PAR asks Jindal for Medicaid explanation

PAR to Jindal: Explain alternative to Medicaid expansion

The Public Affairs Research Council on Tuesday called on Gov. Bobby Jindal to provide specific policy ideas for revamping Medicaid as he continues to reject federal expansion because it lacks “flexibility.”

“The governor should explain his alternative path for health care coverage for Louisiana’s uninsured if he chooses not to expand Medicaid, and the Legislature should play a role in shaping that policy,” a new PAR report concludes.

The nonprofit governmental research group said Jindal has laid out some “broad ideas for reforming Medicaid” instead of embracing the plan called for in the federal Affordable Care Act, known as Obamacare.

“If he has specific policy requests for flexibility under ACA and has not formally sought approval, he should make those requests to the U.S. Department of Health and Human Services. If an alternative plan to Medicaid expansion can be tailored to Louisiana, it deserves the public’s consideration,” according to the PAR report.

PAR does not make a recommendation on Medicaid expansion.

“We have not said we need to jump out there and go with it,” PAR president Robert Scott said. “It may not be the cookie-cutter approach, as they say, is the best for Louisiana.”

However, Scott said, “It’s obvious there are other states that are out there trying to work for an alternative way in dealing with the uninsured population.”

The PAR report comes as Arkansas Gov. Mike Beebe said the Obama administration is willing to let Arkansas use an alternative to Medicaid expansion that would provide private insurance to an estimated 250,000 residents instead of adding them to the Medicaid rolls.

The release of the report comes as the joint Louisiana House and Senate Insurance Committees prepare to meet Wednesday to discuss the pros and cons of Medicaid expansion. State health and insurance leaders as well as national analysts are expected to testify.

Jindal has said in the past that the private sector route is the way to go, instead of expanding the broken government health insurance program for the poor and uninsured.

Jindal declined a request for interview made through his press office.

State Department of Health and Hospitals Secretary Bruce Greenstein discounted reports of an Arkansas agreement. He said no formal plan that he knows of has been filed for Obama administration approval.

Greenstein said he has not talked with Arkansas officials about what it is proposing.

“We made the decision to not expand, so we’re not putting a great deal of time in what-ifs,” Greenstein said.

Greenstein said Jindal does have a “concept paper.”

Jindal has consistently rejected the Medicaid expansion, contending it would be too costly for the state and it did not give states enough flexibility.

The Medicaid expansion is projected to provide health care coverage for between 200,000 and 400,000 Louisiana uninsured depending on which group’s figures are used.

Under the ACA, all adults who earn 138 percent or below of the federal poverty level would be eligible to enroll in Medicaid beginning in 2014 if their states opt in. Today, that would mean individuals earning up to $1,285 a month. For a family of four, the earning level would be up to $2,651.

The federal government initially pays 100 percent for the first three years. Then states would pay a small portion after that, up to 10 percent annually.

Jindal has said the expansion would end up costing the state more than $1 billion over the first ten years.

A recent national report done for Families USA concluded that the $1.1 billion annually spent by the federal government to provide that medical care would have a ripple effect, creating 15,600 new jobs and $1.8 billion in increased economic activity by 2016.

PAR recommended that the governor and the Legislature conduct a more thorough cost-benefit analysis of Medicaid expansion because “key factors have not been considered in previous analyses ... Louisiana deserves no less.”

Greenstein said the agency has been doing “analysis and research for quite some time.” He said the agency is relying on a 2010 survey by Mercer for much of its analysis.

Comments

1) Comment by GardenVariety - 13/03/2013

Always a good time for shameless self promotion--eh, Jeff? Between trolling comment boards and producing a blog devoid of logos or ethos, when do you find time to prepare lectures for your students, meet with said students, conduct legitimate research in your field, attend faculty meetings, do committee work, publish in refereed academic journals,and other duties of a tenured professor at a state institution of higher learning? Are the LA taxpayers and students paying skyrocketing tuition getting their money's worth? Whenever Chancellor Jindaltine's sycophants speak, I almost hope he wins or is appointed to national office, just so he will take them with him. But then, empathy for other Americans kicks in.We're stuck with ya'll until the Jindal train plummets into its sinkhole of disgrace.

2) Comment by jeffsadow - 13/03/2013

Not a bad effort by PAR, but follow its recommendations for further study and you still won't get an accurate picture; see http://jeffsadow.blogspot.com/2013/03/par-expansion-framework-falls-short-for.html

3) Comment by crazycajun - 13/03/2013

agagent is a plant. LOL

4) Comment by prbeav - 13/03/2013

Jindal has a long record of arrogance toward the public. Commenting on his 2003 loss to Kathleen Blanco, Rod Dreher wrote, Blanco turned the tables "by accusing Jindal of balancing the Medicaid budget on the backs of the poor, who rely on Louisiana's public-hospital system for health care." [http://old.nationalreview.com/dreher/dreher200311170844.asp ]>>>>One is constrained to ponder who "the public" is. Regarding control, it seems obvious to follow the money to special interest groups: the NRA, in God we trust, the industrial-military complex, the wealthy elite, the entertainment industry, lawyers, academia, etc.>>>>After his second election, the President referred to the majority voters as "we, the people." Benjamin Franklin is said to have claimed that the US Constitution created a republic (rule of law) “if you can keep it.” Practically, the rule of law is only a pretense, for example, the 1st Congress involved itself in religion.>>>>America operates under an unwritten constitution, because for 225 years Americans have not accepted the gift of the US Constitution in its preamble: We the People with its seven stated goals. The signers of the Constitution intended We the People to provide just governance of the governed; the people have not accepted the duty. Unless it comes to their attention, they never will. We the People needs to happen.

5) Comment by beabea - 13/03/2013

"Jindal has said in the past that the private sector route is the way to go, instead of expanding the broken government health insurance program for the poor and uninsured." Let's take a closer look at this. Private sector = for-profit sector, so he's really saying it would be better if someone can make a profit from ensuring the uninsured people in our state. How can that possibly be more economical than ensuring them through a non-profit (i.e. government-run) program? And if this were such great business opportunity for the private sector, you would think they'd be lining up to grab a share of this market--we certainly have plenty of business for them with 25% of Louisiana adults being uninsured. Also, Medicaid is administered by the states, under federal guidelines which do give the states flexibility. So if Medicaid is in fact "broken," a fair amount of the blame for that goes to the state's administration. So the truthful explanation (which we obviously won't get) would be "We're no good at running something like this, and we don't want to anyway because that would disprove our ideology that government can't do anything well. So we would rather just see if one of our friends can find a way to cash in on this and grab some of that taxpayer dough."

6) Comment by GardenVariety - 13/03/2013

I want to see this!!! The man is exceptionally talented at presenting exhaustive (and exhausting) double-speak, evasions, and outright falsehoods. However, an explanation?! Does he even know how to honestly answer a question, provide a genuine account of his actions, give a clear statement without hedging or equivocating? I would love to see LA's High School Debate Captain in Chief be held responsible for his words and actions. I'm going to turn blue waiting, aren't I, Vernonbrew22?

7) Comment by agagent - 13/03/2013

Health and hospitals took a huge mid-year cut because Medicaid had a huge mid-year deficit. This year Obamacare causes a reduction in DSH funding for our state hospital, which will result in lay offs and reductions in service. The federal Restore Act removed more than $600 million from Louisiana's Medicaid program. Louisiana is paying a laeger share of its Medicaid program. Obama and the Democrats in Congress are the causes of those lay offs and reduction in health care for the poor.

8) Comment by agagent - 13/03/2013

This is the same reporter who said that the vast majority of all births in Louisiana are paid by Medicaid, while less than 20% live in poverty. With the help of a lawyer, you can make yourself cash poor and qualify for Medicaid. The Medicaid system is broken. Fix it before expanding it.

9) Comment by Thurston_Howell_III - 13/03/2013

Good luck with that. He is going to side step this one.

10) Comment by Vernonbrew22 - 13/03/2013

Don't hold your breath waiting for an explanation. Rumor has it that some stout cajun woman grabbed ole pyiush and bones by his scrony neck and pulled him in the sinkhole for some oooo la la. Agheeeei to medicaid. He is the law.

11) Comment by Warp7 - 12/03/2013

It is about time someone starts question our arrogant constantly out of state Governor. Now he seeks to put hundreds of health care workers out of work so he can give contracts to his supports in the private sector. I am sure Christy Nichols will smiling broadly when our spineless Legislators question her. While they continue to gut state government, they reward their hand picked Department Heads with double and in some cases triple the salaries the former incumbents.

12) Comment by dday198 - 12/03/2013

hey cat, your right on point b j speaks ag repeats

13) Comment by twinkie1cat - 12/03/2013

The legislature needs to pick up its family jewels out of Bobby's desk and accept the expansion itself. Surely there are enough moderate Republicans who can join with the Democrats and take care of this with a veto-proof majority. >>>>>> Then they need to ensure that the "no income tax on the rich" law does not pass and rescind the unconstitutional voucher and teacher abuse law they were railroaded into last year. Cut the executive budget in half, don't pay for out-of-state travel, reduce the salaries of the overpaid jindalclones, and take away his ability to appoint and fire department heads and BESE. Neuter Jindal and maybe he will just slink away! The alternative is a rabid pit bull running loose.

14) Comment by gary - 12/03/2013

So, agagent - you must work for BJ - that is same old tired talking points that he and his high paid folks babble on a daily basis.

15) Comment by agagent - 12/03/2013

A substantial percentage of the new enrollees in an expanded Medicaid program would be shifted from private insurance to Medicaid. One state estimate puts that percentage above 50%, while a national study says that percentage could be as high as 70% in some states.

16) Comment by agagent - 12/03/2013

The Supreme Court ruled that the federal government could not coerce states into expanding Medicaid. In spite of that ruling the federal government is still coercing states by reducing Medicaid funding through the Restore Act, reducing DSH funding to state hospitals, and increasing states' share of the Medicaid program.

17) Comment by agagent - 12/03/2013

On the other hand Obamacare, the parent program for Medicaid expansion, was passed because: Obama told us he had a program that would reduce the average family’s health insurance premium by $2500 a year. Obamacare would cost less than $1 trillion dollars, and it would lower the federal deficit. Even though Obamacare takes $760 billion of Medicare revenues it strengthens Medicare. You can keep your doctor and your health insurance if you like them. Speaker Pelosi said we have to pass the bill to see what is in it.

18) Comment by agagent - 12/03/2013

The easy answer is that we are going broke funding a wasteful, ineffective Medicaid program that is not serving the poor very well. It should be reformed, not expanded. Unfortunately, the federal government makes the rules and the states have to play by those rules.