Medicaid expansion killed; Jindal plan advances

Medicaid expansion efforts died Wednesday for the 2014 legislative session, while a plan to test Gov. Bobby Jindal’s national health care plan in Louisiana sailed through the state Senate.

The House Health and Welfare Committee, as expected, killed three separate measures proposing different approaches, including bypassing Jindal and letting the voters decide the issue.

The votes came along almost solid party lines. Republicans lined up in opposition. All but one Democrat supported each attempt, noting the health care of about 240,000 Louisiana residents is at stake.

Later in the day, the Senate voted 35-1 to advance legislation under which the state health agency would develop a health care plan using Jindal’s “America Next” outline.

State Sen. Ben Nevers’ Senate Bill 682 represents an about-face for the senator, who had been the lead proponent of Medicaid expansion. After an expansion bill died, Nevers latched onto the Jindal plan and dubbed it “Louisiana First America Next,” saying it would give Jindal a chance to point to Louisiana’s example “when he travels all over America.” Jindal has presidential aspirations.

“My main goal is to provide better access and quality of care to the people of our state. It’s not about Democrat, Republican, Independent. It’s about any way I can get it,” said Nevers.

The cost of the yet-to-be-developed plan is unknown, and anything the health agency proposes must pass both budget and health care committee scrutiny.

Before Senate passage, Nevers assured state Sen. A.G. Crowe, R-Slidell, that he would not allow the bill to be used as a vehicle to resurrect Medicaid expansion.

The only “no” vote was state Sen. Karen Peterson, D-New Orleans, chairwoman of the state Democratic Party.

In the House committee Wednesday, the Medicaid expansion debate was abbreviated in sharp contrast to prior hearings on the subject.

Opponents, mirroring Jindal, claimed the Medicaid program is broken and expanding it would not improve residents’ health. They said it would significantly increase state costs over time and help people who don’t need it.

“It’s a massive, expensive entitlement program,” said state Department of Health and Hospitals Chief of Staff Calder Lynch.

Phillip Joffrion, state director for Americans for Prosperity, said the Medicaid expansion would provide coverage to able-bodied working adults

Proponents countered that Louisiana is among the unhealthiest states in the nation because it lacks essential access to health care.

“Our health system in Louisiana is the one that’s broken,” said state Rep. Patricia Smith, D-Baton Rouge, sponsor of House Bill 290, which sought a statewide vote on the issue. “We are not doing the right thing for the people of Louisiana.”

Louisiana Budget Project Director Jan Moller said the “charity model” of care, which Jindal’s LSU hospital public-private partnerships continues, is not financially sound. “At some point, we have to abandon the charity model and move to a coverage model that is happening around the country,” he said.

The federal Affordable Care Act allows states to expand Medicaid eligibility to those with household incomes up to 138 percent of the federal poverty level.

Follow Marsha Shuler on Twitter @MarshaShulerCNB. For more coverage of the state capitol, follow Louisiana Politics at http://blogs.theadvocate.com/politicsblog/.