Thread by @charles_gaba

YESTERDAY, the awesome @cynthiaccox posted this thread which explained the tradeoffs involved in healthcare coverage & affordability. 1/

https://twitter.com/cynthiaccox/status/1321513348014460929

Read her thread, and then read this post of mine from nearly a year ago about the Catch-22 "solution" which the state of Louisiana has come up with as a contingency plan in the event the #ACA is indeed struck down by the Trump/GOP lawsuit: 2/
acasignups.net/19/11/14/louis…

Louisiana has a Democratic Governor but is solidly GOP otherwise...including their Attorney General, @JeffLandry, who's also one of the *plaintiffs* in the #TexasFoldEm lawsuit to strike down the #ACA completely. 3/

Landry *himself* pushed through a state law which would, believe it or not, replicate most of the #ACA's protections for those with pre-existing conditions, including Guaranteed Issue, Community Rating, Essential Health Benefits, No Annual/Lifetime Limits, etc etc. 4/

On the surface, this sounds pretty amazing...as well as being one hell of a head-scratcher. Hell, the legislative text literally *references* the ACA language in some places! 5/

So far it sounds like Landry's bill (which passed nearly unanimously) would basically replicate the ACA at the state level (which also raises the question of why he signed onto the lawsuit in the first place). So what's the catch? Well... 6/

That's right: @JeffLandry's "ACA Jr." law would ONLY go into effect IF THE FEDERAL FUNDING provided by the ACA were to keep flowing *or* if the state of Louisiana were to somehow come up with the subsidy money on their own.

How much money? For LA, around $385 million/yr. 7/

Actually, it'd be a lot more than that if the state wanted to keep Medicaid expansion in place as well: Around $2.6 BILLION would be needed per year for that, or nearly $3 billion/year total (the @urbaninstitute pegs it at more like $3.6 billion: 8/ acasignups.net/19/12/19/texas…

LA's *entire* annual budget is ~$30 billion/yr, so they'd have to raise taxes by ~12% just to replace the federal revenue they currently receive from the feds. Alternately, the Supreme Court would have to strike down *only* the pre-existing condtion portion of the ACA. 9/

Here's where @JeffLandry's law gets especially cynical: Instead of actually addressing where the hell the state would come up with the missing $385M (or $3.0B)/year needed to make the law go into effect, the law dumps that little task onto the state insurance commissioner. 10/

Sure enough, that led to this inevitable article: 11/
thecentersquare.com/louisiana/loui…

I haven't followed up on the "task force" since last year, but I'd guess it hasn't become any easier to find additional funding in the states budget, seeing how Louisiana has the 4th highest number of #COVID19 cases & 5th highest COVID mortality rate.
docs.google.com/spreadsheets/d…

If Landry is so gung-ho about keeping protections for coverage of pre-existing conditions, to the point he spearheaded a bill which LITERALLY COPIES the ACA's protections, why is he calling for the ACA to be struck down in the first place? I can think of two reasons:

First, because helping take down "Obamacare" would certainly look good on his Republican Primary resume if he decides to run for Governor or Senate in red Louisiana the future.

Second, because doing so would, as noted above, give a MASSIVE TAX CUT to the wealthy.

Where do you think that $3 - $3.6 billion in federal funding Louisiana gets for #ACA subsidies & Medicaid expansion comes from today?
acasignups.net/19/11/19/there…

THAT'S what this is about. THIS is why the GOP is *STILL* full speed ahead on tearing down the ACA *in the middle of a pandemic*: They hate anything Obama accomplished, and they want even MORE tax cuts for the wealthy.

acasignups.net/20/07/06/basta…

You have to watch the clip itself to get the full effect, but here's the transcript. Remember, this guy is referring to a law which provides affordable healthcare coverage to over 20 million low/moderate-income Americans & protections for everyone else: