Oddly, for a candidate who constantly flung the honor code of his West Point days in the face of voters, Gov. John Bel Edwards seems intent upon avoiding an honest debate over Louisiana’s fiscal year 2019 budget.
In unveiling his proposed budget last month, Edwards offered deep cuts concentrated in health care — unsurprisingly as nearly half of state spending occurs in that area. Exceeding $650 million, that hit mostly comes from cutting payments to the state’s designated safety-net hospitals and nursing homes, eliminating or curtailing those Medicaid services that allow the elderly and children with disabilities to live in the community, and substantially slicing mental health and substance abuse programs.
Edwards argues that only permanent tax increases could prevent these and other cuts totaling more than $1 billion (his budget makes modest spending increases in a few areas). He claims that the state has cut enough already, arguing he has helped to whack approximately $700 million during his time in office.
Nonsense. Edwards’ spending plan is rife with false choices, and his defense of tax increases instead of cuts is full of false information.
With two strokes of his pen, Edwards could find funds to restore over half the pared health care dollars. He could bring nursing homes under managed care, saving about $200 million annually. In addition, emulating 17 states’ practice of asking Medicaid recipients for copayments that cost about as much as a pack of cigarettes and charging them only $75 for a hospital stay would bring in another $172 million yearly.
In the past, Edwards voiced support for both. And it seems like a slam dunk to pursue an alternative that would increase rather than decrease home- and community-based services, as well as something that expands, not contracts, the ability of health care providers to serve Medicaid clients.
When the truth hurts, Democratic Gov. John Bel Edwards feels the need to distract voters from it.
Edwards could do more. Unlike other states, Louisiana guarantees free health care to people whether insured below the 200 percent federal poverty limit, even as Medicaid expansion or federal law already make health care essentially free to those below the 139 percent level. If Edwards helped reverse the policy, the state could realize another $65 million in savings and reduce its uninsured rate that remains stuck at 11 percent even after Medicaid expansion.
Nor does Edwards include in his budget an estimated $226 million in additional revenues stemming from changes to federal individual income tax rates, with these funds already in the pipeline following the recent release of new withholding tables by the federal government. Further, his administration refuses to provide an estimate of almost certain, similar gains from changes to federal corporate income tax rates.
Finally, Edwards’ assertion of past cuts, used to contend that government has downsized enough, employs budgetary smoke and mirrors for which he criticized his predecessor, Bobby Jindal. Among other things, he uses double counts, reductions subsequently reversed, delayed payments, and counterproductive actions that will cost more in future years and that, if altogether excluded, shave about two-thirds off the figure he cited.
In reality, with state-generated spending having grown twice as fast as inflation over Edwards’ two years, cutting remains a viable option. Moreover, revoking preferential treatment of nursing homes and asking those receiving the gift of free health care to pay their fair share if able, along with recognizing higher state income tax revenues, would keep cuts relatively small. That would require little, if any, permanent tax increases to balance the budget.
But in his quest to lock in inflated state government by taking more of what people earn, Edwards can’t admit those realities — even if it means disingenuously distorting the budget debate.
Louisiana lawmakers will return to the Capitol this month for another special session to try to shore up the state's finances. Again.
Jeff Sadow is an associate professor of political science at Louisiana State University-Shreveport, where he teaches Louisiana government. He is the author of a blog about Louisiana politics at www.between-lines.com, where links to information in this column may be found. When the Louisiana Legislature is in session, he writes about legislation in it at www.laleglog.com. Follow him on Twitter, @jsadowadvocate or write to email@example.com. His views do not necessarily express those of his employer.