The state health agency is using a law backed by the Jindal administration to conceal its recommendations for $600 million to $700 million in budget cuts.
State Department of Health and Hospitals officials said the public will know where the reductions will be made on Feb. 27, when Gov. Bobby Jindal’s office submits the proposed state budget for the fiscal year that begins July 1.
DHH denied a public records request by The Advocate for a copy of budget options the agency submitted to the governor’s budget arm. The options were submitted in response to an administration directive to prepare for state funding cuts of $200 million to $300 million. With the federal matching funds state dollars attract, the cuts escalate to $600 million to $700 million.
Louisiana is facing a $1.6 billion shortfall in state revenues to fund the budget. Health care and higher education are the two big areas on the chopping block.
In denying the request, DHH cited a 2009 law that protects “pre-decisional advice and recommendations concerning budgeting” from disclosure for six months from the date the record is prepared.
Jindal got the budget-related documents placed off-limits during his major government “transparency” push soon after taking office. Government watchdog groups and media organizations objected to the provision, citing the need for open government.
DHH’s budget is some $9 billion out of the $25 billion state operating budget. Some $8 billion of it is spent in Medicaid, the government health insurance program for the poor that mainly covers pregnant women, children, the elderly and disabled.
DHH Undersecretary Jeff Reynolds said the agency has developed different scenarios to address various levels of cuts depending on what state dollars are made available.
He said agency officials don’t want to “cause concern in a particular area just because it’s in a scenario.”
“At this point in time, we are still not sure where they are going,” Reynolds said.
As different budget-cutting scenarios were being developed, “everything was on the table,” Reynolds said.
“The low-hanging fruit or easy picking things, those days are gone. Any kind of reduction is significant,” he said.
Complicating the situation are legal restrictions on cutting in some major areas of the Medicaid budget.
Last fall, voters approved a constitutional amendment protecting funding levels for nursing homes, pharmacy and intermediate care facilities for the developmentally disabled. The groups all levy providers fees, which are used to attract federal dollars. In order to reduce their Medicaid funding, the Legislature would have to approve the move by a two-thirds vote and any cut could not be greater than what’s levied in other health care areas.
“We are having to take that into consideration,” Reynolds said.
Medicaid’s optional adult denture program is protected in state law. If it’s to be done away with, the Legislature would have to repeal the law, Reynolds said.
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