WASHINGTON -- The Jindal administration, which has rejected an expansion of Medicaid to increase health coverage for the uninsured, is expressing some interest in a tentative deal between Arkansas and the Obama administration that would provide health coverage through private insurance markets. Under the tentative compromise, coverage for an estimated 215,000 Arkansas residents would be provided from private insurance...
WASHINGTON -- The Jindal administration, which has rejected an expansion of Medicaid to increase health coverage for the uninsured, is expressing some interest in a tentative deal between Arkansas and the Obama administration that would provide health coverage through private insurance markets.
Gov. Bobby Jindal, left, and Louisiana Health and Hospitals Secretary Bruce Greenstein aren't shutting the door on an Arkansas-type compromise on the Affordable Care Act.
Under the tentative compromise, coverage for an estimated 215,000 Arkansas residents would be provided from private insurance firms made available under health exchanges intended to help people who make too much to qualify for Medicaid get coverage.
Jindal's Department of Health and Hospitals Secretary Bruce Greenstein issued the following statement on the Arkansas negotiations:
"We look forward to seeing the final terms of the agreement Arkansas reaches with federal officials. We've consistently said that states should have more flexibility in how they address the coverage needs for their population, including the ability to utilize the private health insurance market, including the Exchange."
"This is one of the common sense elements of Medicaid modernization we've talked about, but HHS should go much further to offer states real flexibility in a more comprehensive and transparent fashion."
Rep. Bill Cassidy, R-Baton Rouge, a physician who has been critical of the president's Affordable Care Act, said using private insurance has advantages over simply increasing eligibility through Medicaid, which he describes as inefficient.
But he said that the plan being discussed for Arkansas does have a significant downside - as envisioned it would provide better coverage for people who aren't working and qualify for traditional Medicaid, while others with full-time jobs and two parent households likely would get private plans with high deductibles.
That he says would be inequitable.
Arkansas Gov. Mike Beebe, a Democrat, said the use of private insurance, rather than Medicaid, is critical to getting the measure through the Republican Arkansas legislature. To enact the expanded coverage, 75 percent of the state's two legislative chambers must approve.
"I am always cautious in my optimism, but I feel good about Arkansas's options coming out of this meeting," the governor said after discussing the idea of providing coverage through private insurers with Health and Human Services Secretary Kathleen Sebelius.
Beebe aides said the Medicaid expansion, envisioned by the Affordable Care Act, could not have passed.
Estimates vary on how many people would benefit from the Medicaid expansion in Louisiana. Some reports have estimated about 400,000 have incomes at 138 percent of the federal poverty level - or $26,952 for a family of three - which would make them eligible for coverage.
The Medicaid expansion would be fully covered by the federal government for the first three years, starting in 2014. After that, the federal portion would be gradually ratcheted down to 90 percent. The Jindal administration has cited studies that say expanding the program would cost more than $1 billion over a decade. But the liberal Louisiana Budget Project concluded in its own report that the state would break even on the expansion because of state spending on the uninsured would fall.