A Louisiana task force reports that repealing the Affordable Care Act could cost the state more than $4 billion and put coverage at risk for more than 900,000 people, though some members objected to the report’s “politically slanted” “doom and gloom.”
The Louisiana Department of Health says the state would lose $3.5 billion if it lost the ACA’s Medicaid expansion funding, based on the fiscal year 2020 forecast, according to the final report of the Protecting Health Coverage in Louisiana Task Force approved Wednesday. Gov. John Bel Edwards created the task force last year to study how the success of a lawsuit seeking to overturn the ACA would affect the state.
The Legislative Fiscal Office, in consultation with the Department of Insurance, estimates it would cost state government $536.18 million to backfill the loss of federal subsidies that help some individuals buy policies they couldn’t otherwise afford. Blue Cross Blue Shield of Louisiana said the total would be about $482 million, the report says.
But Beverly Haydel, a task force member representing Attorney General Jeff Landry, called the report “politically slanted.” She objected to the “doom and gloom scenario” that Congress won’t replace the federal funding through another mechanism if the ACA is invalidated, noting that members of Louisiana’s delegation have pledged to keep the money flowing. Landry is one of the state attorneys general who sued to throw out the law.
“It’s unreasonable to assume that once the ACA is declared unconstitutional in its entirety that Congress will not provide funding for states to provide coverage to their most vulnerable citizens,” Landry said via Twitter.
But other task force members said Congress moves slowly and there is no guarantee a sharply divided federal government would fix anything.
“Hope is not a strategy,” said Matthew Block, Edwards’ executive counsel, who chaired Wednesday’s task force meeting. Block said the report is “realistic” in its assessments.
“We don’t have a crystal ball,” said state Sen. Regina Barrow, a Democrat representing the Senate Health and Welfare Committee. “If we plan for the worst, we’ll be prepared if it’s not the worst.”
Haydel and Frank Opelka, representing Louisiana Commissioner of Insurance Jim Donelon, also objected to including a Kaiser Family Foundation estimate that 932,000 non-elderly Louisiana residents would be at risk of losing coverage because they have a health condition insurers don’t want to cover. Under the ACA, coverage of pre-existing conditions is guaranteed.
While most people get health insurance from their employer or the government, someone whose employment or health status changes might not be able to maintain adequate coverage, the report says. But Opelka said it is “exceedingly unlikely” 932,000 people would lose their health insurance.
“I don’t know what the correct number is,” he said. “The reality is still bad.”
Task force members approved the report by a 9-1 vote, with Haydel voting against and Opelka voting “present.”
Last year, Louisiana lawmakers approved Act 412, which would replicate many of the ACA’s protections at the state level, though the law can only be implemented if the legislature finds enough money to pay for it.