Louisiana to use food stamp data for Medicaid expansion

Louisiana Gov. John Bel Edwards speaks during the opening of a special legislative session in the state House chamber in Baton Rouge, La., Sunday, Feb. 14, 2016. Edwards signed Medicaid expansion into law in January. (AP Photo/Gerald Herbert) AP

Following Louisiana politics for a living is enough to make anyone cynical — frankly, the vocation probably attracts those of us with a jaded view of the field in the first place — but lately I’ve been mulling over ways in which the state’s proverbial glass is actually half full.

I owe the mood to my colleague Quin Hillyer, who devoted his column last week to looking on the bright side and highlighting some ways in which our political class has gotten things right. I concur with much — maybe not all — of what he said, including his praise for the Louisiana Legislature’s history of bipartisanship, and on a very related note, accomplishment. In that spirit, I’ve got my own list of areas in which Louisiana policies make things better for the people of the state.

Near the top is Gov. John Bel Edwards’ very first move in office, and one he rightly considers his most important accomplishment: expanding Medicaid, largely at federal expense.

For a state as poor as Louisiana is, and with health outcomes as discouraging, this should have been uncontroversial. It wasn’t, because after the U.S. Supreme Court declared that key section of the Affordable Care Act optional, Republican leaders across the country, including then-Gov. Bobby Jindal, said no — effectively sending taxpayer money to other states but not Louisiana.

That may have been an easy political call in places where the president behind “Obamacare” was unpopular. But it was no way to look out for the well-being of the citizenry, or to protect the economic interests of any state.

A recent New York Times story highlights just how badly the states that have rejected Medicaid expansion are faring. It noted that the states that haven’t expanded Medicaid, or did so just recently, accounted for nearly three-fourths of rural hospital closures between 2010 and 2021. And it highlighted an analysis backing up one of Edwards’ key arguments: Increased access to preventive care and early interventions saves lives. Tragically, the National Bureau of Economic Research estimated that 16,000 Americans who lost their lives would have survived had the expanded coverage been available everywhere, as the law’s architects intended.

Louisiana is often negatively compared to Texas and Florida, both among the 10 remaining holdouts. On Medicaid expansion, this is the state that got it right.

Something else Louisiana did right years ago is enact a unique consumer protection law concerning property insurance. Except under specific limited circumstances, homeowners who’ve been with a company for three years cannot be dropped without cause as long as the company sells policies in the state. Way too many Louisiana residents have lost coverage recently due to company failure or withdrawal from Louisiana, but without this provision, the crisis would likely be far worse.

Also on my list is the last surviving benefit of the Stelly Plan that voters adopted two decades ago. For the constant talk about the need to reform the state’s tax structure, the Stelly Plan actually did so by making income taxes slightly more progressive and removing regressive state sales taxes on food, utilities and prescriptions.

The income tax changes are long since dismantled, but the provision governing state sales tax on necessities survives. Because it does, lower income residents who generally pay a larger proportion of their income on sales taxes than those who are better off get at least a small break.

There was never a guarantee that any of these policies would be enacted, and there’s no promise that they’ll continue forever. Things change at the Capitol, and not always for the better; that bipartisanship that Hillyer appropriately celebrated is on the wane, for example, replaced by a growing Washington-style partisanship among today’s legislators.

Medicaid expansion does appear to be on solid ground once Edwards leaves office next year, even if he’s replaced by a conservative Republican bolstered by the new GOP legislative supermajority, because the benefits are by now firmly established.

But the Legislature might soon consider repealing the three-year insurance law in an effort to lure companies that don’t like it to write more policies here, Senate Insurance Committee Chair Kirk Talbot, R-River Ridge, said recently. And state Rep. Phillip R. DeVillier, R-Eunice, has filed a bill for the upcoming session proposing to eliminate those Stelly sales tax exemptions.

Here’s hoping lawmakers think long and hard about how these changes would affect the people they serve — and whether they really want to mess with that rarity in Louisiana politics: a good thing.

Email Stephanie Grace at sgrace@theadvocate.com or follow her on Twitter, @stephgracela.