Tag Archives: Medicaid expansion

Jackson-Hewitt Figures Costs for Employers for State Refusals under Obamacare in Billions

New Orleans  Credit to where credit is due, you have to give the devil his due, Jackson-Hewitt, the tax preparers, performed a public service in trying to calculate what businesses are going to have to pay, partially as a result of recalcitrant, Republican denials of full coverage protections under the Affordable Care Act (ACA), and the price tags are in the billions.  I know Jackson-Hewitt well, having been out to the New Jersey suburbs to their offices to negotiate with them regularly when we were not meeting in Manhattan with their general counsel at their spaces near Times Square, and met with their folks from top to bottom to negotiate agreements to reduce the practices and the costs of refund anticipation products.

In the summary of their report they cite the cost to Texas to mid-sized employers with over 50 workers due to the Governor’s refusal to accept ACA at between $250 million and almost $500 million.  In just the 22 states where governors are denying health care, the estimated burn ranges from $800+ million to $1.2 billion.  Nationally all of the potential penalties could range several billion for employers.

Governors’ like Louisiana’s Bobby Jindal are clearly sweating the numbers because they have been pretending that all they were really doing was killing off more poor people by denying coverage expansion, and figuring that their base doesn’t really care so much about that, but these mid-sized businesses are their bread and butter.  Jackson-Hewitt called the Louisiana number for employer payments of penalties at between $51 million and $72 million.  Meanwhile in the Baton Rouge Advocate reports clearly on the dispute as Jindal’s head of Health and Hospitals tried to defend his claim that the cost would only be about 10% of what Jackson-Hewitt’s conservative numbers showed.  The Jackson-Hewitt spokesperson volunteered to meet with Jindal’s folks and show them the math, pointing out that they didn’t have a “dog in the race” because they actually make more money doing the tax returns for businesses having to pay the penalties.  What a painful irony this is!   Jindal’s guy tried to claim that he was sticking to his story, no matter what the facts were, which I read as him really saying that his own job depended on his “lying eyes” as Richard Pryor called it.

The piper is going to be paid by more than just poor people for this last stand at the schoolhouse by these governors.  Here are the Jackson-Hewitt numbers, and thanks again for them!


Venal Politics of Ambition, Ideology, and Contributions Crippling Louisiana Healthcare

New Orleans  What often goes unsaid when the right pontificates and proselytizes about the wondrous benefits of privatization or public-private so-called “partnerships,” is the how much this is all simply a rationalization for personal ambition and the need to raise huge campaign contributions to fuel that fire.

We see this now, painfully and almost daily, in Louisiana while watching the gyrations of Governor Bobby Jindal to cripple the healthcare and educational institutions in the state that go back literally to the days of Huey Long.  His naked ambition as a wildly long shot aspirant for higher office means that he has to raise huge money to campaign and it is easy to tell his desperate strategy is two-fold, by first appealing to the rich ideologues pulling the Republican tail these days and secondly, asset-stripping by leading a giveaway of the state’s long established public hospital system to unnamed private hospital corporations for huge expected later contributions.

On his way out of town for another fundraising and headline hoping trip, Jindal announced his budget proposal.  Of course more cuts for higher education which has endured 5 straight years of reductions, which will force tuition increases.  Jindal wants to avoid having to own the responsibility by having his people claim that tuition increases will be at the decisions of the individual boards and chancellors.  Yeah, right!   In health care Louisiana once led the country in establishing public hospital care, but now Jindal is dismantling the system wholesale.  Of the ten remaining public hospitals within the LSU system, five have already been forced into public-private partnerships.  Two others have guns to their heads.  The hospital in Monroe in the northern part of the state was only put in the budget for the first three months of the new fiscal year.  Seems like that would be a hard message to miss if the hospital administrator was hoping for better bargaining chips in negotiating with private hospital companies, but the budget bullet puts pressure for little more than a cave-in with the governor to thank.

The billion dollar new hospital finally being built in New Orleans where we have been a healthcare desert since Katrina now worries that all of the numbers were wrong on their projections for operating budgets for the facility, since they had calculated them on the assumption that healthcare would be expanding through the Affordable Care Act (ACA).  It had never occurred to these state, city and federal healthcare planners that a far right ideologue in the governor’s chair would deliberately deny a free expansion of healthcare for uninsured citizens in our poor city and region.  Of course Jindal a captive of the Koch types, preferring to be consistent rather than right, literally answers the question of reconsidering his decision in the wake of other Republican governors recanting by laughing.  It’s the kind of response you would probably expect from someone who has also now devastated the prospects of mental health assistance in the state that might have benefited him personally.

Where did this notion come from that public assets and institutions are simply commodities that can be traded away at the whim of individual politicians?  The pretense of public service has to include restraint when embarking on destroying institutions that are hundreds of years standing and critical to citizens, especially those without alternatives.  The road to privatization has long been paved by campaign contributions from the benefiting parties, and certainly none of us are naive in thinking that big time politics is other than big time business.  A governor or politician of any persuasion in this time where money plays such an outsize role can only expect thanks from citizens for continuing to provide first class public services, but contributions flow freely when public assets are transferred to private parties in the name of whatever.

Meanwhile in this crony capitalism of Louisiana’s healthcare assets, the State of Louisiana will still pay for the privately managed outfits to provide service to the citizens creating a future spiral of state cutbacks to these outfits for declining care for the citizens, until they walk away as well, but that is long after Jindal’s term has expired.  How do they live with themselves?