Lawmakers to dissect health funds loss
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With concerns mounting, Louisiana House Speaker Chuck Kleckley on Monday called a legislative briefing on Gov. Bobby Jindal’s plan to start dealing with an $859 million loss in Medicaid health care funding for the poor.
State health chief Bruce Greenstein as well as LSU officials are scheduled to be at a Thursday joint meeting of the state House budget and health committees to undergo a grilling from legislators, Kleckley said.
More than $300 million of some $522.5 million in cuts Jindal aides outlined Friday involve funding for the uninsured care delivered in LSU’s public hospital system. LSU officials previously have said cuts of much less magnitude would result in hospital closures. Other reductions affect rural hospitals, many of which are financially struggling.
Kleckley said he has been flooded with phone calls from legislators and others who want to know “how they determined where the cuts were coming from and the potential impact.”
Kleckley said he is worried about the future of LSU’s W.O. Moss Regional Medical Center in Lake Charles. “It plays a very important part of health care in south Louisiana,” he said.
Other legislators have similar concerns about hospitals in their districts, Kleckley said.
“We are trying to navigate through this and the impact this is going to have on the people,” said Kleckley, a Republican. “You cannot make these kinds of cuts without major impact.”
Greenstein and Commissioner of Administration Paul Rainwater downplayed the impact of the spending reductions. Both specifically denied that the budget cuts would lead to the closure of LSU hospitals.
Known by many as charity hospitals, the facilities run by LSU provide care for the poor and uninsured and help train physicians.
Rainwater and Greenstein said LSU would have to develop a new model for health care delivery, maybe in partnership with the private sector. They insisted it could be done overnight and that savings could be achieved.
Senate President John Alario, R-Westwego, did not return a phone message Monday seeking information on Senate plans in the wake of the health care cuts release.
Also Monday, state Democratic Party chairwoman and state Sen. Karen Peterson blamed Jindal and U.S. Sen. David Vitter, R-La., for not doing anything to stop the reduction in federal Medicaid matching funds that takes effect Oct. 1. Vitter served on a congressional committee that proposed the cut as part of a congressional compromise on a federal transportation appropriations measure.
“It may well be the death warrant for hospitals across the state,” said Peterson, D-New Orleans.
Peterson said she hopes there is sufficient legislative groundswell to prompt a special session to consider other alternatives, such as a tobacco tax increase dedicated to health care or repeal of some of the many tax breaks on the books.
In interviews, other legislators questioned Jindal administration decisions and comments that fly in the face of earlier warnings of dire consequences if cuts proposed by a group of legislators went into effect.
“I want to see what kind of explanation they have,” said state Rep. Tony Ligi, R-Metairie and chairman of the House Republican Caucus. “It’s a big difference from what we were proposing in the session, which was looked upon as catastrophic and going to destroy health care in the state. Now, it’s eight times that amount and they seem relatively confident that everything is going to be OK.”
Ligi was one of the self-called “fiscal hawks” who proposed cuts to reduce the Jindal budget’s reliance on one-time money for recurring expenditures, which conservatives consider irresponsible.
“What I know is the cuts are starting to hurt,” said House Health and Welfare Committee chairman Scott Simon, R-Abita Springs.
Simon noted that part of the plan includes closure of Southeast Louisiana State Hospital in Mandeville, which is located in his district. He said he is concerned because of the “state of mental health and the services we have.”
“Where are we going to absorb these beds? We have more suicides in St. Tammany than any other parish in the state,” Simon said.
Ligi noted that the administration already has closed the New Orleans Adolescent Home. “Everybody from New Orleans got shipped to the facility in Mandeville,” he said.
State Rep. Patricia Smith, D-Baton Rouge and chairwoman of the Legislative Black Caucus, said the effects of the spending reductions need probing.
“You can’t cut without having some severe reductions and eliminations,” Smith said. “I’m concerned that all this just doesn’t give us the true picture of what is happening.”
Any elimination of programs and services in the LSU hospital system will only have a “trickle-down effect,” Smith said. “It puts the burden on the private facilities that cannot absorb all of the patients.”