Our Views: Low costs, high benefit

If extending Medicaid coverage in Louisiana is a tough political challenge, it can’t be said to be a new policy. Why? Because expanding Medicaid coverage for children, pushed in the 1990s by Gov. Mike Foster, was a huge success. It became law with only “a handful” of votes in the Legislature against it.

That was a history lesson from David Hood, who was deputy secretary and then-head of the state health department that oversaw the historic Medicaid expansion for children, called LaCHIP.

And, as history records, Hood was deputy and successor to the young Bobby Jindal at the Department of Health and Hospitals.

That makes Hoods’ current advocacy of Medicaid expansion for working adults an implicit criticism of now-Gov. Jindal, a leading opponent of the expansion.

Hood told the Press Club of Baton Rouge that Louisiana was a leader among the states for LaCHIP. He said the proposed expansion of Medicaid that is part of the federal Affordable Care Act is another chance to improve health outcomes at a very reasonable cost to the state.

The expansion would cover adults making up to 138 percent of the poverty level — less than $32,000 for a family of four. If anyone thinks that insurance coverage can be found for a family feeding itself and putting two children through school on minimum-wage jobs, they’re nuts. Yet Jindal’s policy would turn down billions in federal reimbursements, about 90 percent of the cost of the expanded Medicaid coverage over 10 years.

“Frankly, I don’t know what we’re waiting for. I’m afraid that it’s mainly a political decision,” Hood said.

Hood’s dry exposition of facts and figures about Medicaid does not capture the oddness of a poor state joining some 20 others that have turned down the Medicaid expansion under the “Obamacare” law. Some leading Republican governors, from Ohio to Arizona, have embraced the expansion because it makes financial sense.

What is truly odd is how much the governor and lawmakers are out of touch with the day-to-day realities of people working in law-wage occupations. The notion that Medicaid is somehow a luxury ride in health care is bizarre. It’s as if lawmakers believe that people with severe aches and pains, standing at the grill or lifting boxes in deliveries all day, have plenty of cash on hand for a doctor’s appointment and the inevitable MRI.

The world of work may seem a long way away from the State Capitol halls, but the threat of financial disaster is ever-present for thousands of families for whom lawmakers and the governor should feel just a bit of empathy.