Medicaid outsourcing falls largely in Jindal's lap

by Heather Miller

A column from The Baton Rouge Business Report points out how the biggest privitization deal in state history is moving forward with little scrutiny and virtually no oversight from the Legislature.

When the state starts the process of turning over $2 billion in public money to private insurance companies to execute the state's Medicaid program, the reins will be largely in the hands of Gov. Bobby Jindal - and the Legislature won't see much in the way of the program's details or potential complications.

A compelling column published in The Baton Rouge Business Report reveals that the new Coordinated Care Networks system, the braindchild of Jindal that dates back to his state Department of Health and Hospitals days, will entrust the health care of 850,000 Louisiana residents (mostly children) to five private insurance companies. The administration has estimated $135 million in annual savings through privatization, which begins early next year. Eventually, the state's 1.2 million Medicaid recipients will all be managed by the private sector.

There were very few, if any, legislative gadflies that stood in Jindal's way when he pushed for his plan's passage. As The Business Report explains below, one lawmaker who criticized the plan was silenced by the legislative process. And when the Legislature approved a bill that would allow the state to terminate the private health care contracts after three years if the program wasn't delivering, Jindal vetoed it:

Ordinary citizens who pay for part or all of their health insurance have to deal with private companies, so why should Medicaid patients be different? Lawmakers may have accepted that reasoning, if they were asked, but they weren't.

In the 2010 session, one outspoken critic of privatization, Sen. Joe McPherson, D-Woodworth, had a provision inserted in the appropriations bill in committee to require legislative approval of a final healthcare plan.

When the bill reached the floor, a large set of what were supposed to be clean-up, technical amendments were offered for one up-or-down vote. According to Senate minutes, McPherson complained that, on short notice, there was no way of knowing what was in the many pages of amendments. Senate Finance Committee Chairman Mike Michot, R-Lafayette, assured him all the changes were technical.

After the bill passed, McPherson discovered that in that stack of allegedly technical changes, his amendment requiring legislative approval had been deleted and one sentence was added, authorizing the administration to establish and write rules for "Coordinated Care Networks" for Medicaid.

Privatization marches forward, and the babies will lead the way.

One hopes for the best for them. The likelihood, however, of the sweeping transition taking place without complications, mistakes and unintended consequences is as remote as no political indictments being handed down in the next year.

Read more here.