The Louisiana House on Tuesday snuffed out any chance of legislative passage of a Medicaid expansion to provide health insurance to some 400,000 of the state’s working poor.
The Medicaid expansion, included in the federal Affordable Care Act, is an option for states. Gov. Bobby Jindal has rejected state participation.
House Bill 233 came up 16 votes shy of the majority needed to approve the proposed private insurance based plan similar to what Arkansas is pursuing.
The vote was 37 for the Medicaid expansion and 59 opposed, with Republicans lining up in the “no” column. Nine representatives did not vote.
The House also killed a proposed constitutional amendment that would have allowed state residents to decide whether they wanted to abide by mandates in the federal health care revamp also known as Obamacare.
House Bill 429 would have amended the Louisiana Constitution to include a prohibition of any law that requires a person or health care provider to participate in a health system and to say a person couldn’t be fined for not participating.
The vote was 34 for the proposition and 44 against. Seventy votes were required for House passage.
“This is not a partisanship issue,” said state Rep. Paul Hollis, R-Covington and sponsor of HB429. “This is my attempt to have the people of my district and of Louisiana to have their voice heard.”
Hollis argues that the federal Affordable Care Act is wrong and should be abolished.
State Rep. John Bel Edwards, D-Amite and head of the House Democratic Caucus, said the law had been found constitutional by the U.S. Supreme Court. “This is an attempt to put a nullification provision in the Louisiana constitution,” Edwards said.
Under HB233, the Medicaid expansion bill, residents with incomes up to 138 percent of the federal poverty level would have been able to get coverage through a health insurance exchange beginning Jan. 1, 2014. The premiums would have been funded with 100 percent federal funds.
State Rep. Rogers Pope, R-Livingston, told the House he made a mistake on the committee vote that allowed HB233 to get to the floor. He said he would not make another one, urging his colleagues to vote “no.”
HB233, sponsored by state Rep. Patricia Smith, D-Baton Rouge, was similar to one pushed by state Sen. Ben Nevers, D-Bogalusa, that made it past one Senate committee then died Monday in another.
“Have compassion for people in your district who do not have insurance,” Smith said.
The state has no plan for taking care of the uninsured other than through the LSU hospitals that are undergoing private takeovers, she said. “The partnership funding is in flux,” Smith said, noting that funds are lacking.
HB233 would have allowed private insurance companies to sell policies to those people included in the Medicaid expansion. It would have saved state government about $300 million through 2016, she said.
The federal government pays 100 percent of the Medicaid expansion costs for the first three years, said state Rep. Regina Barrow, D-Baton Rouge.
“This is a no-brainer,” Barrow said. “This really insures that all the people we represent can at least have access to coverage.”
State Rep. Jared Brossett, D-New Orleans, said the infusion of federal health care dollars translates to 15,600 new jobs and $1.8 billion in new economic activity.