INDReporter

Senate budget committee stalls Medicaid expansion

by Walter Pierce

State senators rejected a proposal on Monday for Louisiana to offer government-subsidized health insurance to the working poor through the federal health overhaul law known as the Affordable Care Act.

BATON ROUGE, La. (AP) - State senators rejected a proposal on Monday for Louisiana to offer government-subsidized health insurance to the working poor through the federal health overhaul law known as the Affordable Care Act.

The 7-3 vote by the Senate Finance Committee largely fell along party lines, with all but one Republican voting against tapping into the federal Medicaid dollars available for the health coverage.

Sen. Karen Carter Peterson's bill would have required the state health department to seek federal approval for a program using the Medicaid expansion dollars to provide private insurance coverage to adults making up to 138 percent of the poverty level - less than $32,000 for a family of four. The federal government would cover much of the cost.

A similar proposal is scheduled for a House vote Tuesday, but passage seems like a long-shot at best. Gov. Bobby Jindal and Republican Party leaders oppose the expansion, which was authorized under the health revamp championed by President Barack Obama.

Peterson, D-New Orleans, said the insurance expansion would improve health care for thousands of Louisiana citizens who work at low-wage jobs and can't afford the coverage on their own, while also providing an influx of dollars for health care providers.

"How in good conscience can we turn down 100 percent of anything that we know will tend to the needs of working class people?" said Peterson, leader of the Louisiana Democratic Party.

Rob Tasman, representing the Louisiana Conference of Catholic Bishops, said the bishops backed the proposal as consistent with church teachings that support the life and dignity of people and consider health care a basic right.

"Let's elevate the status of the poor today, the uninsured," Tasman said.

About one in five Louisiana residents are uninsured. Estimates are that as many as 400,000 uninsured people would be eligible for Medicaid under the insurance expansion.

Jindal says the increased insurance coverage would be too costly for Louisiana and could shift people from private insurance to government-funded health care. His health secretary, Kathy Kliebert, said Monday that the modified bill seeking to use the federal Medicaid money for private insurance doesn't change the administration's concerns.

"We do not see this as a worthwhile plan for the state of Louisiana," she told the Senate Finance Committee.

Kliebert, interim secretary of the Department of Health and Hospitals, said the private insurance model is unworkable because of federal restrictions governing the Medicaid funding. She said the Affordable Care Act doesn't offer enough flexibility to tailor an insurance program to Louisiana's needs.

In response to criticism that the Jindal administration hasn't offered an alternative, Kliebert pointed to the privatization of the LSU-run hospitals that provide safety net care to the uninsured. She said the efforts will improve access and health services.

Sen. Fred Mills, R-Breaux Bridge, noted that only three deals have been signed for the 10 hospitals - and that questions have been raised about whether the financing is available to support the arrangements.

Mills sought to delay action on Peterson's bill while awaiting further details about the ongoing efforts to privatize the LSU hospitals. He couldn't get enough votes for such a delay, however. He was the lone Republican senator to vote against shelving Peterson's bill.

The nonpartisan Legislative Fiscal Office estimates the Medicaid expansion could save Louisiana as much as $510 million over 10 years, with the state receiving up to $15 billion in federal funding. The Jindal administration disputes the fiscal office analysis.