Louisiana state senators at a committee meeting on Tuesday expressed concern over Gov. Bobby Jindal's refusal to opt into a massive federal health care overhaul, while administration officials said they would not "entertain" a model now being considered by the Arkansas Legislature. The Jindal administration has repeatedly held its ground on refusing the 2014 Medicaid expansion as part of...
Louisiana state senators at a committee meeting on Tuesday expressed concern over Gov. Bobby
Jindal's refusal to opt into a massive federal health care overhaul, while administration officials said they would not "entertain"
a model now being considered by the Arkansas Legislature.
The Jindal administration has repeatedly held its ground on refusing the 2014 Medicaid expansion as part of the Affordable Care Act, saying the federal health system is a "one-size-fits-all" program that has little consumer engagement or responsibility. The Medicaid expansion would extend health care benefits to anyone earning up to 138 percent of the federal poverty line and the federal government will cover the full cost of the expansion for the first three years.
Five lawmakers have filed bills that would require the state to conform to the standards set by the Affordable Care Act, commonly known as Obamacare, by Jan. 1, 2014.
Louisiana Department of Health and Hospitals Interim Secretary Kathy Kliebert reiterated the administration's stance at the committee meeting, which was intended to discuss other options for the expansion, including a proposal from the Arkansas Legislature. "One of the major reasons for not expanding is the uncertainty," Kliebert said.
The Senate Health and Welfare Committee heard testimony from Ray Hanley, president and CEO of the Arkansas Foundation for Medical Care, who called in to the meeting to discuss Arkansas' expansion plan.
Hanley said Arkansas has proposed legislation that would use the federal dollars to finance private insurance programs. The plan was proposed because Republicans control both chambers of the Arkansas Legislature and it was unlikely they would opt into the federal expansion, he said.
"You can actually, I think correctly, state the expansion is the anti-Obamacare to the extent it mitigates harmful things that are otherwise going to happen if you don't do this expansion," Hanley said.
Kliebert said the Jindal administration will not be duplicating Arkansas' plan. When Sen. Fred Mills, R-St. Martinville, asked her if the department was looking into similar options, Kleibert said the plan wasn't a "silver bullet."
"Yes, we have looked at it and no, we are not entertaining it. And the reason we're not is because it's really not a silver bullet," Kliebert said. While she said some aspects of the proposal "sound good," Kliebert reminded the committee that the Arkansas proposal had not yet been approved by the federal government and the plan might not provide the flexibility the Jindal administration wants.
Kliebert and Jindal have said the expansion could cost the
state $1.7 billion in the first 10 years while forcing 248,000 residents out of private coverage and into the Medicaid rolls. Other estimates, including previous comments from Jindal administration officials, have pegged the cost at about $1 billion over 10 years.
Sen. Yvonne Dorsey-Colomb, D-Baton Rouge, said she was troubled by the figures Kliebert put forward and, responding to assertions that accepting the expansion would be risky, argued that everything in health care is a gamble.
"So we'd rather risk people's lives than their health care, people that cannot afford anything. People that are poor and old and underprivileged and cannot afford anything, you'd rather risk lives and health and people that are citizens that pay taxes through some form or fashion, you'd rather risk that," Dorsey-Colomb said.
Sen. Dan Claitor said he has heard from constituents who are asking why the state is rejecting federal dollars, and he expressed frustration about the administration's refusal to consider other options. "Arkansas seems to be at least attempting to thread the needle and get where they need to be," Claitor, R-Baton Rouge, said.
The Louisiana Hospital Association came out in favor the Medicaid expansion Tuesday, and said they support "strong coverage for all uninsured Louisianans."
"While it is critically important for Louisiana to take advantage of the significant federal resources available to expand health care coverage, such an expansion must be done in a thoughtful manner. Louisiana has its own set of issues; a 'one size fits all' approach toward Medicaid expansion is not necessarily the best course for our state," the association said in a statement.
Dorsey-Colomb said it doesn't make sense for the state to reject federal dollars when Louisiana has already had to slash its public hospital safety net to compensate for shrinking budgets. "You understand why I'm not convinced and why other people aren't convinced as we close hospitals and close clinics and all that stuff, and then we decide to not take the money or even consider taking the money," Colomb said.
Also on Tuesday, the Louisiana State Medical Society came out against the Medicaid expansion. "Simply expanding Medicaid eligibility to individuals with income levels at or below 138 percent of the federal poverty level would add thousands of patients into a system plagued with inefficiency and facing regular budget shortfalls," Executive Vice President and CEO Jeff Williams said in a statement.