Issues

Lawmakers Find Louisiana Alternative to Affordable Care Act Might Not Be Affordable

Louisiana State Capitol
Louisiana State Capitol / Wikimedia Commons

Louisiana lawmakers on Wednesday reviewed two bills that would create a state-level replacement of the federal Affordable Care Act, also known as Obamacare, if the ACA is thrown out by the courts. They learned the state may not be able to afford to replicate the act’s protections.

Attorney General Jeff Landry is supporting a lawsuit that seeks to have the ACA declared unconstitutional. He also supports Senate Bill 173 by Sen. Fred Mills, R-New Iberia, to preserve in Louisiana some of the most popular aspects of the ACA, such as guaranteeing access to insurance for individuals with pre-existing medical conditions.

But if the entire ACA is declared unconstitutional, hundreds of millions of dollars in federal subsidies would go away, and Louisiana doesn’t have the money to fill the gap. A fiscal note attached to the bill said it could cost $256 million next fiscal year and $634 million annually by fiscal year 2024.

An amendment to Mills’ bill clarifies it would only go into effect if a funding source can be found. Mills admitted he had no ideas about potential sources but said his bill "starts the conversation."

"I do believe it’s a farce," Sen. Dan Claitor, R-Baton Rouge, said of the bill. "It’s feel-good legislation to tell folks we’re going to take care of you if we find a pot of gold at the end of the rainbow."

Mills agreed to withdraw his bill and "go back to work" on it.

Gov. John Bel Edwards is supporting House Bill 237 by Rep. Chad Brown, D-Plaquemine, which has similar goals. Edwards addressed the House Health and Welfare Committee about the bill Wednesday.

"We can all agree the Affordable Care Act is flawed," he said. But Brown’s bill seeks to protect those aspects that "pretty much everybody believes in," Edwards said, including guaranteed access to health insurance for about 850,000 Louisiana residents with pre-existing conditions.

The fiscal note to the original version of HB 237 projects a $280 million cost next fiscal year and anywhere from $683 million to $834 million by fiscal year 2024. Brown amended his bill to say it will not take effect if the entire ACA is thrown out.

But it is possible only parts of the act will be invalidated. Brown’s bill would preserve the act’s protections if premium tax credits that subsidize those protections are maintained.

Brown’s bill was discussed Wednesday but no vote was taken. Another hearing is planned for next week.

In other legislative session action on Wednesday:

• The House Health and Welfare Committee advanced a measure that would raise the legal age to smoke or vape tobacco from 18 to 21. Supporters say many people get addicted to cigarettes young, so raising the age could lower the state’s smoking rate and improve overall health in a state often ranked among the least healthy in the nation.

Rep. Larry Bagley, R-Stonewall, said he could not support the measure, arguing that someone who is old enough to vote and die for their country is old enough to make their own decision about using tobacco. Some anti-smoking activists worry the penalties in the bill are not strong enough.

• The Senate unanimously approved House Bill 391, which creates the Veterans First Business Initiative. Louisiana Economic Development would certify a business as veteran-owned and cooperate with the Department of Veterans Affairs local chambers of commerce, regional economic development organizations, and local economic development organizations to promote veteran-owned businesses.

• The Senate and Governmental Affairs Committee advanced a measure that could eventually allow Louisiana to become the 38th state to enact the Equal Rights Amendment to the U.S. Constitution. The amendment would ban gender discrimination.

Louisiana’s approval would be enough to ratify the amendment, except for the fact that the deadline set by Congress passed in 1982. Some activists and federal lawmakers are calling for that deadline to be abolished.