If every part of the shaky state budget deserves close scrutiny, the biggest single problem might be the health care financing that is almost daily the source of more bad news in the State Capitol.
The state recently got basically a $307 million demand letter from the U.S. government, based on spending that federal officials feel violated the rules of the state-federal Medicaid program.
“That has a huge impact on our budget,” said Sen. Ben Nevers, D-Bogalusa. “We’ve already spent much of that money and sent it to hospitals.”
For the record, the state hopes to negotiate itself out of this new fiscal pothole. But after years of budget cuts, the administration of Gov. Bobby Jindal is running out of rabbits to pull from potholes; trust funds have been drained, dollars are shifted around recklessly, one-time money spent in the operating budget with a disregard for ordinary standards of financial prudence.
Nevers and other senior lawmakers of both parties have pretty much lost faith in Jindalnomics but the Louisiana Constitution forbids tax increases in this year’s session, so cuts are almost the only option when the potholes come in view of the Appropriations and Finance committees.
But there is one more easy answer that, after years of desperate expedients, the governor is not willing to accept: expanding Medicaid coverage for the working poor.
Jindal’s excuses for refusing the federal money are unconvincing, and the chronic financial emergencies in health care require that legislators look afresh at the issue this year.
Under the Affordable Care Act, the much-criticized Obamacare, an estimated 250,000 Louisiana families would gain limited Medicaid coverage. It’s a 100 percent federal deal for the first year, and 90 percent after that. It’s priceless for a low-wage worker struggling with health problems but unable to afford medical care.
U.S. Sen. Mary Landrieu, D-La., is calling for legislators to revisit the issue because of the financial burdens of the state, but also because of the financial burdens on families that today work full-time but cannot afford insurance.
“In order to have a strong workforce, you need a healthy workforce,” Landrieu told editors and reporters of The Advocate. “This is not just a health care issue but an economic issue for our state.”
Last year, Jindal and the Republican-led Legislature rejected the first appeals for Medicaid expansion. As every week has gone by, more reasons have come along to make this a financial and moral no-brainer.
The Medicaid expansion is not a permanent solution to the problems of health care finance in a state with so many poor families. But turning down the chance to return our U.S. tax dollars to the state, when the state’s budget is in such bad shape, is simply irresponsible.