Political Horizons: Chances of expanding Medicaid slim

Last year, the Louisiana Legislature’s Democrats systematically threw themselves against different parts of the Republican majority’s electric fence — looking, unsuccessfully, for weaknesses in the GOP opposition to the federal Affordable Care Act, widely known as Obamacare.

Democrats tried several bills with different variables; they trotted out a variety of parliamentary strategies; they held rallies — everything short of shutting down state government. The goal was to press Gov. Bobby Jindal and his Republican majority to expand Medicaid, the government health insurance for the poor.

In the coming weeks, Louisiana Democrats will make another run at trying to shift the state out of the “no way, no how” column and into the column occupied by 27 other states that have expanded Medicaid. This time, some legislators want the state’s voters to decide, and they are pushing bills in the House and Senate that would add the statewide vote to the Nov. 4 ballot.

The outcome likely will be the same as it was last year.

Jindal says even though the feds would pick up the cost initially, ultimately Louisiana taxpayers can’t afford to pay their part for increasing the percentage of the state’s Medicaid rolls from about one-fourth of the state’s population to about one-third. But that has been his position for more than a year.

Now, apparently eyeing a presidential career upon completion of his second term in 2015 and polishing his deep-thinker image, Jindal released an alternative to Obamacare through America Next, his national “conservative policy group” based in the Virginia suburbs of Washington, D.C.

Basically, Jindal’s “Freedom and Empowerment Plan” would first get rid of Obamacare, then privatize much of Medicaid and Medicare.

The Nation, a liberal magazine, said Jindal’s plan was a rehash of what “Republicans have been advocating for two decades.” Its conservative counterpart, National Review, said Jindal’s plan “would probably result in millions of people losing their coverage.”

Under Obamacare Medicaid expansion, nearly 250,000 Louisiana residents would get coverage if the Medicaid rules were changed, according to the Kaiser Family Foundation.

U.S. Sen. Mary Landrieu refers to them as members of the “Jindal gap” and notes that their number exceeds the populations of Lafayette and Lake Charles combined. “It’s like saying ‘no’ to the entire city of Shreveport. We like you, but you’re not valuable enough to provide health care,” she said Monday.

The next day, Democrats gathered in the aisles of a pharmacy across the street from Baton Rouge General Medical Hospital Mid City to dramatize the “Jindal gap” and plug their upcoming efforts to push a statewide vote on the issue.

Standing next to a display of pill organizers, Jan Wells, of Slidell, said she made too much as a graphic artist to qualify for Medicaid but too little to buy private insurance. Her husband suffers from cerebral palsy, so they would soon move to a state that expanded its Medicaid rolls.

“I stayed after Hurricane Katrina, and now I’m leaving because of Hurricane Bobby,” Wells said.

Democratic State Rep. Walt Leger III, of New Orleans, pointed to the hospital across the street when explaining what differs this year from last when so many Medicaid expansion efforts failed. Private hospitals are recognizing that they are going to end up eating a lot of those costs.

“That’s the ultimate selling tool: The hospitals are feeling the pinch,” Leger said. Late Thursday night, as if to provide punctuation for Leger’s argument, the Jindal administration admitted that federal authorities were withholding $307 million that would pay for services already provided to uninsured patients in Louisiana.

Leger points to two recent polls saying a sizeable number, though not a majority, of Louisiana residents supports expanding Medicaid.

“True, it’s not a majority. But it’s close to half,” Leger said.

“The people have the right to decide,” interjected state Rep. Patricia Smith, D-Baton Rouge. “Our colleagues across the aisle recognize that it’s the people’s decision.”

Maybe, but apart from the GOP not wanting to fuel a large turnout of voters in November, which would help Landrieu’s re-election chances, there’s no way Jindal is going to allow his Republican-dominated Legislature to go on record with anything that hints at support for Obamacare.

It takes no Nostradamus to predict that Louisiana will leave the legislative session June 2 still firmly among the 19 states that want nothing to do with Medicaid expansion.

Mark Ballard is editor of The Advocate Capitol news bureau. His email address is mballard@theadvocate.com.