House health committee rebuffs Medicaid expansion

By By Jim Beam / American Press

BATON ROUGE — A House committee on Wednesday rejected the first of a half-dozen bills aimed at forcing Louisiana to join the

expanded Medicaid program under the federal Affordable Care Act.

The 10-8 decision by the House Health and Welfare Committee came by a party-line vote. It followed a five-hour hearing. The

10 are Republicans, and the 8 are Democrats.

The Senate Health and Welfare Committee debated a similar bill, but postponed its hearing for a week when it ran out of time.

Gov. Bobby Jindal opposes expanding the

insurance program for the poor, calling it a costly and unworkable

system that needs

to be fixed. He said an expanded program could cost the state $1.7

billion over the next 10 years. Legislators who disagree

are trying to force the state to join the program.

Rep. Barbara Norton, D-Shreveport, is sponsor of House Bill 110. It would have required the secretary of the state Department

of Health and Hospitals to take the actions necessary to expand the program along the lines provided for by Obamacare.

Norton opened and ended her remarks in the same fashion, telling committee members the votes they cast against her bill would

come back up again when voters go to the polls.

“I will be making sure word goes out that you prevented people from getting additional benefits,” she said. 

During her closing remarks, Norton said, “Whatever you do will follow you the rest of your life. The future of the people

in this state is in your hands. You have a responsibility to provide people with affordable health care.”

Rep. Katrina Jackson, D-Monroe, said more than 400,000 uninsured people would benefit with the state’s expansion of Medicaid.

Both she and Norton said Louisiana would be leaving money on the table that would go to other states.

“I don’t understand why this is being so heavily debated,” Jackson said. “We are not debating the health care law. We are

here to say it’s in place and we should take advantage.”

The point was made over and over again

during the hearing that the federal government would pay 100 percent of

the costs to

expand the Medicaid program for the first three years. That would

drop to 90 percent in succeeding years. Supporters of expansion

also stressed that states can opt in and out of the expanded

Medicaid program at any time.

Rep. Regina Barrow, D-Baton Rouge, said an expanded program would increase employment by putting people to work.

Rep. Lance Harris, R-Alexandria, and chairman of the Republican House Delegation, said expansion of Medicaid is not a national

issue. It has to do with fiscal responsibility in Louisiana now and in ensuing years, he said.

Funding is too unstable, he said, to be counted on. He talked about the reduction of federal medical assistance to the state

from a 72 percent to a 61 percent federal match.

“The federal government changes its mind in midstream,” Harris said. “We are just as concerned about the health of Louisiana

citizens, but how we get there is the issue.”

The federal Affordable Care Act won’t be fully implemented until 2014, Harris said. Even the U.S. senator who was a lead author

of the act is concerned about its impact, he said.

U.S. Sen. Max Baucus, D-Mont., has said he is afraid the Affordable Care Act could be a train wreck for the nation, Harris

said.

Rep. A.B. Franklin, D-Lake Charles, who voted for Norton’s bill, said he had talked with senators from Maine and they told

him their state was saving money under Medicaid expansion.

Rep. Kenny Cox, D-Natchitoches, said Louisiana needs to help people become taxpayers so they can make it.

“Why won’t we help the least of our people for three years?” he said.

Harris said 248,000 people could go off private insurance plans to join an expanded Medicaid program.

“What happens to them?” he said. “It’s not easy to opt out, is it?”

Jackson said $1.6 billion in business investments have been made since Jindal took office.

“Can’t we make the same investment in our people?” she said.

Rep. Kenny Havard, R-Jackson, said he was disappointed the state doesn’t have a Plan B.

“If it’s a good plan, I will support it,” Havard said. “But no one in this room or in this country can tell me what’s in ACA.

I won’t vote for expansion until I know what’s in it. I’m just afraid of the consequences to our businesses.”

Robert Tasman, associate director of

the Louisiana Conference of Catholic Bishops, said the conference

supports Medicaid expansion

even though it still has serious concerns about other parts of

Obamacare.

“It’s about the people,” he said of the expansion. “This is one of the most crucial issues of this session.”

Kathy Kliebert, interim secretary of

the state Department of Health and Hospitals, and Jerry Phillips,

undersecretary, explained

why expansion of Medicaid is questionable. They said there are

uncertainties in too many areas, and federal funding that continues

to unravel tops the list.

“We have good estimates on our programs, but not on this one,” Kliebert said.

Barrow countered that the state deals with uncertainties all the time. 

Both DHH officials said there are more

effective ways to deliver health care, and DHH isn’t giving up on those

people who

need assistance. It’s questionable, they said, whether the health

care structure could handle the additional 600,000 people

who would join an expanded program.

The two officials echoed other speakers who said Medicaid expansion is being rushed too quickly.