ERA 3 State Strategy LA Medicaid Expansion Louisiana Senate committee kills Medicaid expansion bill
Wednesday, 23 April 2014 00:00

Louisiana Senate committee kills Medicaid expansion bill

Written by  Emily Lane |
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The Louisiana Senate Health and Welfare Committee halted a chance on Wednesday (April 23) for the full body to vote on a bill that would "let Louisiana decide" on Medicaid expansion.

As a medicaid expansion bill gets debated by state lawmakers, local organizations head to state capitol Today, the Senate Committee on Health and Welfare will debate about a bill that would expand medicaid services across the state. The local non-profit organization, A Community Voice, has sent members in the state capitol hoping to have their voice heard on the healthcare issue.

The Louisiana Senate Health and Welfare Committee halted a chance on Wednesday (April 23) for the full body to vote on a bill that would "let Louisiana decide" on Medicaid expansion.

Senate Bill 96, sponsored by Sen. Ben Nevers, D-Bogalusa, proposed a constitutional amendment mandating the state implement a program to provide health insurance to those living at or below the federal poverty line. If the proposal was adopted by voters, the state would accept billions in federal funding for Medicaid expansion under the Affordable Care Act, often called Obamacare, to provide heath care for those who make about $11,490 for a single person and $23,550 for a family of four.

The definitive 6-2 vote against expansion likely ends the Senate's debate on the issue for the session. Similar bills await discussion in the House health committee, but they are expected to meet the same fate. Nevers, though, said he may offer a substitute bill to his pending Senate Bill 107, which might be more likely to garner support.

The committee vote to shelve the bill was made on party lines. Voting to defer the bill was Sen Dale Erdey, R-Livingston; Sen. Elbert Guillory, R-Opelousas; Sen "Bret" Allain, R-Franklin; Sen Sherri Smith Buffington, R-Keithville; Sen. Fred Mills Jr., R-New Iberia; and Sen Dan Claitor, R-Baton Rouge. Voting against deferring the bill was Sen. Yvonne Dorsey-Colomb, D-Baton Rouge; and Nevers. Committee chair David Heitmeier, D-New Orleans, didn't vote. Guillory and Mills voted for a failed Medicaid expansion bill last year. Guillory has switched parties since the last vote.

"I think you see tremendous pressure from Washington-style party politics injected into Louisiana," Never said after the vote. He pointed to opposition voiced during the hearing from a conservative "multi-million dollar campaign organization," referring to Americans For Prosperity.

Backers said the move would allow access to health care coverage for 250,000 adults who typically can't afford or don't qualify for other types of health insurance. It would not require the signature of Gov. Bobby Jindal, who strongly opposes Medicaid expansion, but it would require a two-thirds vote from the legislature to make it on a voter ballot.

"Let Louisiana decide" became a rally cry and social media hashtag in recent weeks for advocates of Nevers' bill, and a number of witnesses suggested voters would be in favor of the measure.

Former U.S. Sen. John Breaux, who served as Democratic whip while in Congress and was also appointed chairman of the Medicaid reform commission by former Republican Speaker of the Newt Gingrich, said providing health care for the poor should not be a partisan issue. Appealing to the conservative sentiments of the committee, he listed examples of red states, like Arkansas, that opted to expand Medicaid. "Louisiana can design Medicaid extension to include the best of what government can do with the best of what the private sector can do."

Nevers, and others testified the measure would create 15,600 jobs.

Louisiana Department of Health and Hospitals Secretary Kathy Kliebert testified Wednesday expanding Medicaid would cost Louisiana taxpayers too much, about $1.7 million over 10 years. Heitmeier replied: "You're talking about a worst case scenario."

The nonpartisan Legislative Fiscal Office estimates the Medicaid expansion would decrease state spending for the first three years, but would cost the state as much as $886 million over a decade.

The federal health care law was "rushed into implementation," Kliebert said, and "prioritizes coverage with able-bodied adults to those with disabilities."

Testifying for the bill were a number of Louisiana House members, U.S. Rep. Cedric Richmond and a policy advisor for Sen. Mary Landrieu. Landrieu and U.S. Rep. John Fleming both issued statements after the bill's defeat, the former calling the move senseless and the ladder calling it a victory for Louisiana taxpayers.

Two images during the testimony illustrated heart of the debate.

Pelican Institute President Kevin Kane, who leads Libertarian think tank that opposes Medicaid expansion, painted one of them. Kane asked committee members to imagine planes dumping suitcases filled with money on downtown Baton Rouge to spur economic growth and create jobs. It would certainly stimulate the economy, he said. "(But) where are these hundreds of millions of dollars coming from?" he asked.

"Last I checked, the federal government is having a hard time paying its bills...(Medicaid expansion) is doubling down on a wrong approach at the wrong time."

Nevers, in his final plea for support, harkened back to Kane's image. "If we do not choose to expand Medicaid, (the plane) is going to take those suitcases of money and fly over California and New York and open them up."

Phillip Joffrion, the Louisiana state director of Americans for Prosperity, a policy advocacy group whose founder are the billionaire Koch brothers, touched on the issue. "Many say we have to provide (expansion) because it's free money," he said. "I'm here to remind you that there's no such thing as free money. "

Several proponents of the bill said during the hearing that Louisiana's rejection of Medicaid expansion funds would result in the funneling of those missed dollars to other states that opted to expand Medicaid. Though it's difficult, if not impossible to directly link where the rejected funds go, Nevers said the point remains that the state will not get its share of a return on their federal tax dollars. "It's forever lost," he said after the hearing.

The other image capturing the debate was an estimated 11-by-14-inch photo of a New Orleans woman named Donna Risso that Nevers and another witness panned across table where committee members sat.

Cynthia Mitchell, with the Substance Abuse and Mental Health Services Administration in New Orleans, said Risso's death at age 47 was avoidable, had she had access to health insurance. "I'd like to talk about the human toll," said Mitchell, who knew Risso through services at the Sampson House in New Orleans.

Mitchell said Riso sometimes sold etchings she filled with ink, which left her fingers black, and she was homeless for about 20 years. She lived in recent years underneath an overpass in Gentilly. Risso lost her Medicaid disability insurance in 2013, which prevented her from affording her medicine. She died on April 1 of this year in hospice care -- a service Mitchell said will only be paid for pending favorable outcome from a lawsuit.

Nevers, who spoke slowly and sounded choked up at times during his closing, said when contemplating Risso's death in preparation for his testimony, tears began to run.

"This (bill) is not for me, nor for my family, but for those that are less fortunate than it...Most of you know that I strongly believe in conservative values, but I can also tell you that regardless of what happens here today, I can go home and lay my head down and I can know," he paused. "That I did my best."

"I agree we can do better," said Sen. Dan Claitor, R-Baton Rouge, as he made the motion to kill the bill. "I disagree that this is the answer."

Associated Press Reporter Melinda Deslatte contributed to this report.

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