration recently terminated two U.S. Department of Agriculture programs that paid farmers to provide fresh and minimally processed foods to schools and food banks. Jazmin Orozco Rodriguez of KFF Health News reports on the far-reaching consequences of these cuts:
The collision between rising demand and falling support is especially problematic for rural communities, where the federal program might cover 50% or more of food supplied to those in need, said Vince Hall, chief government relations officer of Feeding America. … Farmers who benefited from the USDA programs that distributed their products to food banks and schools will also be affected. … [Director for the Southeast region of Common Market Bill] Green said his organization won’t be able to fill the gap left by the federal cuts, but he hopes some schools and other institutions will continue buying from those farmers even after the federal support dries up.
Feeding Louisiana has created a petition urging Gov. Jeff Landry to oppose the USDA’s termination of the Local Food Purchase Assistance (LFPA) Program and the Local Food for Schools (LFS) Program. Sign here.
Number of the Day
132,000 – Estimated number of Louisianans who would lose Medicaid coverage under potential federal work requirements. (Source: The Commonwealth Fund)