Letter: Louisiana needs an exchange

In his first interview after the November elections, Gov. Bobby Jindal called for an end to what he called “dumbed-down conservatism” and “bumper-sticker slogans,” and instead, for serious solutions to our pressing challenges. I could not agree more. But when it comes to health reform in Louisiana, the governor has yet to heed his own advice. He is about to squander an opportunity to reduce health insurance premiums, strengthen our economy by supporting businesses and health providers and provide access to care for Louisiana’s uninsured — all for the sake of ideology.

Most people agree that robust competition is necessary for an affordable and high-functioning health insurance market. Unfortunately, this does not exist in Louisiana. Our own insurance commissioner, who has said he supports state-based exchanges, recently called our health insurance market “noncompetitive.” When individuals, families and small businesses in Louisiana shop for health insurance, they have very limited options and it is expensive.

The Affordable Care Act helps address this problem by creating health insurance exchanges, a pro-market mechanism that was conceived by conservatives and has been supported by Republicans for years.

Exchanges function like health insurance malls, giving consumers multiple options to buy insurance, instead of just one or two. This encourages competition among insurers to provide the best product to attract customers. Exchanges also give small firms many of the advantages of large businesses by reducing the burden and cost of enrolling employees in small group plans. Following similar reforms in Massachusetts, health insurance premiums in the individual market dropped by as much as 40 percent.

But not every state is like Massachusetts, so under the Affordable Care Act each state has the opportunity to create its own state-run health exchange, uniquely tailored to the needs of its people. If, however, a state fails to act, the law requires the federal government to do so.

As a strong states-rights advocate, one would expect Gov. Jindal to jump at the chance not to cede control over Louisiana’s exchange to the federal government. But instead he refuses to engage, which will result in one-size-fits-all reforms that won’t reflect Louisiana’s unique needs.

I acknowledge that the Affordable Care Act, passed by Congress and upheld by the Supreme Court, may need some adjustments as we go along, and I stand willing to work with the governor on smart improvements. But as the governor said himself, “you can’t beat something with nothing.” He still has the chance to take his own words to heart and implement a health exchange for the people of Louisiana. The clock is ticking — I urge him to take this historic opportunity before Friday’s deadline. That is what the people of Louisiana need and deserve.

Mary Landrieu

U.S. senator

New Orleans

Comments

1) Comment by HerbF - 12/12/2012

Actually, having the federal government set up the exchanges, rather than the state, might not be a bad idea. I'm not so sure that they wouldn't do a better job. I like the idea of state control of the exchange. On the other hand, I don't have a lot of confidence about the ability of this state to do ANYthing right. We tried to pass Creationism!! So, if there's a way to screw it up, they might well find it it Louisiana runs the system.

2) Comment by agagent - 11/12/2012

The state is closing hospitals to fill a huge deficit in Medicaid. Medicaid, an idea brought to you by liberals. Medicaid is eating up most states budgets. Medicaid covers the vast majority of births in Louisiana when only about 20% have incomes below the poverty level in the state. What a mess the federal government has made of health care.

3) Comment by slye753 - 11/12/2012

Mary, the things about obamacare you talked about sound pretty good. so what are in the other 2777 pages of the bill that you dodged?

4) Comment by postscript56 - 11/12/2012

8point6, i bet you have a good health insurance plan. good for you. hope you never need it. but some folks did need their's which prompted their insurance providers to immediately drop them. and some folks tried to be responsible and continue to pay for services out of their pocket. but specialists who care more about their bottom line than their patients sent those folks off to the charity system. as we all know only lazy bums use socialist state-provided medical services so there is no need to fund it. of course, the resulting backlog is proof government health care is inefficient and slow. if you could repeal "obamacare" like you want, you should really hope you never need your insurance.

5) Comment by Bighug - 11/12/2012

I agree, HerbF. I have never understood how the drug companies can sell a drug in another country for a fraction of what they charge here, where it is made. The answer they give is that they must recoup devolpment costs. That is fine, but why must we pay all of it?

6) Comment by 8point6 - 11/12/2012

Surprise, surprise! news.yahoo.com/surprise-insurance-fee- health-overhaul-law-185726448.html mary, did you read this? "We need to pass this so we can see what's in it." pelosi. IMO, there will probably be many more "surprises" in this health care bill before it's over.

7) Comment by HerbF - 11/12/2012

The ACA passed was the best we could get. It needs changes, and will probably be changed incrementally over the next few years. Two things I would want would be to allow out of state companies to quote and sell insurance. That competition would cut costs quickly. The second is to allow the government to negotiate with drug companies for drug purchases/prices. That will also bring prices down. Why can Canada and other countries do this and we can't? How can the Republicans oppose these changes that are so obviously beneficial?

8) Comment by nimby? - 11/12/2012

the premise of the ACA is that EVERYONE will participate , bringing costs down . yet groups are being allowed to opt out , other groups are offered different , premium care . then there are those who will ignore the mandate , continue their (ab)use of the ER . it will be unenforceable with the cost passed on to the taxpayer . those who obey the law , play by the rules will continue to do so , as will those who don't ...

9) Comment by DMJ - 11/12/2012

The bottom line is this: Republicans don't want to cover everyone. This would bring costs down, which means doctors, hospitals, insurance companies and Pharma would make less money. Also, bringing costs down would make Medicare and Medicaid solvent, which they also don't want. Republicans have been against Medicare and Medicaid since their inception. Heck, Ronald Reagan even put out a record (literally, a vinyl record) railing about Medicare, how it would usher in Socialism and all that. Congressional Republicans have never been honest about their true intentions in regards to health care.

10) Comment by Bighug - 11/12/2012

I don't know what terms of use I violated earlier, but it was probably for refering to Vitter for what he is. OK, here is about the worst thing you can say about a Senator: "You are Senator Vitter!"

11) Comment by Bighug - 11/12/2012

Although I am somewhat right of center, I will always vote for Landrieu and against Vitter. Quality wins. It would really help the average person with health care costs if insurance companies and care providers were not allowed to price-fix. Other businesses are prevented from doing it by anti-trust laws.

12) Comment by Bighug - 11/12/2012

****Comment Removed for Violation of Terms of Use****

13) Comment by HerbF - 11/12/2012

He's closing hospitals, and he won't accept an act that will save us money. He has zero chance for the Republican presidential nomination. The only election I would be inclined to vote for him would be between him and Vitter. Can the legislature do anything to change this?

14) Comment by Whatnow - 11/12/2012

Come on, Mary. Even you had to be bought to pass it.

15) Comment by swinham - 11/12/2012

I agree with DMJ. Whoever wrote this letter for Senator Landrieu did an excellent job! It is unfortunate that the ideologues who will read, but not understand, and comment on this letter will ignore the simple realities it presents and attack it on purely superficial grounds.

16) Comment by WhoCares - 11/12/2012

The exchange is bipartisan idea. There is real cost to setting up the "governmental" entity to oversee and manage it, but I bet if you polled the industry they'd be for it. I assume that republican states who choose not to create the exchange are wanting the Feds to break under the weight of the program. Which begs the question: when does wanting your country fail cross the line of politics an into total ***** It's one of the only parts of the reform that makes sense in my opinion. There is some other stuff, but of the Obamacage big three its alright with me. Medicaid expansion on the other hand is a joke. Medicaid needs to be blown up and totally rebuilt. It's legitamately unaffordable no matter how many things you find to tax.

17) Comment by DMJ - 11/12/2012

Jindal (and all Republicans) say that states can run things better than the federal government. Sure, that's a nice talking point. But when he had the chance to actually prove it, to put his (our) money where his mouth his, he chickens out, opting instead to go stand in the corner and pout. Pathetic. Great letter, Senator Landrieu. A good reminder of why I voted for you and not for King Bobby.