The House Insurance Committee voted Tuesday to ask the insurance commissioner’s office to study creating a Louisiana replacement of the federal Affordable Care Act should the latter be declared unconstitutional.
Senate Bill 173 seeks to replicate the ACA’s guaranteed access to health insurance for people with pre-existing medical conditions, its ban on lifetime benefits limits, and the ability of young adults to stay on their parents’ insurance through age 26. Essentially, the bill directs the commissioner of insurance to create a Louisiana model so the state would be ready to move if the ACA is thrown out.
Louisiana Attorney General Jeff Landry is among the state attorneys general suing to overturn the federal law. He is also the most vocal proponent of SB 173.
What the Louisiana program would look like and how it would be funded is unclear. Landry and Commissioner of Insurance Jim Donelon pointed to a potential model that was used in Maine, whereby the state subsidized costs for consumers with expensive health problems.
Landry and Donelon said they expected Congress to continue funding the subsidies and the Medicaid expansion currently provided by the ACA, which might otherwise cost the state hundreds of millions of dollars annually. Donelon said Medicaid is outside of his office’s responsibility.
“I can’t find a federal government welfare program that has ever been eliminated,” Landry said.
A representative of AARP Louisiana said his organization opposed the bill’s provision that insurers could charge older people five times more than younger people for the same level of coverage, saying it would significantly raise costs for older consumers who are not yet eligible for Medicare. Current law allows a 3-1 ratio.
“Of course, there’s no free lunch,” Donelon said.
If you cap costs on older people, you increase costs on younger people, Donelon said, which is why some young consumers have been reluctant to buy coverage under the ACA. Landry said the Maine program was able to lower costs for older consumers by getting more young people into the risk pool.
Matthew Block, Gov. John Bel Edwards’ executive counsel, said the administration did not oppose the bill. A similar bill Edwards supported could not get out of committee.
But Block cautioned lawmakers not to get their hopes too high.
“The bill before you is a wish list,” he said. “It is a plan to develop a plan.”
Block called for a broader and transparent study of the issue. On Tuesday, Edwards issued an executive order calling for a task force including the governor, the head of the Louisiana Department of Health, the insurance commissioner, the attorney general, members of the Louisiana Legislature, representatives of the insurance industry and health care consumer groups and experts in economic and fiscal modeling.