If Congressional Republicans and President Donald Trump are ultimately successful in repealing the Affordable Care and Patient Protection Act (more popularly known as Obamacare), Louisiana stands to lose 37,000 jobs, $639.7 million in revenue, $39.1 billion in business output, and $21.5 billion in gross state product (GSP) and strip health insurance from more than 400,000 people, according to multiple reports published by non-partisan organizations and projections released by the Congressional Budget Office.
These losses would practically guarantee financial insolvency for a state that has already been lunging from one budget crisis to the next during the last four years, thanks almost entirely to the ineptitude and dishonesty of the state’s Republican leadership and the failure of the state’s Democrats to effectively champion a law that saves both lives and money.
Remember, of course, that for nearly six of his eight years in office, Louisiana Gov. Bobby Jindal did everything in his power to oppose the implementation of Obamacare. He refused to set up a state-based marketplace. He lambasted the law in blistering editorials in both state and national publications and nearly every time he appeared on cable news. He made his opposition to Obamacare into the centerpieces of his campaign for re-election and his brief attempt at the presidency.
Jindal has always fashioned himself as a health care policy expert. When he was only 24 years old, he earned his first job in public service, the Secretary of Louisiana’s Department of Health and Hospitals, the youngest person in state history appointed to a cabinet-level position, largely due to a white paper about health care policy that had impressed the then newly-elected governor, Mike Foster. A few years later, he worked for President George W. Bush in crafting the massive Medicare Part D plan.
Although the framework of the Affordable Care Act was initially conceived by conservatives and first implemented by a Republican governor, Bobby Jindal smeared the law as a “government takeover,” which played well to his base of supporters who were already reflexively opposed to anything with the imprimatur of Barack Obama.
In the meantime, however, during his two-terms as governor, Louisiana suffered from from some of the worst health care outcomes and the highest proportions of the uninsured in the entire country. Jindal made draconian cuts to health care spending, forcing the closure of emergency rooms and hospitals throughout the state and entering into questionable deals with large corporations to privatize a charity system that had once been the envy of the rest of the nation.
But most egregiously, for nearly six years, Bobby Jindal refused to accept billions of federal dollars that Louisiana was guaranteed to implement Medicaid expansion, a decision that eventually earned the ire of his Republican colleagues. He left Louisiana with a broken and bankrupted health care system and a budget deficit of more than a billion dollars, which isn’t a paltry sum in a state as small as Louisiana.
Every major candidate who ran to replace him as governor, including all three Republicans in the race, promised to reverse Jindal’s decision on Medicaid expansion. Voters, however, weren’t willing to take the chance of trusting another Republican with the keys to the Governor’s Mansion, and on Nov. 21, 2015, they shocked the entire country by electing the Democratic candidate, John Bel Edwards, by more than 140,000 votes and 12 points over Republican and senior U.S. Sen. David Vitter, a man who had once been considered a shoo-in for the job.
Almost immediately after taking office, Gov. Edwards moved to accept the federal government’s funding for Medicaid expansion. Within the very first year, Louisiana saved $184 million as a result, which was critical in patching a budget crisis that threatened to undermine the state’s credit rating and bond capacity.
Today, according to numbers released by the state’s Department of Health and Hospitals, more than 408,000 people in Louisiana now have health insurance as a direct result, and already, the law has saved nearly 2,000 people from dying of colon cancer and helped nearly 100 women in the diagnosis and treatment of breast cancer.
According to an analysis conducted by members of both the U.S. House Committee on Energy and Commerce and the U.S. House Committee on Oversight and Government Reform and based on projections reported by the non-partisan Congressional Budget Office, the ongoing effort to repeal Obamacare would immediately result in 193,000 Louisianans losing health care coverage through Medicaid expansion and an additional 170,800 Louisianans losing health care coverage as a result of eliminating federal stipends for the purchase of private insurance. All told, a repeal would immediately cost 363,800 Louisiana residents to lose their health care insurance.
A more recent analysis conducted by David Cutler, a professor of applied economics at Harvard University and Emily Gee, a health economist at the Center for American Progress, is even more dire. They conclude that 403,500 Louisianans would lose their health care insurance if the Affordable Care Act is repealed and replaced with the plan being currently proposed by Republicans in Congress and supported by President Donald Trump.
Both of these analyses, based on real data collected by non-partisan and objective sources, reveal that the implementation of Obamacare has already resulted in massive gains in the rate of people in Louisiana covered by health care insurance. The two House committees broke down this data on the congressional district level:
- The uninsured rate in Louisiana’s First Congressional District, currently held by Republican Steve Scalise, has dropped from 15.5% to 11.4%, a decrease of 4.1%.
- The uninsured rate in Louisiana’s Second Congressional District, currently held by Democrat Cedric Richmond, has dropped from 18.3% to 13.%, a decrease of 5.0%.
- The uninsured rate in Louisiana’s Third Congressional District, currently held by Republican Clay Higgins, has dropped from 17.0% to 12.1%, a decrease of 4.9%.
- The uninsured rate in Louisiana’s Fourth Congressional District, currently held by Republican Mike Johnson, has dropped from 16.1% to 12.9%, a decrease of 3.3%.
- The uninsured rate in Louisiana’s Fifth Congressional District, currently held by Republican Ralph Abraham, has dropped from 20.9% to 14.0%, a decrease of 6.9%.
- The uninsured rate in Louisiana’s Sixth Congressional District, currently held by Republican Garett Graves, has dropped from 13.7% to 8.3%, a decrease of 5.4%.
And there’s more.
In January, the non-partisan Milken Institute of Public Health at George Washington University and the Commonwealth Fund collaborated on an analysis of state-level economic impacts that would occur if the Affordable Care Act were to be repealed. (You can read about their methodology here). Their findings about Louisiana were staggering: 37,000 lost jobs, spread out over a variety of sectors; nearly $640 million in lost revenue, and tens of billions in lost business output and gross state product.
There is no question that the Affordable Care Act, just like any other government program, will continually need to be refined and that there are structural deficiencies that require immediate attention. But there’s also no question that, even in its very first year of full implementation in Louisiana, the law has been staggeringly effective and incredibly beneficial for both the state’s finances and its general welfare.
If Louisiana Republicans refuse to acknowledge the facts, they relinquish any claim they may have as the party of “fiscal responsibility.”