Jindal's healthcare plan for La. advances

Without opposition and to much fanfare, a Louisiana House committee on Wednesday approved legislation that would lead to this state adopting Gov. Bobby Jindal’s national health care plan.

Then the representatives promptly forwarded the bill for another hearing by another committee that’s not scheduled to meet again during the five days left in 2014 legislative session.

The House Appropriations Committee, which held its last meeting last week, was sent Senate Bill 682 to consider and vote on before the Senate-passed measure can proceed to the full House for the needed approval. SB682 would require the state Department of Health and Hospitals to come up with a plan for implementing the governor’s counterproposal to “Obamacare,” which Jindal recently released through his national “America Next” committee.

The measure was sponsored by state Sen. Ben Nevers, the Democrat who had led unsuccessful efforts to expand Medicaid to cover uninsured working poor. Though many took Nevers efforts to push Jindal’s plan instead as tongue-in-cheek, only one legislator has voted against the measure during its trek through the Legislature.

However, a lot of legislators, Republicans and Democrats alike, have wondered aloud how much “Bobbycare” would cost since the governor’s plan is general. SB682 would have DHH fill in those details, provided it gets a hearing and approval by the House.

“It would have to be an ‘emergency special-called’ meeting,” said Appropriations chairman Rep. Jim Fannin, R-Jonesboro.

Regardless of the tactics used, the House is going to have to suspend the rules to advance SB682 any further.

Basically, when SB682 comes up on Thursday’s House agenda for recommittal to another committee, the rules would have to be suspended to avoid sending the measure to the Appropriations committee for another hearing. Or Fannin will have ask to suspend the rules in order to hold the “emergency special-called” meeting of the Appropriations Committee. The hearing would have to be held later Thursday.

If the rules are suspended and SB682 is kept alive, the vote could not come before Friday and it would have to be approved by at least 53 of the 105-member Louisiana House before 6 p.m.

After that point, a two-thirds vote, or 70 representatives in the House, would be needed.

Nevers says Fannin was noncommittal during their conversations Wednesday. “He told me he hadn’t planned on meeting, but he didn’t slam the door,” Nevers said, adding that though difficult there are still ways to push SB682 to final passage.

“I am in earnest. I want to implement some plan that will help people,” Nevers said late Wednesday. Since Jindal blocked every effort to expand Medicaid, adopting Jindal’s own plan seemed the most efficient way to get health care coverage for the uninsured in Louisiana, he said.

“It’s the only option we have open to us right now,” Nevers said.

There are other issues, though, Fannin said. The Appropriations committee has not advanced any bills that have a financial cost attached because it could disrupt the state’s budget.

The Legislature’s fiscal advisors have said the cost of the Jindal plan is “indeterminable.”

Fannin says he plans to study the legislation Wednesday night. If Fannin determines that SB682 has no financial exposure in the new budget year, he said the committee could be bypassed and the measure go to the House floor on Friday.

SB682 already has sailed through two Senate committees and passed the Senate floor. The Senate Finance Committee required the plan to be approved by the Legislature’s money committees before it is implemented concerned about how it would be paid for.

“If this plan is good enough for America, surely it will be good enough for Louisiana,” Nevers told the House health committee Wednesday.

“I could see this huge bus with (the slogan) “Louisiana First America Next” on it traveling to Iowa,” he said alluding to an early presidential primary state and Jindal’s national aspirations.

Nevers, D-Bogalusa, has led the legislative fight to expand Medicaid for the last two years - getting nowhere because of Jindal’s and legislative opposition. The expansion, a part of the federal Affordable Care Act, would provide government health insurance to about 240,000 Louisiana adults who make too much to qualify for Medicaid but too little to afford their own policies on the private market.

Committee members noted the vagueness of the Jindal plan.

“I applaud you for attempting to get health care for our citizens by any means necessary,” said state Rep. Regina Barrow, D-Baton Rouge. But she said, “there seems to be an outline of what you are proposing to do and not much substance. That really gives me some concern.”

Others wondered whether the state Department of Health and Hospitals could meet a September deadline for coming up with a plan using Jindal’s “America Next” document as a guide.

DHH Secretary Kathy Kliebert said the agency could provide a plan but that would only be a starting point because of potential federal and state approvals that may be required. In some aspects, there would have to be changes in federal law to accomplish the goals, she said.

State Rep. Lenar Whitney, R-Houma, suggested the panel scrap the legislation and instead push for repeal of Obamacare in Louisiana. She said many of the things in the Jindal plan can be adopted without Nevers’ legislation. She dropped the idea in favor of filing a resolution stating legislative intent.

According to the legislation, the program would be funded with any money available.

Jindal wants the federal government to provide health care block grants to states that would be free to develop their own health programs. Louisiana would have to seek special federal permission for block grant funding. The plan could consider various health care access initiatives such as increasing medical savings accounts, providing greater incentives for wellness, focusing on fraud prevention, guaranteeing access for those with pre-existing conditions and seeking federal changes related to insurance, such as cross-state insurance purchasing.

Mark Ballard of The Advocate Capitol news bureau contributed to this report.

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