The Jindal administration withdrew its request for Obamacare to fund a program that would have provided in-home health-care services for some adults, a state Department of Health and Hospitals official said Wednesday.
Calder Lynch, DHH policy director, said the staff recommended that Louisiana’s health chief, Secretary Kathy Kliebert, cancel the agency’s application because new federal rules would have required “a vast expansion” of the Community First Choice program.
The federal government would have paid about 68 percent of the costs, but that still would have left state taxpayers with 32 percent of the bill and that amount would have been unaffordable, Lynch said.
Gov. Bobby Jindal frequently criticizes parts of Obamacare, such as the section that seeks to include more of the working poor under Medicaid, the insurance program for the poor that is paid mostly by the federal government and partially by the state government.
His administration last year quietly applied for funding under a different, less controversial section of the Patient Protection and Affordable Care Act, commonly called Obamacare.
Lynch said soon after the state submitted its application, the federal Centers for Medicare & Medicaid Services, or CMS, changed the interpretation of the rules governing the program. DHH negotiated with CMS for about a year, he said.
“CMS didn’t give us flexibility to tailor the program, so it was too heavy a lift,” Lynch said. The paperwork to formally cancel the application was sent to Washington, D.C. on Monday, he said.
In Fiscal Year 2012, DHH reported making payments of more than $202 million for nearly 21,000 individuals to receive personal care services and more than $443 million for personal care waiver services. The program under the new federal rules would have roughly doubled that amount, Lynch said.
Basically, Community First Choice is available to adults who meet a “nursing home” level of care. In order to qualify for the program, the patients are judged on how well they accomplish certain daily activities, such as bathing, eating and using the toilet.
The new federal interpretation of the rules would have required DHH to offer services to a wider variety of other patients, such as people in need of acute hospital care and those having mental health problems and children, Lynch said. Those patients are offered other services by DHH, he said.
“It would have been very costly to the state,” Lynch said. Plus, it would have opened the state to lawsuits, he said.