Last Modified: Wednesday, July 04, 2012 11:50 PM
BATON ROUGE (AP) — When a bloc of conservative state lawmakers pushed to strip money from the health department, the Jindal administration outcry was loud, suggesting the cuts could devastate health care services.
A month later, the $859 million in budget cuts hitting the Medicaid program from new congressional action are far larger, but Gov. Bobby Jindal's administration has been muted in talking about the ramifications.
There was no public outcry from the Republican governor as congressional House Republicans slashed the state's Medicaid funding, and he's not commented on the reduction since Congress passed it as part of the federal highway bill.
Jindal's health secretary, Bruce Greenstein, said the cuts will be difficult but are "doable." However, when smaller cuts were proposed during the legislative session, Greenstein's comments were bleaker, saying they would affect "everyone's quality of life."
Pearson Cross, a political scientist at the University of Louisiana at Lafayette, suggested the administration's rhetorical shift was tied to Jindal's national political aspirations and his very public stance against the Medicaid expansion offered through President Barack Obama's health law.
The Medicaid money targeted by Congress for cuts was given to Louisiana through the Democrats' federal health law that Jindal, considered a possible vice presidential contender, said must be repealed.
"The current position rises out of a need to be politically pure," Cross said. "He's decided to take this stand against Obamacare and the expansion of Medicaid, so regrettably it seems as if this Medicaid cut is kind of playing into that and getting swept along."
The Department of Health and Hospitals continued working Tuesday on a plan to shrink spending in the program that pays for health services for the poor, uninsured, disabled and elderly. The cuts will strip 11 percent from the $7.7 billion Medicaid budget that had been planned for the fiscal year.
On the chopping block are charity hospitals, rural hospitals, hospice care, a breast and cervical cancer program and the rates paid to nursing homes, doctors and other health providers who take care of Medicaid patients.
Requests by The Associated Press to speak with Health and Hospitals Secretary Bruce Greenstein about the cuts on Monday and Tuesday were denied.
Louisiana's state lawmakers say they've heard little from the Jindal administration about where the cuts will fall or what they will mean for patients. The governor's top budget adviser and DHH haven't said when they expect the cuts to be decided — or made.
Commissioner of Administration Paul Rainwater said the slashing would be tough.
"Obviously, our Medicaid program is going to be smaller," he said.
Rainwater and Greenstein last week outlined possible cuts in a conference call with reporters. At that point, Greenstein said they wouldn't be painless. But he added, "The Medicaid program will go on. We know it will be difficult to do, but it's doable."
Similar and less deep health care cuts were described as devastating in May when the Jindal administration was fighting against reductions that could have stripped as much as $500 million from health care services.
The dire scenarios outlined of shutting down a state-run psychiatric hospital in central Louisiana and eliminating an early intervention program for children with hearing, speech and motor control problems helped persuade senators to reverse House-backed cuts pushed by a group of fiscal conservatives seeking to shrink the size of state government.
In his testimony before senators, Greenstein described those smaller cuts in stark terms, saying, "This will impact everyone's quality of life and their health outcomes at the end of the day."
With congressional action, complaints have come from Democrats, who blame Republicans for the budget slashing.
U.S. Rep. Cedric Richmond, a Democrat from New Orleans, described the cuts as pillaging the Medicaid budget in a way that was "careless with the lives of Louisiana's elderly and disabled."
"Maybe the governor didn't have enough influence, or he decided not to use his influence. Whatever the case, Republican leadership decided to shortchange Louisiana's most vulnerable citizens," Richmond said in a statement.
Asked if the governor contacted anyone in Congress to urge them against the Medicaid cuts, Jindal spokesman Kyle Plotkin didn't directly respond about Jindal's actions.
"Our administration was in close contact with our delegation and outlined the impact this move would have on health care services in Louisiana," Plotkin said in an e-mail.
Congress targeted a provision that U.S. Sen. Mary Landrieu added to the federal health care overhaul law that was designed to buffer Louisiana from a Medicaid rate drop because of the influx of rebuilding dollars after hurricanes Katrina and Rita in 2005. An error in the writing of the provision has sent hundreds of millions more to Louisiana than what was initially expected.