Analysis: Jindal under fire at home for health care

by Patrick Flanagan

Gov. Bobby Jindal has been viewed as a health care policy wonk, and he's tried to build on that image ahead of a likely 2016 presidential campaign, positioning himself as the candidate with substantive ideas.

BATON ROUGE, La. (AP) - Gov. Bobby Jindal has been viewed as a health care policy wonk, and he's tried to build on that image ahead of a likely 2016 presidential campaign, positioning himself as the candidate with substantive ideas.

But his administration's handling of health care matters at home could undermine his bonafides in the subject area and threaten his efforts to sell himself as a health care expert.

Jindal's former health secretary Bruce Greenstein was indicted last week for lying about his involvement in the awarding of a $200 million Medicaid contract, a deal the administration didn't cancel for several years despite ongoing questions about Greenstein's involvement.

The Republican governor's privatization of the LSU charity hospital system remains under scrutiny with federal officials, who rejected the first set of financing plans for most of the deals and who continue to raise questions about the rewrite.

Plus, the Jindal administration's management of the health insurance program that covers 230,000 state workers, public school teachers, retirees and their dependents is facing heavy criticism, as the program continues to drain a reserve fund to cover expenses.

Not exactly the kind of stories Jindal will want retold in New Hampshire and Iowa and in his political speeches to Washington power-players.

In the most recent news, Greenstein was indicted on nine counts of perjury, tied to sworn testimony about the state's now-canceled contract with Client Network Services Inc., or CNSI.

The company was selected by the state in 2011 for a 10-year Medicaid claims processing contract. The deal sparked controversy as soon as CNSI was chosen, with state lawmakers questioning the involvement of Greenstein, a former CNSI vice president.

Under questioning in a confirmation hearing with senators three years ago, Greenstein acknowledged that a decision he made in the bid solicitation process made CNSI eligible for the contract.

But the Jindal administration proceeded with the deal until a federal subpoena seeking information about the contract award became public in March 2013.

Then, the administration scrapped the contract, saying they found out Greenstein exchanged hundreds of phone calls and thousands of text messages with CNSI leaders throughout the bid process. The administration said that created an unfair advantage for the firm.

Greenstein resigned but has denied any effort to steer the contract to his former employer. Greenstein's lawyer says the ex-health secretary didn't lie in his testimony. CNSI officials say the company did nothing improper, and the firm is suing for wrongful termination.

The situation is a messy one for Jindal, with questions about why his administration didn't look more deeply when the allegations were first raised. A grand jury investigation by the attorney general's office is ongoing.

While that canceled contract is under scrutiny, other health contracts that privatized most of the LSU hospital system are under intense review from the federal agency that oversees Medicaid spending.

The Jindal administration is asking for approval of revised financing plans for six hospital outsourcing deals after the U.S. Centers for Medicare and Medicaid Services rejected a previous version of the plans.

Jindal privatized the hospitals without waiting for federal officials to sign off on the financing arrangements. Without that approval, the contracts can't work because there's not enough money to support them, and the state could have to repay what it's already spent on them.

As those Medicaid controversies continue, the Jindal administration is getting hit with angry outcries from state workers, teachers, retirees and lawmakers about changes in the health insurance program overseen by the Office of Group Benefits.

A rewrite of the health plans offered through the program will have many people paying more out-of-pocket costs for their health care. While the Jindal administration places the blame on rising health care costs and new federal regulations, the people most impacted are faulting what they describe as the governor's management of the program.

The trio of health care controversies comes at a bad time for Jindal, with the glare of a national spotlight he only wants to grow larger. Whether the governor can disentangle himself from them could help determine his political fate.