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Louisiana editorial roundup

July 3, 2019

Recent editorials from Louisiana newspapers:

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June 30

The Advocate on Louisiana’s stable budget as the fiscal year closes:

With the June 30 end of the fiscal year, Louisiana closes the books on a much more sedate note than in the previous few years.

One simple reason: money.

State government had more of it, after legislators and Gov. John Bel Edwards compromised on a 0.45 cent increase in the state sales tax. That was the principal result of four years of debate over taxes and the budget that arose after eight years of financial crises during former Gov. Bobby Jindal’s two terms.

While a half-cent sales tax on consumers was part of the reason for new money in the budget, there were also some cuts in business tax breaks and other legislation that raised revenues in the chaotic 2016 political environment.

A House Republican caucus led by its most hardline members — many of them willing accomplices in Jindal’s policies before — entered the tax and budget debate in opposition to Edwards, a Democrat. But all hasn’t gone the House’s way; the GOP-led Senate has worked with Edwards more closely.

That the exhausted parties settled on the sales tax increase for most of the money is unfortunate. We would have preferred almost any alternative, and there were much better ideas proposed by outside experts, but almost all were voted down, almost always in the House, and almost always without much in the way of ideas for significant reforms in Louisiana’s way of doing business.

So where are we now?

The relative peace at the State Capitol results from a combination of new taxes and economic growth. Louisiana is hardly a rich state, but its economy is doing better despite the lingering impact of the oil price crash of late 2014.

The new money funded teacher pay raises and some aid to local school systems this year as well as improvements in colleges and universities’ financial positions. The state is not flush: Analysts figure that the state general fund, the centerpiece of government funding, is still less than it would have been but for Jindal’s tax cuts and business tax breaks.

How long will the era of good feelings last? Depends on how long the money does.

If more teacher raises or other new expenditures are to be funded in 2020, the economy will have to continue to improve.

And finally, can we avoid the mistakes of 2008, when a doctrine of cutting taxes without regard to the consequences in state institutions was all the rage? This year, a repeal of the 0.45 sales tax was proposed, and fortunately not adopted. A real and comprehensive tax reform plan would be a good idea, but whether it will gain traction in the State Capitol is problematic.

Happy New Fiscal Year. With luck, we can keep some of our new-won stability.

Online: www.houmatoday.com

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June 29

The Advocate on the relationship between Medicaid expansion and rural hospitals in the state:

Overall the expansion of Medicaid insurance coverage since 2016 has been a success, giving almost 500,000 people who make very little money access to primary care and life-saving treatment in many cases.

While there are problems with every large-scale insurance program that has an eligibility requirement, the fundamentals of expanding health care access remain a strong positive for the state.

That issue has an economic dimension as well, including one that Gov. John Bel Edwards has touted: In Louisiana since Medicaid expanded on his initiative, no rural hospitals have closed in the state.

That might not seem news, but in fact the failure of smaller, rural hospitals is a big story across the nation.

Governing magazine reported that at least 95 rural hospitals have closed since 2010, according to the University of North Carolina’s Sheps Center for Health Services Research.

Many have been in the southeastern states — largely Republican-led — that like Louisiana shied away from the expansion authorized by “Obamacare,” the 2010 U.S. Affordable Care Act. But of the three states in the region that did expand Medicaid through 2017, Arkansas, Kentucky and Louisiana, only Kentucky has experienced any rural hospital closures, with three facilities shuttered after Medicaid expansion, according to UNC’s research.

That’s an important gain, because smaller hospitals in more rural areas typically have a lot of potential patients in low-wage jobs.

Still, small hospitals feel threatened, and the Legislature responded this year: A new law, signed by Edwards, prohibits the creation of most new freestanding emergency rooms.

State Sen. Fred Mills, a St. Martin Parish Republican, says stand-alone emergency departments drain profitable services from rural hospitals that operate on narrow margins.

The bill was heavily amended, allowing it to be approved almost unanimously, with a 33-1 Senate vote and 92-0 House vote.

Thus, larger metropolitan hospitals are also protected in this game of divvying up the market: Mills’ proposal will prohibit creation of freestanding emergency departments in Louisiana that are not licensed as part of a hospital’s main campus or as a hospital’s off-site campus. Still, no hospitals will be able to create an off-site ER within the primary service area of a rural hospital.

Freestanding emergency rooms permitted by April 1 won’t be affected.

Is this protectionism? Yes, in an election year, as well — hardly a coincidence.

Mills’ protectionist bill might give small hospitals a temporary advantage, but ultimately, their future will still probably be determined by the realities of the marketplace.

As Governing pointed out, there are multiple reasons for rural hospitals to close, from less population in their towns to a growing demand for complex treatment and operations that are never going to be economical except in larger hospitals.

Of the two initiatives, it is Edwards’ Medicaid expansion that does the most for rural providers of health care.

Online: www.theadvocate.com

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June 27

The Houma Courier on issues with recent Alabama solitary confinement reforms:

Thanks to recent criminal justice reforms, Louisiana is shedding its label as the incarceration capital of the world. However, our state still locks away more of its inmates in solitary confinement than any other state. And our rate was recently four times the national average.

Clearly, that is a call for change.

Louisiana prison officials have said they have made some progress by embracing common sense reforms. But touting those changes does little for the people who are still held in terrible conditions for days, weeks, months or even years on end.

And the changes themselves have been rather modest, considering the place our system started. Just three years ago, Louisiana held 17 percent of its prison population in solitary confinement. That is the rate that is four times the national average. After some changes in recent years, the state has reduced the percentage to about 10. But even that sharply reduced number puts our state higher than any other in the nation.

Our prisoners might not get a lot of sympathy, but the conditions under which they are held is a reflection of our entire society. And when we are such obvious outliers in a category like this, it should give us all a reason to embrace reform.

Advocacy groups have embraced various ideas for change, including allowing all prisoners access to visitors and mail, limiting solitary confinement in cases where the inmate has a diagnosed mental illness and placing restrictions on the consecutive days prisoners can be deprived of social interaction.

Those all make sense, and they could all put us on a path toward joining other states, where solitary confinement is comparatively rarely used.

There have been horrific stories in which inmates have been held for decades in solitary confinement. That is unconscionable. And Louisiana must put an end to the excessive use of what should be a last resort for prisons to control the worst-behaved inmates.

There are times when solitary confinement might be a useful tool for jailers to keep their charges from repetitive misbehavior. But there should also be common sense limits on how, when and for how long solitary should be imposed on prisoners.

The sooner we can implement some of these good ideas, the sooner Louisiana can cast off its shameful title as the largest user of solitary confinement in the nation.

Online: www.houmatoday.com

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