Expand Medicaid, Bobby. It’s the only way back
BoJind has made a terrible set of mistakes. Unconstitutional legislation. Federal investigations. Sinkholes. Higher education
chaos. These ships have all sailed. He probably do much to change these disasters. But there is one thing he can do to transform Louisiana for the better.
Dont’ take our word for it.
Expanding health services to Louisiana’s working poor is not a gift, as the state eventually would have to put up some money to match federal Medicaid grants. But it’s a deal worth taking, and we urge Gov. Bobby Jindal and the Legislature to take up the offer. Ultimately, the state has no other solution in view for the problems of the uninsured who are working in low-wage jobs.
With the high rates of diabetes and other chronic but treatable conditions in Louisiana, the broader access to basic health care could save lives. That alone is reason to participate.
The expansion makes sense fiscally as well. For the first three years of the program, 2014 through 2016, the federal government will pay 100 percent of the cost of covering people whose income is 133 percent of the poverty level. After that, Louisiana would have to pay a small percentage — which at most would be 10 percent in 2020 and beyond. Kaiser estimates that the cost for Louisiana would be about $1 billion over 10 years.
The Jindal administration has argued that even 10 percent is too much of a burden. That is absurd, particularly given how many people could be helped with that small investment by the state.
Republican governors and GOP-controlled legislatures will eventually decide to expand Medicaid in their states because the financial benefits are too big to ignore, Health and Human Services Secretary Kathleen Sebelius said in an interview with USA Today. “It not only would bring more people into the health care system, but it would dramatically reduce unpaid medical costs,” Sebelius said Thursday in a wide-ranging interview on the third anniversary of the 2010 health care law, also known as the Affordable Care Act.
Gov. Bobby Jindal says Louisiana is not going to accept the federal dollars available in the expanded Medicaid program because health insurance is better handled by private business. The question is: Better for whom? The governor is obviously not talking about 400,000 Louisiana residents who are unable to afford private health insurance but would be able to get health insurance through the expansion. He cannot be referring to Louisiana taxpayers. The nonpartisan Kaiser Family Foundation makes the point that Louisiana is turning down $15.8 billion in federal funding in order to save $1.2 billion over 10 years. And we Louisiana taxpayers are going to have to pay for the federal Medicaid expansion whether our state participates or not. Our share of the money that pays for this program will be used to support the Medicaid expansion in other states and, meanwhile, our low-income residents will continue to lack access to care. So who is he talking about?
We urge the Legislature to address this issue as they take up budget matters this spring. Meanwhile, we join the grassroots groups, the statesmen and civic leaders around the state who are raising the cry to Jindal to take the Medicaid expansion money.
But if Louisiana follows through on the governor’s threat to reject the Medicaid expansion, the need for uncompensated care will continue to rise, increasing the financial strains on the system and raising the cost of private coverage as hospitals and doctors try to recover their costs. Meanwhile, the injection of billions in new federal dollars will be a boost to Louisiana’s economy, in much the same way that federal dollars helped the state’s economy recover from Hurricane Katrina. The money will help both directly – by creating jobs in the health care sector – and indirectly, by supporting jobs that provide goods and services to the health-care industry.
David Hood was secretary of the Department of Health and Hospitals under Republican former Gov. Mike Foster. Fred Cerise was DHH secretary under Democratic former Gov. Kathleen Blanco. The two men were featured in a newspaper ad published in The (Baton Rouge) Advocate newspaper calling the Medicaid expansion a good deal for Louisiana. “Medicaid expansion offers a path to regular access to healthcare for working adults,” the ad says. Hood and Cerise said the inclusion of up to 400,000 uninsured people in the government-run insurance program would improve people’s health, be a good financial deal for the state and help Louisiana’s healthcare delivery system.
This notion of high costs is illogical, as the federal government will be picking up the full tab for the first three years. And even after that, the cost is negligible, with each state paying just 10 percent of the cost. And as an added slap in the face, if Louisiana does not participate, the portion of the federal money that pays for the program will be used to support the Medicaid expansion in other states. What I don’t get, however, is why Jindal would want to burden Louisiana employers, especially given our tepid economic conditions. Instead of accepting the expansion program, Jindal is opting for a program that gives residents between 100 and 138 percent of the poverty line access to healthcare through the state’s new insurance exchanges. This is where the huge cost from employers comes into play. Individuals would now qualify for premium assistance tax credits. As a result, employers with more than 50 workers would be assessed fees for each employee in that group who received these credits.
We would encourage Gov. Jindal to keep an open mind and to examine his fellow governors’ motivations for their 180-degree turns. The federal government would fund 100 percent of the expanded program for the first three years. After that, the amount would decrease incrementally for 10 years. And that would mean between $15 billion and $25 billion flowing into Louisiana for health care, depending on whose numbers you use.
From the multitude of Louisiana non-profits and advocacy groups (you can sign here too), LaMediciadExpansion.org:
The organizations and individuals listed below believe that Medicaid expansion is the right choice for Louisiana and urge you to reconsider your decision to reject this unprecedented opportunity to improve public health and grow the state’s economy. Medicaid expansion could provide health coverage to 400,000 Louisianans, most of whom are currently uninsured, and bring in billions of new federal dollars. It will benefit Louisiana’s families, businesses, health care providers and the economy—all at little cost to the state budget.
BoJind, there’s only one way to salvation. No amount of exorcisms will be able to expel the demons from your legacy if you don’t take advantage of this opportunity to save lives and improve our future.