Medicaid expansion bill clears Senate committee

A state Senate panel late Tuesday narrowly endorsed a revamped Medicaid expansion plan that would use the private insurance marketplace to provide health care coverage to Louisiana low-income adults.

The Senate Health and Welfare Committee voted 4-3 for what state Sen. Ben Nevers, D-Bogalusa, called “a Louisiana solution” for state participation in the Medicaid expansion called for in federal law. The bill now heads to the full Senate.

Nevers said there are 290,000 to 420,000 uninsured in Louisiana who could benefit, and it would be unconscionable for the state to reject the federal dollars that would cover nearly all of the costs.

Gov. Bobby Jindal has rejected the Medicaid expansion that is part of the Affordable Care Act, or Obamacare, claiming it will be too costly over time and that its basis is a broken health care system.

He reiterated his opposition late Tuesday, saying the committee revamp, which is similar to a private-sector approach being proposed in Arkansas, doesn’t solve anything.

Nevers’ revamp would funnel the uninsured into federal health insurance exchanges, which help people shop for coverage. Another provision includes triggers for termination of state participation if federal funding drops below levels spelled out in law. The federal government pays 100 percent of expansion costs the first three years, then the amount drops annually until it reaches 90 percent.

“We as legislators have a right and responsibility to lead out,” said Nevers, D-Bogalusa, as he proposed using the health insurance marketplace. “This may not be the totally correct model, but this might be the only answer left in this Legislature.”

Nevers’ amendment overhauled Senate Bill 125, sponsored by state Sen. Karen Peterson, D-New Orleans.

Peterson’s bill would have required Louisiana to expand its current Medicaid program, which mainly covers children, to provide coverage for adults in households with income up to 138 percent of the federal poverty level.

For a single adult in 2014 when the program starts, the income would be $15,856. For a family of four, the income cutoff would be $32,499.

Former state health agency heads Dr. Fred Cerise and David Hood testified in support of the expansion.

Current interim state health chief Kathy Kliebert said the administration opposed the Nevers revamp for the same reasons it rejected expansion of traditional Medicaid.

“It is ultimately financially risky for our state,” Kliebert said. She also said there are too many uncertainties with the new program.

Peterson took issue with Kliebert’s comments about “uncertainty,” comparing it with Jindal’s budget proposal. “Our budget is based on one-time money. We can take money that we know for certain is there for three years — 100 percent — for
uninsured citizens,” Peterson said.

Voting FOR the Medicaid expansion rewrite (4): State Sens. Nevers; Yvonne Dorsey-Colomb, D-Baton Rouge; Fred Mills, R-St. Martinville; and Elbert Guillory, D-Opelousas.

Voting AGAINST the amended SB125 (3): State Sens. Bret Allain, R-Franklin; Sheri Buffington, R-Keithville; and Dan Claitor, R-Baton Rouge.

Committee Chairman state Sen. David Heitmeier, D-New Orleans, did not vote.