Congress approves RESTORE Act money

WASHINGTON – Congress approved the RESTORE Act legislation Friday that will direct billion of dollars in BP oil spill fine dollars to Louisiana and the rest of the Gulf Coast states.

The RESTORE Act was included in a multi-billion-dollar transportation and highways funding bill that also includes the plan to keep interest rates low for federal student loans, the five-year extension of the National Flood Insurance Program, or NFIP, and the RAMP Act by U.S. Rep. Charles Boustany, R-Lafayette, to direct more federal funds to river dredging and port projects in Louisiana and the rest of the nation.

But a late addition to the omnibus bill this week also cuts more than $650 million in federal health care funds for Louisiana’s poor that will slice Medicaid reimbursements for many hospitals and providers. State also officials said the loss of the funds would eliminate Medicaid programs for services like breast and cervical cancer screenings, foster care, adult dentures, hospice care and more.

President Barack Obama is expected to sign the bill into law.

The bicameral transportation conference committee managed to squeeze everything into one bill with federal transportation funds set to run out and with student loan interest rates to double after Saturday. Also, the NFIP expires after July. The U.S. House vote of 373-52 and the U.S. Senate’s 74-19 approval came Friday afternoon just before the congressional Fourth of July break.

The entire Louisiana congressional delegation voted

Landrieu: BESE needs to meet on vouchers

U.S. Sen. Mary Landrieu says Louisiana’s top school board should hold a special meeting in July to hammer out state oversight rules for private and parochial schools that accept voucher students.

“A gesture like this would assure the public that you recognize the value in building public support for our state’s aggressive reform efforts,” Landrieu said in a letter to state Superintendent of Education John White.

Landrieu’s office released the letter on Friday.

Under a new state law, low and middle-income students who attend C, D and F public schools can apply for state-funded vouchers to attend private and parochial schools.

The deadline application is Friday.

About 7,800 parents and guardians have applied for the roughly 7,450 slots available so far, said Barry Landry, a spokesman for the department.

The law, which was pushed by Gov. Bobby Jindal, gives White wide authority to spell out accountability rules for schools that accept voucher students, including what kinds of state tests they have to take, whether students in key grades have to pass the tests to move to the next grade and whether private schools, like their public counterparts, should receive letter grades from the state.

White has said the rules will be finalized well before the Aug. 1 deadline.

But Landrieu said any state oversight regulations for the schools should undergo a public review.

The Democrat said she believes that private and parochial schools that take part should receive letter grades from the state.

She said she also favors “serious consequences” for non-public schools that underserve voucher students.

White announced on May 22 that 124 private and parochial schools and one public school signed up to accept voucher students.

Department officials are conducting checks of the schools before any final decisions are made, including how many students each school qualifies for.

The vouchers will be funded with dollars previously reserved strictly for public schools.

The average tuition of schools on the list is $6,100, which would be paid for by the state.

Jindal touted the expanded voucher program as a way to let families trapped in failing public schools to switch to better ones.

Critics contend the law is unconstitutional, and three lawsuits challenging the measure are pending in the 19th Judicial District.

A hearing is set for next month.

The lawsuits were filed by the Louisiana Federation of Teachers, Louisiana Association of Educators and Louisiana School Boards Association.

All three groups vehemently opposed the law, which won approval in the Legislature in April.

In her letter, Landrieu noted that several of the voucher schools tentatively approved by the state Department of Education have generated controversy, including questions on whether they can handle an influx of new students.

“Clearly the department released a list of participating schools prematurely, without the proper vetting,” she wrote.

White was not immediately available for comment.

Baton Rouge area private and parochial schools have offered more than 1,100 seats for students who qualify for the state aid.

The vouchers are supposed to pay for tuition and fees charged by the non-public schools.

Families would be responsible for uniform costs and optional fees.

Family income cannot exceed $57,625 for a family of four; $67,525 for a family of five and $77,425 for a family of six.

PSC votes against nuclear plant charges for Entergy customers

State regulators refused Wednesday to allow Entergy Corp. to immediately charge its customers for about $63 million spent preparing to build another nuclear power plant at River Bend, near St. Francisville.

Entergy, which had gone as far as to negotiate with a building contractor, suspended in January 2010 efforts to build a generator fueled by nuclear rods to make electricity. A dramatic drop in the cost of natural gas made the cost of building a multi-billion dollar plant economically unviable at this time, according to Entergy’s filings with regulators.

The New Orleans-based company then sought to recover from customers, rather than shareholders, the money spent on the reports, studies, examinations and other activities necessary for obtaining licenses and financing. The state’s Incentive Cost Recovery Rule for Nuclear Power Generation allows Entergy to pass those costs to its customers.

The five elected members of the Louisiana Public Service Commission voted 3-2 not to hear any public testimony but to approve an administrative law judge’s decision over that of their own staff.

In wording unusually harsh for regulatory decisions, Chief Administrative Law Judge Valerie Seal Meiners wrote in her opinion that Entergy’s actions “fly in the face of the rules’ intent and gorals of transparency and partnership …”

Entergy did not properly seek the PSC’s approval for about $63 million spent on preparation to build what would have been called River Bend 3, Meiners wrote. Therefore, Entergy should not be able to take advantage of the incentive rule, which would have allowed the companies to seek recompense from its customers, according to Meiners opinion.

Bill Mohl, president and chief executive officer of Entergy Louisiana, said he disagrees with Meiners’ opinion and was disappointed the PSC chose not to debate the issue in a public hearing. He said Entergy pursued a new nuclear plant because south Louisiana needs more electricity and the prices for the fuel necessary to run the generators that make electricity are so volatile that company officials acted prudently when looking at nuclear power.

“It really shifts the burden for the ratepayer to shareholder,” said Commissioner Jimmy Field, of Baton Rouge, about the PSC’s decision. Entergy could still be able to collect the money in the future as part of its rates, provided the utility can prove the costs were necessary and reasonable, Field said.

Congressional delegation pans, lauds ruling

  WASHINGTON–Louisiana’s congressional delegation responded in parts with praise while Republicans pledged to push forward with a full repeal of the health care law.

U.S. Sen. Mary Landrieu, D-La., said the Supreme Court affirmed accurately the law so the public-private health care delivery can make health care services more affordable and equitable.

“It reduces the deficit by more than $1 trillion over 20 years, provides security to millions of middle class and low-income Americans who need and depend on affordable health care that now cannot be taken away, and over the long run, will improve health outcomes for our entire population,” Landrieu said in a prepared statement. “Now that the Supreme Court has made this clear by its ruling, it is the obligation of the states to fully implement and expedite the Affordable Care Act.”

Landrieu touted the impacts on Louisiana specifically, such as insuring more than 53,000 young adults in the state up to age 26, saving Louisiana seniors more than $53 million on prescriptions, offering free preventative services like mammograms and cervical cancer scans to 275,000 women in the state, and potentially covering more than 500,000 working adults in the state through the expansion of Medicaid.

U.S. Rep. Cedric Richmond, D-New Orleans, favorably compared Thursday’s ruling offer health-care access to all Americans to the landmark Brown v. Board of Education ruling that started the end of school segregation.

“When Americans look back on this decision many years from now, we can say we were a part of history,”Richmondsaid in a prepared statement. “We chose to put the needs of the everyday American first.”

As forLouisiana’s Republicans, U.S. Sen. David Vitter, R-La., took to the Senate floor to denounce the ruling written by Chief Justice John Roberts.

Vitter criticized the court for “completely re-characterizing the individual mandate … as a tax” rather than ruling on it from a commerce standpoint as was anticipated. He called it “particularly worrisome” the court “did back flips to rewrite the law” to authorize the health care penalty and mandate as a tax.

Given that decision though, Vitter said, “This is a massive tax increase on the middle class.”

If viewed as a tax, Vitter said the Senate next year – if GOP nominee Mitt Romney is elected president – potentially could repeal the health care law with just 50 votes and the vice president’s tiebreaker through the budgetary “reconciliation process” rather than a necessary 60 votes through others means.

The non-profit, non-partisan Tax Foundation inWashington,D.C.also argued the Supreme Court erred by making the individual mandate penalty a tax, although the foundation did not call for the repeals or unconstitutionality of the law. The foundation contends the ruling expands the definition of a tax.

“The Court was incorrect to reject the widely-accepted definition of ‘tax’ as an exaction imposed for the primary purpose of raising revenue for general spending. There has been no development in law that necessitates such a far-reaching change,” said Tax Foundation Vice President for Legal Projects Joseph Henchman.

U.S.Reps. Steve Scalise, R-Jefferson; Jeff Landry, R-New Iberia; and John Fleming, R-Minden, were among the elected officials criticizing the ruling in front of the Supreme Court.

Landry also seized on the tax wording and called Thursday a “tragic day” forAmerica.

“It was sold to the American people as a mandate and not a tax,” Landry said. “This tax must be repealed.”

Scalise also said the ruling shows Obama lied because the penalty of not buying insurance for many under the individual mandate is now a tax.

“But the American people are going on have their say on the first Tuesday in November,” Scalise said of the Nov. 6 election date.

Fleming said the health care law is “despised” by most Americans and he pledged to help “repeal Obamacare lock, stock and barrel and pull it out by its roots.”

“What we want are more consumer choices and not government mandates,” Fleming said.

U.S. Rep. Bill Cassidy, R-Baton Rouge, wasted little time in sending out an email to supporters seeking campaign donations to assist him in the fight against the health care law. He described himself as “disappointed” but “motivated.”

“(Thursday’s) Supreme Court ruling to uphold Obamacare will not deter my efforts or those of House Republicans to replace it with something that provides affordable, quality health care,” Cassidy stated.

Outside ofLouisiana, some sought to further politicize the issue with Obama and Romney.

“The Supreme Court upheld that Romneycare is constitutional,” said U.S. Rep. Raul Grijalva, D-Ariz., comparing Obama’s law to the one Romney pushed as governor ofMassachusetts.

As for Romney himself, the GOP nominee pledged to “act to repeal Obamacare” starting with his first day in office if elected.

Romney said the health care law is bad policy and will force many Americans to change their insurance. “Obamacare puts the federal government between you and your doctor,” he said.

Obama said the Supreme Court decision will allow the health care law to move forward with “common-sense protection for middle-class Americans.”

“No illness or accident should lead to any family’s financial ruin,” Obama said, adding that people will no longer need to “live in fear” they will lose health insurance coverage if they lose their jobs.

Obama admitted it is not always popular to force people who can afford it to buy health insurance. “I didn’t do this because I believed it was good politics,” he said. “I did this because I believed it was good for the American people.”

On the Senate floor, Senate Majority Leader Harry Reid, D-Nev., and Minority Leader Mitch McConnell, R-Kent., took turns praising and criticizing the health care law, respectively.

Reid said people will be insured “regardless of where they live and how much they make.” He said Republicans want “to give the power of life and death back to the insurance companies.”

McConnell said it is time to move past the Supreme Court ruling and focus on Congress repealing the law.

House Republicans have already scheduled a July 11 repeal vote.

“Americans were promised lower health care costs and they’re going up. Americans were promised lower premiums and they’re going up,” McConnell said.

“The supposed cure has proven worse than the disease,” he said.




Health care officials react to ruling


“For them to have struck down parts of it would have been extremely problematic for all of us,” said Louisiana Hospital Association president John Matessino.  “At least we now have a little clarity of what is going to be expected in health care. There are going to be a lot of changes going on in the next several years,” Matessino said.
Matessino said the impact of a cut in federal Medicaid funding that’s in a compromise congressional  transportation bill “has me much more concerned than anything that came out of the Supreme Court today.”
The federal transportation bill would prompt a $1.1 billion cut in Louisiana’s Medicaid health insurance program for the poor, including a potential 10 percent cut in reimbursement to hospitals for care delivered.
“That is a bad situation,” Matessino said.
Matessino said hospitals have always been in favor of getting more people covered by health insurance. 
“Obviously, they answered the constitutional question of whether individuals can be forced to buy insurance. People who can afford to buy need to have health insurance. Our hospitals get hit all the time with these people who think they are bullet proof and they are not,” he said.
Louisiana State Medical Society president Dr. Andy P. Blaylock said he was disappointed in the decision. However, “we stand ready to support patients and their physicians during this time of change,” he said in a statement issued shortly after the decision’s release.
“Our challenge is, and always has been, to improve our system by making it more affordable and accessible for all Americans without sacrificing choice and quality of care,” said Blaylock.
“The LSMS will move forward with an open minded, constructive approach to building on the positive aspects of the law” while working with the Louisiana delegation and Congress “to address the strong concerns physicians still have regarding protecting patients’ access to care … and preserving the rights of physicians and patients to choose their own health care services,” Blaylock said.

Charity hospital chief expects increased demand

Health insurance for more people through the Affordable Care Act    will create an increased demand for services provided by the LSU hospital system, said LSU System Vice President Fred Cerise, a physician.
With 63 out of Louisiana’s 64 parishes professional health care shortage areas, “we believe there will be plenty of work to be done,” said Cerise.
The LSU System of hospitals must do some adjustments in the financial reimbursement model with less reliance on uncompensated care and more on Medicaid reimbursement, Cerise said. But for the first three years Medicaid expansion expense will be 100 percent federally funded then taper to 90 percent, he said.
“There’s nothing to preclude us from continuing to do our work. We believe there will be a need like never before to be providing these services,” said Cerise.
After Massachusetts adopted the insurance mandate, the two major public hospitals saw an increase in use of out-patient services as well as in-patient care, Cerise said. “There’s really experience in Massachussetts to point to the logic the uninsured underutilize services today. When insured they are looking to use more services,” he said.
The Massachusetts insurance mandate was adopted under its former governor Republican presidential candidate Mitt Romney.

Congressional deal could cost Louisiana

WASHINGTON – The latest federal transportation bill compromise would take more than $650 million from Louisiana’s federal health care services dollars for the poor combined over the next two years.

The nearly $3 billion total highways bill does direct billions of dollars in BP oil spill fine money to Louisiana for RESTORE Act restoration projects, but U.S. House and Senate leaders on Wednesday afternoon were  opting to balance some of the other spending measures on the back of Louisiana’s health care, according to state government officials and the congressional delegation.

Louisiana Department of Health and Hospitals Secretary Bruce Greenstein said Tuesday the Medicaid spending cuts would mean the state having to cut its reimbursement programs for services like breast and cervical cancer screenings, foster care services, hospice care and more.

Greenstein also said the state would have to cut its uncompensated care payments to LSU hospitals and rural hospitals, while also chopping 10.2 percent of the state’s total payments to health care providers for Medicaid services performed.

“It will not be painless by any stretch,” Greenstein said. “It comes after years of several reductions already.”

A final compromise on the federal transportation bill was expected Wednesday because the U.S. House and Senate must vote on the bill by the end of the week. Transportation conference committee chairwoman Barbara Boxer, D-Calif., and vice chairman John Mica, R-Fla., both declared victories on completing the bill late Wednesday afternoon.

The Louisiana-specific potential health care cut is part of a long-running battle over the federal government’s matching share of Medicaid dollars, called FMAP, to Louisiana that had resulted in U.S. Sen. Mary Landrieu, D-La., securing more federal Medicaid dollars for the state.

Landrieu and state officials have successfully argued that the state’s per capita income levels over a three-year period — a chief determiner of the award — were artificially high, due to dollars paid out for rebuilding as part of Hurricane Katrina recovery. Those funds were unexpectedly further boosted because of a math issue from the inclusion of the 2008 Hurricane Gustav disaster impact.

Critics in Congress called the surplus of federal health care dollars to the state the “Louisiana purchase.”

Now, members of Congress are trying to bite back into those funds.

But state Commissioner of Administration Paul Rainwater noted that the state’s 2012-2013 budget process was already completed earlier this month and now the federal government is trying to go against its own calculations.

When state matching dollars are factored in, Rainwater said, the total loss for Louisiana is $1.1 billion because the state cannot make the loss of the federal funds.

“We based our current budget on the FMAP,” Rainwater said. “We don’t think you should take from the FMAP – a published match.”

The Louisiana Medicaid budget for the fiscal year that begins July 1 is $7.7 billion.

Some of the cuts like eliminating breast and cervical cancer screening were targets of budget cuts when the state Department of Health and Hospitals had to develop plans in the wake of the House stripping one-time money from the budget bill. But the programs got restored when the Senate restored the one-time money.

All but 2 schools meet GRAD Act standards and can now raise tuition again

The state’s top higher education board gave the go-ahead Wednesday to all but two of Louisiana’s public colleges to raise tuition beginning in the fall.

Only LSU at Eunice and Southern University at Shreveport did not meet the standards set forth in the 2010 LA GRAD Act which ties student performance to tuition raising authority.

The 10 percent tuition hike is all but certain at the state’s other public colleges. Management board for the LSU, University of Louisiana and Louisiana Community and Technical College systems have already voted to approve increases for the fall semester.

Southern System President Ronald Mason said he will recommend Southern follow suit at their board meeting scheduled for Friday morning.

The GRAD Act is made up of several dozen benchmarks based predominantly on student success. The law allows colleges to increase tuition by up to 10 percent a year, if they meet those performance goals. Additionally, the state’s performance-based funding formula ties 15 percent of overall state funding for each college on meeting the GRAD Act goals.

The Louisiana Board of Regents determines each year which schools have reached their GRAD Act targets. Larry Tremblay, the Regents deputy commissioner for planning research and academic affairs, told the board Southern’s Shreveport school, known as SUSLA, plans to appeal the ruling.

Significant changes in public school instruction system

A new state law will allow students in C, D and F public schools to pursue all but one class outside of a traditional school setting, a state official said Wednesday morning.

Ken Bradford, assistant superintendent for content, made the comment, during a 50-minute webinar on a little-noticed but significant part of one of Gov. Bobby Jindal’s public school overhaul bills.

The Louisiana Legislature approved the measure, which is known as Act 2, in April.

Most of the attention was focused on another provision, which is a statewide expansion of Louisiana’s voucher program for low and middle-income students in struggling public schools.

But another component, called the “course choice program,” is sparking questions from superintendents, guidance counselors and others as state officials unveil the details.

State Superintendent of Education John White has touted the change as largely a way to aid students in low-performing schools to catch up with their peers and graduate on time.

White said Louisiana will be the first state that allows some students to tailor their own education plans with public dollars paying for individual courses.

He said in a press release that the change means students “will have more customized options tailored to their particular needs and interests.”

Online schools, business and industry groups, independent teachers and colleges are being asked to submit proposals for courses, which would be reviewed by department officials, an independent panel and the state’s top school board.

Bradford said that, under the law, students who pursue “course choice” will only be required to attend one class per day at their home school.

Bradford was not immediately available to elaborate on that point.

But apparently students would have the option of pursuing courses similar to those offered at school that instead would be taught by one of the private providers.

Those classes could be taught online, in person or through a combination.

Course providers, once they are approved by the state Board of Elementary and Secondary Education, would be eligible for state payments based on a formula spelled out in the law.

BESE is set to approve the course providers on Dec. 5.

An online catalogue will be published on Jan. 1, and registration will begin on March 7 for the 2013-14 school year.

About 380,000 students attend schools rated C, D or F in Louisiana out of a total of about 700,000.


Tuition raised using incorrect data

Neither Baton Rouge Community College nor Capital Area Technical College did a very good job reporting student performance data the state’s top higher education board uses to determine whether schools can raise tuition, according to a legislative audit report released Monday.

The report, which looked at data from last year, says 11 out of 16 schools in the Louisiana Community and Technical College System submitted student information to the Louisiana Board of Regents that was “not sufficiently reliable” — a conclusion LCTCS President Joe May acknowledged on Monday.

The Regents use the data submitted to verify whether schools meet the performance standards spelled out in the in the 2010 LA GRAD Act.

The GRAD Act is made up of 52 different benchmarks based predominantly on student success including improved graduation and retention rates. The law allows colleges to increase tuition by up to 10 percent a year, if they meet those performance goals. Additionally, the state’s performance-based funding formula ties 15 percent of overall state funding for each college on meeting the GRAD Act goals.