By Sam Karlin

After calling the bill a "fig leaf" aimed at saving Louisiana's attorney general from embarrassment, Gov. John Bel Edwards quietly signed into a law a measure pushed by one of his political rivals that aims to eventually offer some protections to patients if the Affordable Care Act is overturned.

The bill was backed by Attorney General Jeff Landry, and authorizes the state's insurance commissioner to study other state's health care models to come up with a potential replacement for the ACA's individual health exchange. It would only be necessary if the ACA is overturned--which is the goal of a lawsuit that Landry has joined.

Both Landry, a Republican, and Edwards, a Democrat, backed bills during the recent legislative session that they claimed would protect people with pre-existing conditions in case the lawsuit joined by Landry is successful.

But the GOP-led Legislature sided with Landry's idea, sending it to the governor's desk after killing the measure pushed by Edwards. Most state lawmakers, along with Landry and Edwards, are running for re-election to their respective offices this year, and the Legislature passed the bill relatively easily.

Edwards has said Republicans killing his measure was "Washington-style politics."

After lawmakers passed Landry's bill, the attorney general called on Gov. Edwards to "follow the will of our people's representatives and sign the bill into law as soon as possible."

Edwards quietly signed the bill Thursday without a formal announcement.

"Louisiana has now become the country's leader in protecting patients with pre-existing conditions," Landry said in a statement Friday. "Protecting pre-existing conditions is not partisan, it is proper. I appreciate the governor joining our bipartisan efforts"

The new law would direct Insurance Commissioner Jim Donelon to study other states' best practices for insurance pools, which could eventually replace the ACA's current individual market. Landry has said he wants to enact an insurance pool similar to what Maine has in place, called an "invisible high-risk pool."

Such a pool would subsidize insurers offering plans for people who don't get coverage through work or other means, like the individual exchange currently does. But it is not clear where the money would come from to fund the system, something lawmakers pointed out as the bill made its way through the Legislature.

Edwards previously cast doubt that the bill would maintain the current level of protections for those with pre-existing conditions, and highlighted the uncertainty surrounding its funding.

"The bill doesn't do any harm," Edwards spokeswoman Christina Stephens said Friday. "It conducts a limited study of a problem that Jeff Landry's own lawsuit causes. The Governor respects the will of the Legislature to pass this bill and hopes to continue the discussion of how to protect Louisiana's families."

Currently, those who don't receive health coverage through their employer, the government or other means can access insurance through the Affordable Care Act's individual exchange. Enrollment in the exchange in Louisiana has fallen from a high of 214,148 people in 2016 to a record low of 92,948 this year, as people migrated to other forms of insurance like Medicaid expansion and employer-sponsored coverage.

About 800,000 people in Louisiana have pre-existing conditions. Another nearly half a million receive health coverage through Medicaid expansion, which was also part of the Affordable Care Act.

Louisiana would still need to come up with money to pay for a replacement for the individual market, and the new law orders Donelon to evaluate paying for the potential insurance pool. A plan would need approval from lawmakers.

Edwards signed the bill despite hammering Landry over his stance on the Affordable Care Act and chastising the bill repeatedly as not doing enough to replace the ACA.

"I will never call it an Affordable Care Act replacement," Edwards said shortly after the legislative session ended. "Studying a high risk pool is not a replacement for the Affordable Care does not protect adequately those in Louisiana that have a preexisting health condition."

The bill pushed by Gov. Edwards was carried by state Rep. Chad Brown, D-Plaquemine. A House committee voted along party lines to kill it.

Both Landry's and Edwards' bills had to be revised after running into a major problem--cost.

State officials estimated consumers would be hit with hundreds of millions of dollars in higher premiums if the ACA was killed and the state tried to offer some of the law's popular protections. Currently, the federal government subsidizes the individual exchange, paying part of the costs of insurance for the vast majority of people in the market.

Both Landry and Edwards amended their legislation to get rid of the hefty price tag. After initially facing pushback from state senators, Landry won relatively easy passage of his bill.

Edwards also announced Friday the members of the Protecting Health Coverage in Louisiana Task Force, which will evaluate what the state can do to protect people with pre-existing conditions "in the event the Attorney General's lawsuit to invalidate the Affordable Care Act is successful."

The task force will meet July 17 for the first time. Attorney General Landry or his designee has a spot on the panel.

(c)2019 The Advocate, Baton Rouge, La.