www.thecentersquare.com – By Nolan McKendry | The Center Square – (The Center Square – ) 2025-05-27 14:48:00
The Louisiana Legislature passed House Bill 148, granting the insurance commissioner broader power to regulate rates, including declaring rates “excessive” regardless of market conditions. It removes the distinction between competitive and noncompetitive markets and expands the definition of excessive rates to include high administrative costs. Insurance Commissioner Tim Temple and the Insurance Council of Louisiana oppose the bill, warning it grants subjective authority that could destabilize the market, reduce insurer participation, and limit consumer choices. The bill also mandates insurers disclose prior premiums at renewal to improve transparency. Critics argue it could undermine ongoing reform efforts and worsen the insurance crisis in Louisiana.
(The Center Square) – The Louisiana Legislature has passed a bill that would give the state insurance commissioner broader authority to regulate insurance rates − including the power to declare rates “excessive” regardless of market conditions.
The bill now heads to the governor’s desk.
House Bill 148, authored by Rep. Jeff Wiley, R-Maurepas, eliminates the legal distinction between “competitive” and “noncompetitive” insurance markets, a framework that previously limited when the commissioner could intervene.
By law, rates can only be declared excessive in noncompetitive markets. The bill repeals that restriction and applies a uniform standard.
The bill also updates the definition of “excessive” rates to include cases where administrative or overhead costs are too high for the services provided.
This provision was introduced through an amendment and had been proposed in several failed bills earlier in the session. Insurance Commissioner Tim Temple opposed those earlier efforts and has continued to voice concern.
In a letter to lawmakers, Temple warned that the bill would grant the commissioner “unfettered power to deny any rate based on only the subjective belief that it is too high,” without adequate guardrails. He said that the changes could destabilize the already fragile insurance market by discouraging insurers from doing business in Louisiana.
“Insurers rely on a predictable regulatory framework to make informed business decisions,” Temple wrote. “Allowing – and frankly encouraging – subjective disapprovals could lead to inconsistent regulatory actions … ultimately harming consumers by limiting their choices and driving up premiums.”
The Insurance Council of Louisiana echoed Temple’s concerns, warning that HB148 would make Louisiana an “outlier” in several areas of insurance regulation. The group pointed to provisions that allow the commissioner to retroactively declare previously approved rates excessive and potentially require insurers to issue refunds − without a defined time limit.
It also criticized a new disclosure requirement that would compel insurers to release confidential rate filings before an appeal can be resolved.
“These issues … make Louisiana’s insurance rate and confidentiality laws different than almost every other state,” the group wrote. “The likelihood is that it will cause bad outcomes.”
Temple also criticized the way the measure advanced. After the House of Representatives rejected a similar proposal by Rep. Robby Carter, D-Amite, the language was revived and inserted into Wiley’s bill via an amendment by Rep. Brian Glorioso, R-Slidell.
“As it relates to the changes that are being made, it simply gives the commissioner the ability to make that determination,” Glorioso said while presenting the amendment. “It does not require him to do anything. There are factors that he is to consider … we’re just adding real language – another factor that may be considered.”
In addition to reshaping rate regulation, the bill requires insurance companies to disclose a policyholder’s previous premium amount when renewing homeowners or private passenger motor vehicle policies. Insurers must prominently display the prior premium alongside the new one, a move supporters say will improve transparency for consumers.
The legislation follows mounting pressure from Democratic lawmakers like Sen. Royce Duplessis, D-Orleans, who have called for greater accountability from insurers rather than continuing the legislature’s focus on tort reform.
Temple, however, contends that the real driver of high auto rates is an “excessive” number of bodily injury claims – and that the Legislature’s focus should remain on reforms to reduce claim costs.
“HB148 and SB247 will reverse the positive trends we are seeing and could stifle any progress this session might otherwise achieve,” Temple said, referencing a separate Senate bill carrying similar provisions. “This is not the path for Louisiana. We cannot overregulate our way out of this crisis.”
The Insurance Council also warned that HB148 could undercut other pending reform bills – such as those addressing Louisiana’s comparative negligence rules and litigation costs – by introducing instability into the regulatory environment.
“While this bill may come out of good intentions,” said ICL Executive Director Rodney Braxton, “the likelihood is that it will cause bad outcomes.”
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Centrist
The article presents a factual account of House Bill 148 and its implications on insurance regulation in Louisiana, reporting on the perspectives of various stakeholders without endorsing a particular side. It includes statements from the bill’s author, Insurance Commissioner Tim Temple, the Insurance Council of Louisiana, and Democratic lawmakers, highlighting both support for increased regulatory authority aimed at consumer protection and concerns about potential negative impacts on the insurance market. The language remains neutral and descriptive, focusing on policies, differing opinions, and potential effects rather than employing emotive or partisan rhetoric. This balanced presentation indicates that the content is primarily informative and neutral, reporting on ideological positions without conveying an intrinsic political bias.
SUMMARY: A ransomware attack on the OPSO’s inmate management system has disrupted jail releases and court proceedings. Despite inmates being eligible for bail, releases have stalled because the system is down, leaving defendants stuck even after paying bond fees. The sheriff’s office cannot locate offenders digitally, halting releases and delaying first court appearances for new arrestees. Families, like Mona Gibson’s, express frustration as they wait indefinitely for loved ones’ release. Defense attorneys warn the ongoing delays may violate Louisiana’s 48-hour rule for bringing arrested suspects to court, raising constitutional concerns. The sheriff’s office has yet to provide an update.
Ransomware attack at OPSO delays court arraignments and releases; residents share frustration as cyber issues continue to disrupt daily operations.
SUMMARY: Two days after a five-alarm fire damaged the Gentilly Ridge Apartment complex in New Orleans East, some residents have been allowed to return home as power is restored and damage inspections continue. One building suffered extensive fire damage, while others mainly sustained water and smoke damage requiring mitigation before reentry. Residents express mixed emotions—thankfulness for spared homes and concerns over those displaced. About 23 people remain at the Joe Brown Recreation Center shelter, likely to move to hotels soon. Relief efforts include the Red Cross, local organizations providing aid, and a United Way fund supporting affected families with housing and essentials.
President Donald Trump’s new tax and spending law will cap Medicaid payments to doctors and hospitals in over half the states, potentially reducing reimbursements by 10 percentage points annually starting in 2028. Critics warn this will strain rural hospitals already struggling financially, risking service closures like obstetrics and chemotherapy. Medicaid often covers only two-thirds of care costs, so extra state-directed payments have been vital for provider sustainability. The law aims to cut $149 billion from Medicaid over ten years, sparking concern among health groups. Some states, like Kansas and Mississippi, seek funds from a new Rural Health Transformation Program to offset losses, but uncertainties remain.
President Donald Trump’s new tax and spending law will likely force more than half the states to reduce payments to doctors and hospitals that treat Medicaid patients, a change critics warn will be particularly harmful to rural hospitals struggling to stay afloat.
Medicaid, the joint state-federal health insurance program for low-income people, reimburses doctors, hospitals and nursing facilities for treating enrollees. But in many cases, the program doesn’t fully cover the cost of care, straining providers that serve a large share of Medicaid patients.
To help providers cover losses and continue to serve poorer populations, the federal government allows the 41 states, plus the District of Columbia, that have contracted with Medicaid managed care organizations (MCOs) to run their Medicaid programs to direct them to pay providers more — in some cases, as much as commercial plans
Ultimately, taxpayers cover the costs of these so-called state directed payments — and those costs are growing. As of August 2024, the higher payments were projected to add $110.2 billion per year to Medicaid spending, nearly 60% more than the previous year’s projection.
That higher spending attracted the attention of conservatives on Capitol Hill.
Beginning in 2028, the One Big Beautiful Bill Act will cap the payments, forcing state Medicaid programs to reduce reimbursement rates by 10 percentage points each year until they reach either 100% or 110% of what Medicare pays. States that expanded Medicaid under the Affordable Care Act would be capped at the lower rate.
The new law will reduce Medicaid spending by $149 billion over the next decade, according to the Congressional Budget Office, and reduce Medicaid provider payments in as many as 31 states, according to KFF, a health policy research group. A separate analysis by The Commonwealth Fund, another research group, found that Medicaid payments to hospitals would drop by at least 20% in 19 of the 25 states that had publicly available data.
Critics say the change could be disastrous for hospitals, many of them in rural areas, that see a large share of Medicaid patients.
“This is all on top of an already pretty strained financial situation for rural hospitals,” Alexa McKinley Abel, director of government affairs and policy at the National Rural Health Association, a group representing rural health care providers, said in an interview. “We are worried about seeing service line closures at hospitals in an environment where OB-GYN and chemotherapy service lines are already being cut.”
Covering the cost of care
Supporters of the change say the extra payments inflate federal spending on the Medicaid program, giving hospitals “windfall profits.”
“Not only do these programs sidestep the truly needy on Medicaid and favor special interests instead, but all this is financed by growing the federal debt, leading to inflation and higher interest rates for all Americans,” the Paragon Health Institute, a conservative think tank that helped draft the bill, stated in a policy brief.
Hospital leaders dispute that. Earlier this year, the American Hospital Association asserted that without the extra payments, Medicaid managed care organizations in 2023 only covered about two-thirds of the actual cost of care.
Cindy Samuelson, senior vice president of the Kansas Hospital Association, said the additional payments are especially critical in a rural state such as Kansas, where some researchers have found that 87% of rural hospitals are in the red. Kansas is one of 10 states that did not expand Medicaid, and like other nonexpansion states, it will have to begin reducing direct payments to 110% of what Medicare pays starting in 2028.
“Over time, commercial payers are paying less and less,” Samuelson said. “Many hospitals in our state are at risk of closure.”
Samuelson said that in rural areas, health care providers see fewer patients, which makes it hard to spread out the cost of care and make up for losses that come from serving underinsured, Medicaid and Medicare patients. One result is that rural hospitals are trimming services. A report published this year by Chartis, a health care consulting firm, found that between 2011 and 2023, nearly 300 rural hospitals across the country stopped offering obstetrics care, and 424 rural hospitals ceased chemotherapy services.
In Hutchinson, Kansas, Benjamin Anderson, CEO of the rural and community-owned Hutchinson Regional Health System, said his hospital barely broke even this year, and lower Medicaid payments will take a toll. The 190-bed hospital serves more than 65,000 people in the central Kansas region, and sees a lot of patients who are struggling with mental health issues and substance use disorders.
When we think about the cuts to Medicaid, it isn’t simply about cutting services to the poor. It’s threatening services to everyone.
– Benjamin Anderson, CEO of Hutchinson Regional Health System
“We are closely managing our workforce expenses. We’re going to be relying more heavily on philanthropy,” Anderson said, adding that the hospital wouldn’t lay off staff but would reduce the number of workers by not filling open positions.
He said his hospital has some cash reserves that should enable it to keep going, but that many other rural hospitals lack such a cushion.
“When we think about the cuts to Medicaid, it isn’t simply about cutting services to the poor. It’s threatening services to everyone, because in a rural community, we all get care in the same place,” he said. “If we cut out the safety net that’s sustaining these hospitals, everyone’s health care is threatened.”
Searching for answers
Three hours northeast of Hutchinson is the rural town of Holton, where about 3,400 people live. Holton Community Hospital is a 14-bed critical access hospital, meaning that it provides emergency care around the clock for a rural community. For the past two years, it has been struggling, according to Carrie Lutz, the hospital’s CEO.
Lutz said the hospital is not part of a broader health care group, and it relies on philanthropy and local taxes. Due to financial strains, it’s in the process of selling off its home and hospice services to another health care facility. The cap on extra payments will be an additional barrier, she said.
Samuelson said Kansas is applying for money under the five-year, $50 billion Rural Health Transformation Program, which Congress added to the One Big Beautiful Bill Act amid concerns about its impact on rural hospitals. She expects Kansas to get at least $500 million between 2026 and 2030.
Rural hospitals in Mississippi also hope to tap into those funds. The Mississippi Hospital Association, which is advising state leaders on their application, said it expects Mississippi to get at least $500 million over the next five years.
Like Kansas, Mississippi did not expand Medicaid under the Affordable Care, a decision that deprived it of additional Medicaid patients and thus extra revenue.
“A few years ago, we had several rural hospitals that were facing some imminent closure challenges, and so our enhanced supplemental payment based on the average commercial rate has been a lifeline,” said Richard Roberson, president and CEO of the Mississippi Hospital Association.
“What we’re concerned about is that when those payments start to decrease, then we’re going to be right back to where we were in 2022, with concerns about rural hospitals again.”
Roberson said Medicaid, with the additional payments, had become “one of the best payers, if not the best payer, for our hospitals over the last two years,” and helped a lot of hospitals stay out of the red.
He said the new rural health care fund is promising, but noted that Mississippi will decide where to spend any money it gets, and some rural hospitals might miss out.
“We want to make sure we’re working with the state to provide sustainable solutions, not one-time fixes,” Roberson said. “The big wild card is the Rural Health Transformation fund and what the state chooses to do with that money.”
This story was originally produced by Stateline, which is part of States Newsroom, a nonprofit news network which includes Louisiana Illuminator, and is supported by grants and a coalition of donors as a 501c(3) public charity.
Louisiana Illuminator is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Louisiana Illuminator maintains editorial independence. Contact Editor Greg LaRose for questions: info@lailluminator.com.
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Left
The content presents a critical view of a policy associated with a Republican administration, emphasizing the potential negative impacts of Medicaid payment cuts on rural hospitals and vulnerable populations. It highlights concerns from healthcare providers and advocates while also including conservative perspectives on fiscal responsibility. The overall tone leans toward concern for social welfare and healthcare access, common in center-left reporting, but maintains a balanced presentation by acknowledging opposing viewpoints.
