Medicaid expansion bill set aside

An effort to find a way Louisiana could expand the ranks of Medicaid — by proposing private companies sell the insurance — ran into a roadblock Monday in the Republican-dominated state Senate Finance Committee.

The panel voted 7-3 to defer action on the measure, which attempted to move Louisiana toward what is called the “Arkansas model,” which would allow access to private insurance for those who would be included in the Medicaid expansion.

Medicaid is the health insurance program for the poor that is paid for by federal and state governments. The federal Patient Protection and Affordable Care Act, called Obamacare, would expand Medicaid to include people who previously made too much money to qualify, but not enough to afford adequate health coverage.

Medicaid expansion is optional to states. Gov. Bobby Jindal has rejected the expansion, saying it is too costly, and the GOP delegation, which has a legislative majority, also opposes it.

Senate Bill 125 sponsored by state Sens. Karen Peterson, D-New Orleans, and Ben Nevers, D-Bogalusa, had narrowly cleared the Senate’s health committee. The legislation required fiscal review in the Senate Finance committee.

“The vote taken (was) not based upon the facts, but based upon what’s best for the politics,” Nevers said after learning about the vote during a speech at the Press Club of Baton Rouge. He urged supporters to rally behind House Bill 233, a similar measure scheduled to be debated in the House of Representatives Tuesday.

On Monday, proponents said that the Medicaid expansion plan before the Senate committee included provisions to sunset in 2017 after the federal government stopped paying 100 percent. Supporters, like Nevers and Peterson, argued it would be foolish for Louisiana with its 290,000 uninsured and poor health rankings to turn down the federal dollars to improve residents’ access to health care.

Nevers said the state would save $300 million savings over three years based on a Legislative Fiscal Office analysis.

The expansion would provide coverage beginning in 2014 of residents with incomes up to 138 percent of the federal poverty level, which is about $15,856 for an individual and $32,199 for a family of four.

“It’s really difficult to answer how you turn down 100 percent of anything that will help meet the needs of the citizens,” Peterson said.

Never and Peterson said the infusion of federal cash would boost the state’s economy as well prevent taxes on business.

Top state health agency officials testified against the legislation in Senate committee, saying the Arkansas plan has problems and could end up costing Louisiana move than an expansion of traditional Medicaid.

“It’s not a silver bullet,” state Department of Health and Hospitals Secretary Kathy Kliebert said.

Kliebert said the straight Medicaid expansion would be too costly at a high-end $1.6 billion over 10 years. “We simply do not feel we have had sufficient guidance from CMS,” she said, referring to the Centers for Medicare and Medicaid Services.

Kliebert said all but 6 percent of Louisiana’s uninsured residents would get coverage through the health insurance exchanges that will become available through the federal legislation.

The public-private partnerships with LSU hospitals will provide the “safety net” of care for those without insurance coverage at much less financial risk to the state, Kliebert said.

State Sen. Fred Mills, R-St. Martinville, said the state is $108 million short of the funding required to complete those private hospital agreements.

Kliebert said the Division of Administration was preparing information on a commitment being made and long-term financial requirements.

Sandra McDade, of Shreveport, with the Eagle Forum, testified against the legislation — complaining that her Medicare costs were increasing because of the Medicaid expansion.

State Sen. Ronnie Johns, R-Sulphur, said the projections of people with health insurance moving over to the Medicaid plan concern him. He said the movement could end up increasing insurance costs for those who remain in private plans.

Support for the measure came from two former state health secretaries — Dr. Fred Cerise and David Hood — who served under Democrat and Republican governors, respectively.

Hood said the Medicaid expansion was a much better bargain than the state accepted when it undertook the Louisiana Children’s Health Insurance Program which has been a great success.

Others proponents included the AARP, the Louisiana Conference of Catholic Bishops, the League of Women Voters, the Louisiana Hospital Association, the Louisiana Developmental Disabilities Council, the Louisiana Budget Project and advocates for various health care interest.