Deal in Congress good, bad for Louisiana
by jordan blum
Advocate Washington bureau
June 28, 2012
WASHINGTON – The latest federal transportation bill compromise would take more than $650 million from Louisiana’s federal health care services dollars for the poor combined over the next two years.
The nearly $3 billion total highways bill does direct billions of dollars in BP oil spill fine money to Louisiana for RESTORE Act restoration projects, but U.S. House and Senate leaders on Wednesday afternoon were opting to balance some of the other spending measures on the back of Louisiana’s health care, according to state government officials and the congressional delegation.
Louisiana Department of Health and Hospitals Secretary Bruce Greenstein said Tuesday the Medicaid spending cuts would mean the state having to cut its reimbursement programs for services like breast and cervical cancer screenings, foster care services, hospice care and more.
Greenstein also said the state would have to cut its uncompensated care payments to LSU hospitals and rural hospitals, while also chopping 10.2 percent of the state’s total payments to health care providers for Medicaid services performed.
“It will not be painless by any stretch,” Greenstein said. “It comes after years of several reductions already.”
A final compromise on the federal transportation bill was expected Wednesday because the U.S. House and Senate must vote on the bill by the end of the week. Transportation conference committee chairwoman Barbara Boxer, D-Calif., and vice chairman John Mica, R-Fla., both declared victories on completing the bill late Wednesday afternoon.
The Louisiana-specific potential health care cut is part of a long-running battle over the federal government’s matching share of Medicaid dollars, called FMAP, to Louisiana that had resulted in U.S. Sen. Mary Landrieu, D-La., securing more federal Medicaid dollars for the state.
Landrieu and state officials have successfully argued that the state’s per capita income levels over a three-year period — a chief determiner of the award — were artificially high, due to dollars paid out for rebuilding as part of Hurricane Katrina recovery. Those funds were unexpectedly further boosted because of a math issue from the inclusion of the 2008 Hurricane Gustav disaster impact.
Critics in Congress called the surplus of federal health care dollars to the state the “Louisiana purchase.”
Now, members of Congress are trying to bite back into those funds.
But state Commissioner of Administration Paul Rainwater noted that the state’s 2012-2013 budget process was already completed earlier this month and now the federal government is trying to go against its own calculations.
When state matching dollars are factored in, Rainwater said, the total loss for Louisiana is $1.1 billion because the state cannot make the loss of the federal funds.
“We based our current budget on the FMAP,” Rainwater said. “We don’t think you should take from the FMAP – a published match.”
The Louisiana Medicaid budget for the fiscal year that begins July 1 is $7.7 billion.
Some of the cuts like eliminating breast and cervical cancer screening were targets of budget cuts when the state Department of Health and Hospitals had to develop plans in the wake of the House stripping one-time money from the budget bill. But the programs got restored when the Senate restored the one-time money.