Hood: Medicaid expansion will be tough sale

David Hood
David Hood

Proponents of Medicaid expansion will continue the battle in the 2014 Louisiana Legislature but it will take “a miracle” to win approval on the politically charged issue, a former state health chief said Monday.

“We are not giving up. We are going to keep this issue in everybody’s face,” said David Hood, who was secretary of the state Department of Health and Hospitals under the Foster administration. “We are passing up an opportunity to do something good for our people … good for business. It would be good all around.”

But Hood said there’s “not much change that I can see” from when the Legislature last year agreed with Gov. Bobby Jindal and rejected Medicaid expansion that’s provided for in the federal health care revamp.

He is preparing an analysis on behalf of the Campaign for Health Care for Everyone on Medicaid expansion.

States have the option of expanding Medicaid, and half have embraced it. Twenty-one states, including Louisiana, refuse to participate. Four other states are undecided.

Louisiana’s reaction is more about politics than the good the Medicaid expansion will do, Hood told the Press Club of Baton Rouge.

“Most red states are also anti-participation states,” Hood said, referring to Republican-leaning states .

Out of 16 states represented by the Southern Legislative Conference, only four have opted for Medicaid expansion, 11 decided against and one — Missouri — is undecided, he said.

Jindal has rejected the idea, saying a broken Medicaid system should not be expanded, asserting it will ultimately be too costly for the state.

The expansion is 100 percent federally funded in 2014, 2015 and 2016, then the state begins paying up to 10 percent of program costs.

The Medicaid expansion would provide coverage for nonelderly adults with incomes at or below 138 percent of the federal poverty level, which is about $32,000 for a family of four in 2013.

Hood said the state is being foolish in rejecting an infusion of $18.5 billion in health care over the next decade while having to put up an estimated $1.8 billion.

“If everybody can get together on this subject, it will be one of the best things to happen in Louisiana,” Hood said.

In Louisiana, there are 866,000 uninsured, according to the Kaiser Commission, with 242,000 who could be covered with the Medicaid expansion, Hood said. Another 298,000 Louisiana residents would be eligible for a tax credit to purchase coverage through the insurance market exchanges, he said.

Hood said Louisiana is no stranger to Medicaid expansion, having embraced in 1998 a program that expanded coverage for Louisiana’s children. At that time, the Medicaid expansion was “strongly supported” by then Republican Gov. Mike Foster — and his health secretary Bobby Jindal. The Legislature too was “mostly” behind it, he said.

“It was a major success,” said Hood, adding that the federal funds were “much smaller” than those provided to support the expansion for adults. “Louisiana is one of the states that’s a model,” he said. “We need to do that for adults, too.”

“We can not leave this by the side of the road and think everything is going to be alright. It’s not,” he said.