After getting pushback from lawmakers a week ago, Attorney General Jeff Landry on Wednesday brought forth another health insurance proposal he said would put a framework in place for keeping some of the protections in the Affordable Care Act if his lawsuit seeking to repeal the health law is successful.
A few hours later, a Louisiana House panel killed a competing bill by Gov. John Bel Edwards, the Democratic political rival of Landry who had sought to craft his own protections for people with preexisting conditions.
Both pieces of legislation are hypothetical, relying on the landmark health law being tossed out by the courts before they would go into effect.
But the votes give Landry, not Edwards, the opportunity to pass a law on a popular issue, protecting people with preexisting conditions, even as Landry seeks to repeal that protection at the federal level in the courts.
Edwards and state Rep. Chad Brown, D-Plaquemine, had filed a competing bill to protect some of the health law's more popular provisions. After delaying a vote last week, the House Insurance Committee deferred it on a party-line 7-4 vote, with Republican members siding with Landry on the issue.
“It is an absolute shame that the House Insurance Committee involuntarily deferred HB237 by Rep. Chad Brown today,” Edwards said in a statement. “This is pure Washington-style politics and Louisianans deserve better than that. This was a simple bill that would have enshrined critical preexisting condition protections into state law.”
Both bills ran into a major issue after being filed: The individual exchange costs hundreds of millions of dollars, funded through federal subsidies, to operate. To solve that problem, both Edwards and Landry amended their bills to get rid of the price tag.
After facing pushback from his amended bill last week, Landry made yet another change. If approved by lawmakers now, the bill would grant Insurance Commissioner Jim Donelon the ability to study options for a high-risk pool that might replace the health law's individual exchange if it is repealed. The two officials said they want to model the pool after Maine’s “invisible” pool that subsidizes insurers offering plans for people who don’t get coverage through work or other means.
Louisiana’s individual exchange offers insurance to about 90,000 people who don’t get it from their employer or elsewhere. The biggest effect of the health law on Louisiana is Medicaid expansion, which extended coverage to about half a million people, though neither Landry’s nor Edwards’ bill addresses that federal program.
It is still not clear exactly where the money would come from under Landry’s plan, but lawmakers on the Senate Health and Welfare Committee who were skeptical last week were won over by a presentation by Landry and Donelon. The backers of the bill indicated the state would still need the feds to help pay for it.
“I appreciate the framework. I appreciate perhaps the funding is not clear,” said state Sen. Dan Claitor, R-Baton Rouge. “Nobody is 100% comfortable” with the funding portion yet.
Republican members on the House Insurance Committee were also apparently convinced. State Rep. Kirk Talbot, the River Ridge Republican who chairs the committee, called Landry’s legislation a “good bill,” and said it, unlike Edwards’ bill, provides a “mechanism” for finding funding.
Nick Albares, a policy adviser for Edwards, responded that the administration is not the one “actively trying to get rid of the protections” in the Affordable Care Act.
Landry pitched his legislation as a protection for people with preexisting conditions and said it presents an opportunity for Louisiana to "lead on one of the most important issues of this century, and that's health care."
“This gives the commissioner of insurance the opportunity to study and come back to you and show you something that works,” he told lawmakers.
The Edwards administration has criticized Landry for joining a lawsuit that seeks to repeal the health law. Edwards said last week that it’s “kind of strange” Landry is bringing a bill to include protections currently in a law he’s trying to invalidate.
Edwards said on Wednesday that 850,000 Louisianians with preexisting conditions remain at risk of losing protections if Landry’s “misguided lawsuit” is successful. Landry in committee disputed that number, saying only the 90,000 or so people in the individual exchange are really at risk.
The governor said he’s monitoring Landry’s bill, which is being carried by Parks Republican state Sen. Fred Mills, but he’s concerned that an amendment would allow insurers to charge elderly people more. Landry’s staff said the Maine pool actually decreased costs for people in their 60s by about $7,000 on average.
“It’s also clear that establishing a high-risk pool, as the bill seeks to do, would cost hundreds of millions of dollars that haven’t been identified,” Edwards said. “And it’s not clear that such an arrangement would maintain the current level of protections in law.”
Landry’s amendments introduced Wednesday would let Donelon study high-risk pools and bring a plan back to lawmakers to put in place in case the courts toss the Affordable Care Act. Donelon said he expects some, but not all, of the health law will be thrown out.
“I don’t believe in the history of our country have we seen Congress put people out on the street when they have money already in the budget,” Donelon said, suggesting Congress would fund a replacement for the health law.