Inside Report: La. state lawmakers tackle Medicaid expansion

The political and philosophical divide was never clearer as state lawmakers earlier this week took up the issue of whether Louisiana should go along with the Medicaid expansion called for in the federal Affordable Care Act or “Obamacare.”

When the vote came up in a Louisiana House committee, all 11 of its Republican members rejected the idea, while all eight of its Democratic members endorsed the expansion. It was the first state legislative vote on the highly-charged issue.

Republican Gov. Bobby Jindal has made his position abundantly clear. He’s against Obamacare and its Medicaid expansion. He wants its repeal.

Jindal reiterated his stance as he met with the House Republican delegation the day before the House committee vote. He said he’s not budging.

Democratic committee members encouraged their Republican colleagues to think of the Medicaid expansion as a state, not a national, issue and to think of their constituents — tens of thousands of working adults who can’t afford health insurance.

“Over 400,000 people need affordable health care,” said Democratic state Rep. Barbara Norton, of Shreveport.

In committee, House Republican delegation chairman Rep. Lance Harris rejected the notion that national Republican-Democratic party politics played a part in legislators’ opposition.

“This is not a political issue to us. It’s strictly a fiscal matter,” said Harris, R-Alexandria.

“This has to do with fiscal responsibility for the state of Louisiana, not for just now but ensuing years,” said Harris. He noted that the biggest problem in Louisiana’s budget during the current fiscal year was caused by federal officials, as Congress reduced the federal contribution to the state’s Medicaid program.

Harris noted that U.S. House Budget Chairman Congressman Paul Ryan had just that day said, “The fastest thing that’s going to go when we’re cutting spending in Washington is a 100- or 90-percent match rate for Medicaid (promised with the expansion). There’s no way. It doesn’t matter if Republicans are running Congress or Democrats are running Congress. There’s no way we’re going to keep those match rates like that.”

Other Republican committee members came at their opposition from different perspectives.

“My concern is that this Medicaid expansion puts so many people as government dependents, dependent on the government for their health care,” said state Rep. John Morris, R-Monroe.

State Rep. Kenny Havard, R-Jackson, said he’s “torn on this issue,” adding that 40 percent of his legislative district is minority, and 80 percent Democrat.

Havard said he is “disappointed” that Jindal doesn’t have a Plan B and there’s no negotiations going on with federal officials on a plan that would be acceptable to Louisiana.

State Rep. Julie Stokes, R-Kenner, said Louisiana should not get locked into Medicaid expansion when it’s unclear that it is going to work.

“As a society we need to take care of people,” said Stokes. “This is not a forever choice. We can see if it works in other states.”

Stokes said the state might want to see how the private sector-based Arkansas model is working.

If Louisiana accepts the Medicaid expansion then finds it not working, it would be difficult to pull the plug because people will have become accustomed to the services, Stokes said.

Republicans made it clear that they are firm in expansion opposition — just as firm as Democrats are in support. But with Republicans having a majority in both the House and Senate, the prospects are not good for Medicaid expansion legislation to pass. And, then there’s Jindal — still adamant about Louisiana rejection.

Marsha Shuler covers health care policy for The Advocate’s Capitol news bureau. Her email address is mshuler@theadvocate.com.