Louisiana
Senate’s proposed changes to the One, Big Beautiful Bill alarm Louisiana hospitals
WASHINGTON – Representatives of Louisiana’s largest hospitals converged Tuesday on Capitol Hill after a Senate committee released its recommendations to squeeze more spending cuts out of Medicaid than the House did in the One Big Beautiful Bill Act.
Louisiana’s hospitals are still evaluating the suggested Medicaid cuts, but a first read of the 549-page bill released Monday night is not optimistic, said Paul A. Salles, president and chief executive officer of the Louisiana Hospital Association.
“Unlike the House bill, which takes a more balanced approach to controlling Medicaid spending, the new proposal from the Senate Finance Committee includes devastating reductions that could jeopardize rural access, medical education, and essential services such as maternity care, children’s services, behavioral health, and access to specialty care for patients across Louisiana,” Salles said Tuesday.
The legislation, which includes most of President Donald Trump’s domestic agenda, cleared the House by a single vote. It would cut spending over the next 10 years by $1.6 trillion, mostly from Medicaid reductions, but add $2.4 trillion to the national debt, mostly from tax breaks. An estimated 10 million people would no longer be able to enroll in the state-federal program that pays for healthcare services for low-income Americans, according to the Congressional Budget Office.
Senators promised significant changes to the House-passed bill.
Senate Finance Committee draft of House-passed budget bill seeks further reductions in Medicaid spending.
Their suggestions go much further on Medicaid than the House by cracking down on strategies states have used to raise more money for their share of Medicaid, which brings in more federal “match” dollars. That would have the effect of transferring the costs from taxpayers around the country to just those in a state.
Officials from Louisiana’s largest health systems gave U.S. Sen. Bill Cassidy an earful Tuesday morning, both Cassidy and hospital administrators in attendance acknowledged.
“I’m very much conscious of the impact that would have on our providers back home, but that’s the setting in which this is occurring,” Cassidy said after meeting with the Louisiana healthcare officials. The Baton Rouge Republican is a member of the Senate Finance Committee and chair of the Senate Health Education Labor and Pensions committee.
“States have gotten incredibly greedy about pulling down money from the federal taxpayer as governors and legislatures have decided to spend their own dollars on things besides Medicaid,” Cassidy said.
Cassidy said the the tax breaks in the bill will energize the U.S. economy and Louisiana workers.
Cassidy and the hospital executives note that the bill as released serves as a base for negotiations and is a long way from the shape it’ll be in when the legislation heads to the floor for Senate passage.
But the language now has worried hospitals in rural areas of the state, whose patients are mostly on Medicaid, said Jeff Reynolds, executive director for the Louisiana Rural Hospital Coalition.
“Right now, the way the bill reads,” Reynolds said, “all my member hospitals would have to see what programs they could reduce and what layoffs they’d have to order to stabilize” their finances.
In particular, wording was changed to require “state directed payments” for Medicaid programs to equal the rate paid for Medicare, which is the federal healthcare program for the elderly. The rules now allow the upper limit of those payments to be calculated from the average commercial rate for hospitals and nursing facilities.
For Louisiana, the rural hospitals are set to receive $245 million in the state’s budget for the fiscal year — the money coming primarily from the “state directed payments” the bill targets — to help offset providing healthcare services that cost more than the amount Medicaid covers.
If the Senate’s proposed legislation becomes law, equalizing those payments with the Medicare rate would immediately drop the amount the state receives to $211 million. Then the federal government would start withholding 10% annually until the calculated rate equals the Medicare rate.
Eventually, payments would drop to about $128 million annually, Reynolds said. State legislators would have to cover the difference — or they could cut Medicaid services.
“Senate Republicans are actively looking at ways to support rural hospitals,” Cassidy said. “As a doctor who worked in the charity hospital system, seeing referrals from rural parishes, I understand the importance of these hospitals and will work to maintain them in Louisiana and elsewhere.”
Additionally, the Senate Finance Committee basically reduced the amount a state can tax hospitals, clinics, and other healthcare providers from 6% to 3.5%. Louisiana and most other states use the taxes to offset the portion they owe for services rendered, which leads the federal government picking more of the costs.
Nobody knows for sure how much this provision would cost the state treasury, but lowering those percentages would shift the burden of raising the state’s match to the state’s taxpayers.
“Frankly, states have backed out their commitment to the Medicaid program and use provider taxes to replace the state commitment with federal taxpayer dollars. When we say federal taxpayer dollars, that’s you and me,” Cassidy said.
Less in the regulatory weeds is the proposed change likely to attract the most attention: Able-bodied adults with children over the age of 14 years are going to have to work or volunteer work at least 80 hours a month to qualify for the health insurance program.
The House’s work requirement was only for childless adults. In the House version, the Congressional Budget Office estimated about five million beneficiaries would lose their Medicaid – mostly from being unable to keep up with the paperwork and confusion over the qualifications. Those estimates likely would grow as the numbers required to work increases dramatically in the Senate version.
House Speaker Mike Johnson, R-Benton, has repeatedly asked senators to take a light hand in the changes they make, pointing out that House leadership crafted the bill’s provisions to win over GOP reps who had opposed the legislation. The measure passed the House in May by a single vote.
Johnson’s staff on Tuesday said the speaker wasn’t ready to comment on the Senate’s ideas for changes.
Senate leadership hopes to get a vote on the bill next week and begin negotiations with the House on final language and deliver to Trump by July 4th.
BATON ROUGE, La. (WAFB) – South Louisiana’s coast has long served as a natural buffer between communities and rising water.
But since the 1930s, Louisiana has lost nearly 2,000 square miles of coastal land.
Dr. Torbjorn Tornqvist, a professor at Tulane University, said Louisiana is one of the most vulnerable coastal areas in the world because of climate change, sea level rise and subsidence.
“Louisiana is arguably one of the most vulnerable… perhaps the most vulnerable coastal zones in the world when it comes to climate change and sea level rise… and there are several reasons for that but one important reason is that we have high subsidence rates, and that means sea level rise here is a lot faster than the average around the world,” Tornqvist said.
Tornqvist is the lead author of a recently published study examining the long-term impacts of sea level rise across south Louisiana.
He said the issue is no longer limited to communities closest to the Gulf Coast.
“People are leaving the coast of Louisiana, but it’s going to accelerate over the course of the century. And those people are going to have to go somewhere, and it’s likely that a significant number are going to look at a place like Baton Rouge to move to,” Tornqvist said.
Since Hurricane Katrina, Louisiana has invested billions of dollars in large-scale restoration projects designed to reduce flood risk and strengthen the coast.
Some researchers believe those projects are important but not permanent fixes.
“We have…right now we have a pretty high-quality flood protection system that’s obviously way better than it was during Katrina and we should certainly keep investing in upkeep, but we also have to recognize that’s only going to take us so far,” Tornqvist said.
State officials say those investments remain critical as Louisiana adapts to future flood risks.
Micheal Hare, executive director of the Coastal Protection and Restoration Authority, said the state’s coastal plan is designed to balance restoration work with protection projects, including levees.
“Our 2023 master plan certainly incorporates the best science available to us to then come up with a balanced approach between how do we effectively spend money on restoration as well as money on protection projects like levees,” Hare said.
Hare said those projects will continue to evolve as future risks change. CPRA and the Army Corps of Engineers are re-evaluating portions of the West Bank and Vicinity levee system in New Orleans to meet projected future flood risks within the next half-decade.
“Morganza to the Gulf is a great example, location communities came together, they started funding it…so that protection is critical…It will constantly be maintained and constantly elevated to meet the new levels of threats and risks that are out there,” Hare said.
Coastal officials and researchers agree that what happens along Louisiana’s coast will continue to affect communities far beyond the shoreline for generations.
“And so maybe you don’t live behind the levee, but I promise you want those coastal communities to stay there and to keep working, and to stay productive and engaged…so that we don’t have to have these flood fights further north or lose parts of our economy,” Hare said.
Tornqvist said the decisions made now could shape the future of Louisiana communities.
“What’s really important to recognize is that the next few decades are basically going to decide the long-term future of cities like Baton Rouge,” Tornqvist said.
Louisiana has always lived with water. As the coast changes and sea levels rise, the challenge is how communities across south Louisiana continue adapting for generations to come.
From the Gulf Coast to Baton Rouge, the future of Louisiana’s coastline is a conversation that impacts the entire state.
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Louisiana ranks among the top 10 most affordable states to retire, according to a new study from Retirement Living, a national journal of retirement research.
Researchers analyzed each state’s housing costs, living expenses and tax friendliness to compile the ranking. Louisiana, they say, is the eighth most affordable state for retirees.
In Louisiana, the median monthly rent for a one-bedroom apartment is $932, the median home sale price is $255,000, monthly grocery spend per capita is $272, the average price per gallon of regular gas is $4, the average Medicare Advantage monthly premium is $13.35 and the average effective property tax rate is 0.55%.
West Virginia is the most affordable state to retire, followed by Mississippi, Alabama, Oklahoma, Arkansas, Kentucky, Missouri, Louisiana, Indiana and Kansas. Researchers describe the South as “the sweet spot for an affordable retirement.”
The most expensive state to retire, meanwhile, is California, followed by Hawaii, Washington, Oregon, Colorado, New Jersey, Massachusetts, Utah, New York and Minnesota.
Read Retirement Living’s full report here.
BATON ROUGE, La. (WAFB) – With hurricane season approaching, the Louisiana Coastal Protection and Restoration Authority is bringing the community together to prepare before a storm forms.
“We can’t stop disasters from happening. We can’t stop hurricanes from happening. But what we can do is equip our communities with the resources that they need to prepare for these storms ahead of time,” said Jayda Morris, CPRA outreach manager.
The agency hosted an event featuring interactive storm simulations and a full model of the Mississippi River.
“If you do it now, like on a sunny day like today, you’re ready to go for the rest of the season,” Jay Grymes said.
El Niño may reduce storms, but Louisiana still at risk
State Climatologist Jay Grymes said an El Niño pattern may reduce the number of storms in the Atlantic but warned against a false sense of security.
“In those 25 years, Louisiana, some part of the state has been impacted by 29 storms. That’s one a year, regardless of El Niño. So that should tell you something,” Grymes said.
He said the bigger concern is storms that can form in the Gulf with little warning.
“If we’re going to get a storm, it very possibly could be one that bubbles up in the Gulf and doesn’t give us five or seven days to track it coming our way. It gives us 40 hours to get ready for a landfall. So it’s imperative that you go ahead and do it now,” Grymes said.
Preparation goes beyond stocking water
Preparing now includes walking through yards, checking trees, and knowing whether everyone in the family can survive two weeks without power.
PhD students with the LSU College of the Coast and Environment gave the community a virtual reality experience that puts users inside a storm.
“If they wear the goggles or play with the Apple Vision Pro, they can understand how high will the flood be, and they can know how dangerous is the hurricane scenario,” said Yixuan Wang.
The VR simulation uses real historical data to show users what compound flooding looks like in New Orleans and surrounding areas. The goal is to make the science real for people who can’t picture what a flood map means.
“It’s just to let you understand the environment. We will add the audios, the different sound of the wind and the storm. And you can see how tense of the rainfall around you,” Wang said.
Organizers said the event is about making sure that when a storm threatens the area, families already know their plan.
Information from the event is available on CPRA’s website. Hurricane season runs through Nov. 30.
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