By Mike Stagg

Governor Bobby Jindal continues to fight healthcare reform even though the political fight is over now that the Affordable Care Act (ACA) is the law of the land.

Since President Obama signed it into law, Jindal has ordered Attorney General Buddy Caldwell to file suit against the law. He has reversed Insurance Commissioner Jim Donelon’s plan to participate in the high-risk pools the law creates which provide coverage to adults who have been denied coverage due to pre-existing conditions. And he’s had DHH Secretary Alan Levine act as the administration’s public face in the effort to pass a constitutional amendment here to nullify aspects of the ACA, particularly the individual mandate to buy coverage.

These moves might advance the governor’s national political ambitions, but they are bad for Louisiana and harmful to its citizens.

The ACA addresses much of what ails healthcare in Louisiana. Chronic disease is rampant in our state, particularly heart disease, diabetes, high blood pressure and cancer. We have higher death rates from those diseases here than the rest of the country. This is because these diseases go untreated for too long. When people finally go to a doctor, the disease has reached more advanced stages and is harder and more expensive to treat.

That these chronic diseases go untreated for so long is largely attributable to the fact that people don’t have access to care to detect those diseases at the earliest stages. The primary barrier to care is cost.

The ACA will knock down that barrier by providing tax breaks to businesses and subsidies to individuals so that they can afford insurance. That coverage will enable Louisianans to get the care they need when they need it.

The act also mandates that insurance pay the full cost of regular checkups and wellness exams, making it more likely that chronic diseases will be detected earlier.

The prevalence of chronic disease in Louisiana also restricts the ability of residents here to get insurance. The pre-existing condition exclusion severely limits the ability of small businesses to get coverage. It also limits the freedom of Louisiana citizens to change jobs or start businesses because of their inability to get coverage. The pre-existing condition exclusion for adults will be outlawed under ACA by 2014. The ACA will eliminate the pre-existing exclusion for children this summer.

The biggest burden on healthcare providers in Louisiana is the large percentage of people who don’t have health insurance and can’t pay for the care they need. Over the past five years, that percentage has fluctuated between 18 and 24 percent of adults between the ages of 19 and 64.

Providing healthcare to those without insurance is a major financial burden on doctors, clinics and hospitals. It drives up the cost of care for those with insurance as providers shift costs for care for those without insurance onto those with the deepest pockets — health insurance companies. Cost shifting adds an estimated $900 to the annual cost of premiums for each person insured.

The ACA will dramatically lower the number of people without either health insurance or Medicaid coverage. That will benefit providers who will have more paying customers. That will help those with health insurance as the need to shift costs onto those with coverage dissipates.

The act expands Medicaid eligibility to those earning up to 133 percent of the poverty level. The federal government will initially pick up the tab for the Medicaid expansion, and later it will cover 90 percent of the cost. Jindal claims the state will not be able to afford this cost whenever it arrives. He apparently believes state revenues will never increase again. Or, perhaps, he’s just philosophically opposed to people being able to access care without government assistance -- an odd position for someone who has worked in government for most of his adult life.

The Affordable Care Act is good for what ails Louisiana. Expanding access to affordable health insurance will improve the quality of life for our citizens and the financial viability of community hospitals and other providers. It will enable residents to afford the care they need in order to manage the chronic diseases that plague them and help children avoid those diseases or detect them while they are still manageable.

Governor Jindal needs to quit looking at this issue through the lens of his national ambitions. If he does that, he will quit fighting ACA and embrace the positive changes it will bring to our state.
Stagg is a Lafayette-based healthcare information technology consultant and editor of the newsletter Democratic Louisiana.
Copyright (C) 2010 by Louisiana Forum 6/10


Mistress B said...

Medicare is one that will pay that portion of the bill not covered by Medicare as well as cover some additional health services not provided by Medicare. For example, some Medigap policies provide limited prescription drug coverage, a benefit not provided by Medicare.Medicare Supplement Plan J is one of the Federally-standardized Medicare Supplement plans. Much has been written and discussed about the upcoming June 1, 2010 changes to the standard Medicare Supplement plans. One of the major changes with the modernization of the plans is the elimination of several plans, including Medigap Plan J. It is important to note, however, that existing Plan J policyholders will not lose their current Plan J coverage with this modernization of the plans.
Medigap Insurance

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