- Associated Press - Wednesday, May 11, 2016

Recent editorials from Louisiana newspapers:

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May 11

The Times-Picayune on Medicaid expansion in Louisiana:

Louisiana is behind on expanding Medicaid because the state refused to accept the extra federal money until Gov. John Bel Edwards took office in January. But an innovative approach by the Department of Health and Hospitals could allow tens of thousands of eligible residents to be approved almost immediately.

That could make a huge difference for those families and would jumpstart the state’s effort to sign up an estimated 375,000 Louisianians expected to qualify for Medicaid under the expansion.

DHH officials are “highly confident” that federal Medicaid officials will approve their request to use food stamp records to add uninsured residents to the health care program for low-income residents. A half-dozen other states have been allowed to fast track their enrollment process, but Louisiana would be the first one to use food stamps.

That would not only save time for families, but it would save money for the state as it implements the expansion. “We don’t have to make an eligibility decision” for food stamp recipients, said Ruth Kennedy, who is overseeing the state’s Medicaid expansion. That judgment has already been made by the Supplemental Nutrition Assistance Program, which issues food stamps.

Ms. Kennedy, who formerly served as DHH’s Medicaid director, said the agency is getting ready to send out 100,000 letters to uninsured Louisiana residents who are eligible for coverage based on the food stamp rolls. All they need to do is answer a few questions about their household and send the information back to DHH. They can email, phone or fax to get enrolled. Coverage begins July 1.

DHH also is enrolling people who participate in the Greater New Orleans Community Health Connection and the Take Charge program. The Medicaid expansion will give those patients more benefits, including access to prescription medications.

For other enrollees, Ms. Kennedy is hoping to deploy 90 eligibility workers to 60 locations across the state to sign people up. The Legislature should make sure money is in the budget to cover those costs.

It is refreshing to see Gov. Edwards’ administration come up with creative ways to get the expansion in place quickly.

“I think it makes a huge difference, and it makes a lot of sense,” said Adam Searing, a senior research fellow at Georgetown University’s Center for Children and Families. “What the experience has shown us so far is that people are very motivated to sign up because it’s such an expense and a benefit to be able to go to the doctor. But there’s not one day when everyone signs up. It typically takes a few years” to get everyone enrolled.

Under the expansion, families can make up to 138 percent of the poverty level. The state expects that change to bring in 375,000 low-income Louisiana residents who had earned too much to qualify for Medicaid coverage before. Processing all those people is a huge undertaking.

DHH Secretary Rebekah Gee was smart to put Ms. Kennedy in charge. She led the state’s successful implementation in the 1990s of LaCHIP, the Medicaid-funded children’s health program.

The LaCHIP process was streamlined to get thousands more children enrolled. Children who were eligible for the Supplemental Nutrition Assistance Program were automatically enrolled in Medicaid, which has the same eligibility requirements.

Louisiana’s push to get more low-income children covered by health insurance paid off. In 2003, a DHH survey found that 11.1 percent of Louisiana children were uninsured. By 2011, that number was down to 3.5 percent.

Having health coverage makes it easier for a family to get preventive care. That helps keep people healthier, which is good for them and for the state as a whole.

Thankfully, the Edwards administration understands that.

Online:

http://www.nola.com/

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May 10

The Daily Advertiser on the TOPS college scholarship:

Cameron Henry’s gambit to fully fund TOPS is great news for many graduating, college-bound seniors. For Louisianians who are poor and in bad health, not so much.

Henry, Republican senator from Metairie, convinced the House Appropriations Committee, which he chairs, to shift budget money from other expense areas to the highly popular state scholarship program, fully funding it while leaving Louisiana’s charity hospitals short on funds for Fiscal Year 2017, which starts in July.

Specifically, Henry’s effort would leave the charity hospitals some 6 percent short, which he dismissed as making the state institutions live within their means. Maybe so, but such a measure may be far more onerous than that. Here in Lafayette, it could endanger the medical residency program that has been bolstered and expanded under Lafayette General Health System over the past three years.

Gov. John Bel Edwards’ preference would be to cut TOPS and fund indigent care, tending to TOPS spending during a special session he will call following this regular 2016 legislative session. Both demand funding: Louisiana has tended to its indigent sick for centuries; TOPS has become something akin to a contract between state government and Louisiana’s high school students.

So, should we let the sick go untreated or keep our young people from college?

In truth, this showdown may be based upon partisan, political druthers. Henry, the conservative Republican, prefers a program that the state’s middle class embraces. And why shouldn’t the middle class get some benefits? Working Louisianians send a lot of money to Baton Rouge.

Worse, families who have planned on TOPS to fund some of their children’s college expenses may be in a world of hurt if TOPS is not funded. Through the TOPS program, the state has made something akin to a pact: If students meet (admittedly low) standards - pass an established curriculum, meet GPA and ACT requirements - the state will pay a portion of their college expenses. To break that promise now would devastate some students’ chances of attending college.

Edwards, a mainstream Democrat, would opt to protect a safety-net program for the poor, which is completely defensible, part of what makes Louisiana a special state.

Funding both would be difficult, if near impossible, under current state funding. Next year’s budget faces a hole of some $600 million. But not funding either would represent a woeful neglect of some portion of Louisiana’s people.

There are other answers - raising taxes, cutting tax breaks, trimming government programs - but none are painless. Leaders are elected to make tough decisions, and must, soon.

Henry and Edwards may be outlining the limits of the continuing debate. The answer is likely in between. With session’s end on June 6, the debate should be further along.

Online:

http://www.theadvertiser.com/

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May 10

The Advocate on the Inspector General’s Office:

Is there a better case of “penny wise, pound foolish” than saving money by cutting the budget of one of the agencies that is a watchdog over public corruption?

The argument, heard over several years in the Legislature, is that the state does not need an Inspector General’s Office because those investigators’ work may overlap with those of the larger Legislative Auditor’s Office.

At one time, the House Appropriations Committee actually cut the small appropriation for the inspector general’s operation, about $2 million a year. The budget ultimately was restored by the House.

This year, appropriators once more cut the inspector general’s budget out of House Bill 1. It was part of a 55-page amendment reworking the bill, offered by Rep. Cameron Henry, R-Metairie, chairman of the Appropriations Committee.

That should not stand.

Is there too much overlap in what the two agencies do? We don’t think so, at least in theory. The inspector general is intended to be an entirely independent investigator of potential malfeasance in any level of government, with its findings reported directly to the governor for action.

The Legislative Auditor’s Office also does investigations, although typically, its agenda includes more comprehensive looks at an agency. Its reports are much more typically the “paper trail” that could, of course, expose wrongdoing as well as waste. Louisiana State Police also have manifold other duties, and their head is a direct appointee of the governor, hardly politically as independent as the inspector general. An office like that of Inspector General Stephen Street is not going to please everybody, particularly local officials whose actions, or those of their employees, are reported to the inspector general for investigation.

They also can be criticized by those who don’t feel they are hard enough on officialdom: We recently have been critical of the inspector general’s report into the ongoing saga of Burl Cain, former Louisiana State Penitentiary at Angola warden. If there are some overlapping responsibilities, that is why it is important that the inspector general and Legislative Auditor Daryl Purpera have a good working relationship with each other, as well as with law enforcement with whom both could cooperate in a criminal matter.

To cut the inspector general’s budget seems a classic case of saving some pennies but costing the taxpayer more in the long run because the tips the investigators receive may result in an investigation that can save a lot more money than the annual cost of the office.

We agree with Gov. John Bel Edwards, who told the Press Club of Baton Rouge that the savings from cutting spending on the office would not offset the hit on public confidence if the state is paying for the watchdogs over the public’s money.

Penny wise, pound foolish.

Online:

http://theadvocate.com/

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