Commentary

Mary Landrieu: Jindal has put Louisiana's health care system ‘in crisis' and ‘serious jeopardy'

by Patrick Flanagan

It is distinctly possible control of the U.S. Senate will hinge on Louisiana, which is why, during the last several months, outside groups have made this the most expensive election in Louisiana history.

[Editor's Note: This is Part 1 of a series from IND contributor Lamar White's phone interview with Sen. Mary Landrieu this week.]

On Tuesday, Nov. 4, 2014, it is distinctly possible that control of the U.S. Senate will hinge on Louisiana, which is why, during the last several months, outside groups have poured millions into the state, making it the most expensive election in Louisiana history.

It is easy to understand why Republicans would target three-term incumbent Mary Landrieu: Louisiana has a two-term Republican governor who now has his sights set on the White House, a Republican U.S. senator who now has his sights set on the governor's mansion, a Republican super-majority in the Legislature, a Republican attorney general, a Republican secretary of state, and a Republican lieutenant governor.

Mary Landrieu is Louisiana's last remaining statewide elected Democrat (though one could argue that AG Buddy Caldwell, who was elected as a Democrat and subsequently defected to the Republican Party, also technically qualifies).

She has endured close elections before, so close, in fact, that it earned her the ironic nickname "Landslide Landrieu." This year, Republicans want to flip the script, and even though they have a spectacularly weak candidate in Bill Cassidy, they still see a clear path to victory, a strategy that can be summed up in two words: Barack Obama. The president has never been popular in Louisiana, and unlike the last Democratic president, Bill Clinton, he's never genuinely attempted to be. Republicans aren't running against Mary Landrieu; they're running against Barack Obama. And so far, the strategy has been working.

However, there's ample reason to believe that, in the upcoming weeks, their strategy is doomed to backfire.

Mary Landrieu, to the dismay of many self-identified liberals and progressives in Louisiana, hasn't always been in league with President Obama; often, she has been a thorn in his side, particularly when it comes to energy policy (a topic I will explore in a later article). But perhaps more important, in framing this election around Barack Obama and, specifically, Sen. Landrieu's vote in favor of the Patient Protection and Affordable Care Act (also known as the ACA, also known as Obamacare), Republicans were banking on the success or, at the very least, the solvency of Jindal's alternative health care plan.

Indeed, Republican outsiders, most notably the Koch Brothers, have spent millions of dollars on television commercials and billboards and direct mail advertisements bashing Sen. Landrieu for voting in favor of Obamacare. They have made this the No. 1 issue in the campaign. Her main Republican challenger, Bill Cassidy, has repeatedly called for repealing the law.

It was a bad bet on the bayou for the Koch Brothers. Because, during the last few weeks, as they have continued to criticize Landrieu for supporting the Affordable Care Act, which would have supplied $16 billion in federal funds to the Louisiana economy over the next 10 years in order to expand Medicaid enrollment for more than 250,000 citizens who otherwise qualify, dramatically renovate and modernize critical health care facilities and hospitals on all corners of the state, and provide thousands of decent, high wage-earning jobs, Jindal's health care vision for Louisiana has become a nightmare.

Jindal's former secretary of the Department of Health and Hospitals, Bruce Greenstein, is now under indictment.

Nearly 230,000 state retirees are at risk of losing parts of their pensions and health care benefits because the Jindal Administration privatized their plans and squandered nearly 80 percent of their reserves.

Instead of expanding and modernizing our robust system of charity hospitals and clinics, they have been shuttered and privatized, now forced to provide care and services in untested and loosely regulated private facilities that treat patients as profit centers and not human beings, a model that has stretched both the private sector and the state government toward the brink of bankruptcy.

All the while, at least 250,000 Louisiana citizens who would qualify for insurance are watching as the $16 billion once guaranteed to them gets shipped away to participating states like California and New York. None of this makes economic sense.

It is devastating.

Mary Landrieu voted for Obamacare; she even was criticized for negotiating an amendment that readjusted federal payments for Louisiana Medicaid, with some calling it "The Louisiana Purchase." But this wasn't a bribe or extortion; Landrieu was using her clout and seniority to ensure that Louisiana Medicaid payments were properly compensated. Jindal, on the other hand, could never be accused of skillfully engineering any deal that resulted in increased funding for Medicaid, because he was too focused on figuring out ways to privatize services to the lowest bidder.

Here's an excerpt from my conversation with Sen. Landrieu (bold mine):

Lamar: I want to move on to the Affordable Care Act. When you poll voters in Louisiana on the Affordable Care Act in fact, there was a poll, I'm not sure if you saw it, that was just released by PPP today that says 56 percent of Louisiana voters support Medicaid expansion as opposed to only 31 percent who disapprove.

Landrieu: Correct.

Lamar: When you poll Louisiana voters on the component pieces of the Affordable Care Act, the majority of them seem to be in support.

Landrieu: Oh, absolutely. By wide, wide margins, people of Louisiana are very supportive. And you're right, getting to keep your insurance, so ...

Lamar: So what can be done to convince voters that the law is not perfect but still in the state's best interest and related to that, just speak a little bit about Medicaid expansion because, you know, we're still one of the few states that's still holding out on this, and it seems like every day you read a story about how our health care system is in crisis in Louisiana. And recently there was that story about the Office of Group Benefits and state retirees potentially losing some of their health care benefits. Just curious if you could talk a little bit about the economic and moral consequences of refusing to expand Medicaid and more broadly the Affordable Care Act.

Landrieu: OK. It's a big question, so let's start with Medicaid first. Independent analysis has shown that the state of Louisiana and Gov. Jindal have refused about $16 billion in support for the health care industry, meaning that he has said no to jobs and growth and development, because that is what expanding health insurance to people who work with 100 percent federal support would do.

Independent studies show that it would create 15,000 jobs. It would sustain thousands of other jobs. And it would impact our economy in a 10-year period at $16 billion in a positive way.

So, the health care system in Louisiana is in crisis because of Bobby Jindal, not because of Barack Obama or Mary Landrieu. He has put the health care system in serious jeopardy.

And most affected are the rural hospitals and hospitals in medium-sized to smaller parishes. And you can see evidence of this everywhere you look. Now, that's No.1: Medicaid expansion and health care expansion for the 252,000 people that work is an economic boost to Acadiana, to the Lake Charles area, to the whole state.

Now, on the Affordable Care Act, what I've said is I support the concept that anyone who works should have health insurance that they can afford and that they can never lose, particularly when they get sick or when they're diagnosed with a serious illness.

And the Affordable Care Act may not be perfect, but in my mind, it's a step in the right direction to ensure that hard workers and entrepreneurs, people who work for small, medium and large businesses can stay in those jobs where the health care is provided or leave and take their health care with them.

And you're right: **There's just so much propaganda and outright lies and misinformation. It's skewed. It doesn't poll well in the popular name, but it's off the chart popular in the component parts.
**

(Back to my commentary.)

Jindal, meanwhile, doesn't just not poll well in popular name. According to several recent polls, he would lose his seat to Gov. Edwin Edwards. He also doesn't poll well in any component parts of any plan he has ever advanced and enacted. Republicans are attempting to juxtapose Landrieu's vote to send $16 billion to Louisiana as if it's nothing more than kowtowing to President Obama; meanwhile, Bobby Jindal's plans that have led to indictments, under-funding, poor care, and the decimation of facilities that had served their communities for generations. This, I imagine, is a fight Sen. Landrieu is willing to take and one that she is almost certain to win.

Stay tuned for Part Two, which will focus on the impact of Citizens United.