BATON ROUGE, La. (AP) — As Louisiana struggles with budget troubles, private hospitals are offering lawmakers a way to draw down more federal health care dollars for patient care, but only if the money is used to expand coverage through the Medicaid program.
Legislation filed by House leaders would let the state tap into a voter-backed plan that allows hospitals to pool their dollars and use that money to attract new federal Medicaid money to compensate them for their care for the poor.
The proposal, developed by the Louisiana Hospital Association, would let the private hospitals share in the state's cost for the Medicaid expansion allowed under the federal health overhaul. In turn, the move would help the cash-strapped state bring in more money to fill gaps in the health budget, as hospitals are threatened with reductions to their payments.
"I think it's just something that we need to put on the table. It's clearly an option that we can work on to help solve our health care challenges here in the state," said House Speaker Chuck Kleckley, R-Lake Charles, who is sponsoring the legislation.
Kleckley introduced the proposal with Rep. Walt Leger, a New Orleans Democrat and the second-ranking member of the House.
But while lawmakers may be desperately looking for cash to plug budget holes, the proposal could be a tough sell in a majority-Republican Legislature that has repeatedly rejected Medicaid expansion bills.
Supporters are trying to downplay the partisan dispute. They say the legislation doesn't lock Louisiana into doing a Medicaid expansion and doesn't require a specific model, giving the state freedom to devise its own coverage expansion.
Paul Salles, president of the Louisiana Hospital Association, described it as "real pragmatic legislation. It's not about politics."
"We think it helps patients. We think it helps the state budget situation," he said.
Gov. Bobby Jindal, a Republican considering a presidential campaign, opposes the expansion. He described it as "a bad deal for the state of Louisiana."
But he couldn't veto the legislation, because it's a concurrent resolution that doesn't go to the governor's desk. That could help its chances, though it still requires a hefty two-thirds vote for passage.
Kleckley and the Louisiana Hospital Association are looking past Jindal, saying the legislation would set up a payment mechanism for Louisiana's next governor. Jindal is term-limited, and his successor will be chosen this fall.
All four major candidates in the governor's race, three Republicans and a Democrat, said at a recent forum they'd consider the Medicaid expansion.
Kleckley's legislation would give them a way to immediately enact the coverage expansion with the hospitals' payment structure when one of them takes office in January, to start the money flowing in the second half of the budget year.
"I think it's very clear what this governor's position is. I think it's something we can do and he can certainly put that on the shelf," Kleckley said. "But the next governor can come in and consider an expansion."
The Medicaid expansion authorized under President Barack Obama's health law allows states to offer government-funded insurance coverage to adults making up to 138 percent of the federal poverty level — less than $33,000 for a family of four. Most of the cost would be paid by the federal government.
Backers say health coverage would be extended to 240,000 people, giving the working poor better care. Opponents say the increased coverage would be too costly for Louisiana and the federal government and would expand a broken government-run health system.