Words like “devastating” and “unsustainable” were tossed around when the state House balked at Gov. Bobby Jindal’s proposed budget in the spring legislative session.
Ultimately, the budget battle resulted in the House backing down on the some $300 million from the state general fund in proposed cuts — above those earlier baked into the budget by Jindal.
Those general fund cuts would be magnified in health care, because a state dollar often matches at least two other federal dollars from the federal-state Medicaid program for the poor.
That was then. Now, with the abrupt withdrawal of $859 million in Medicaid funding, the response from the administration has been subdued, almost soothing. The cuts are doable, various officials have said.
The administration is now cool, calm and collected — about cuts that are in health care well beyond the dimensions of the those that provoked skyrockets of rhetoric in the session.
“I want to see what kind of explanation they have,” said state Rep. Tony Ligi, R-Metairie, who is chairman of the House Republican Caucus. “It’s a big difference from what we were proposing in the session, which was looked upon as catastrophic and going to destroy health care in the state. Now, it’s eight times that amount and they seem relatively confident that everything is going to be OK.”
Part of the explanation is that the cuts will come entirely from Medicaid. In the session, the cuts pushed by the House insurgents — Ligi was one — would have included deep cuts in college funding, thus spreading around the impact of the cuts.
Another part of the explanation, we believe, is the political calendar. Medicaid has — in the wake of a U.S. Supreme Court decision on the new health-care law — become something of a political football nationally. Jindal has been among the leaders among the governors saying he would reject an expansion of Medicaid coverage pushed by President Barack Obama.
While Jindal’s ideological compass may wobble a bit on state issues, it is true and sure on national politics. The political season is now one in which ruthless economy is a virtue. It would not do, at least just now, to whine about cutting Medicaid budgets.
Still, the cuts reflect real spending — including money to hospitals, public and private, including vulnerable institutions in small towns — that will be forgone. “You can’t cut (this much) without having some severe reductions and eliminations,” commented state Rep. Patricia Smith, D-Baton Rouge, and head of the Legislative Black Caucus.
Any elimination of programs and services in the LSU hospital system will have only a “trickle-down effect,” Smith said. “It puts the burden on the private facilities that cannot absorb all of the patients.” The governor is right to address the shortfalls now, before the federal fiscal year begins Oct. 1, when the new Medicaid formula hurts the state.
But in doing so, Jindal will have to show some sensitivity to his rhetoric of just a few months ago.