Gubernatorial candidate Scott Angelle on Thursday questioned whether his former boss Gov. Bobby Jindal’s Medicaid privatization is working, saying not enough evidence is in yet to call it a success.
“Certainly, it’s saving money, but it’s not just about money,” Angelle said. A current Public Service Commission member and ex-top Jindal aide, Angelle said he wants to make sure the savings is not coming at the expense of patients.
“I want to see some of the outcomes of the program” before making a commitment to expand it to include long-term care for the elderly and developmentally disabled, Angelle said, deeming it “a vulnerable population.”
Angelle’s position came as he and two other candidates for governor — Lt. Gov. Jay Dardenne and state Rep. John Bel Edwards — participated in a forum tackling issues impacting the elderly. U.S. Sen. David Vitter did not participate, citing a scheduling conflict in Washington. Edwards is a Democrat. The remainder are Republicans.
Dardenne said he would move forward with privatization and include providers of nursing homes — who want out — and community-based services. Edwards said he wanted to “work toward comprehensive managed care” but did not say what shape that would take.
Jindal already has turned over to private insurance companies medical and behavioral health components of the state’s $8 billion-plus Medicaid program. The companies are charged with managing the care of Medicaid recipients.
Under “managed care,” the idea is to provide needed services to people at the right time and in the most appropriate and generally less expensive setting.
Long-term care for the elderly and developmentally disabled was supposed to be the final part of the initiative where private companies manage the care of Medicaid recipients. But the administration said Wednesday it will leave the move to the next governor who takes office in January.
A question about the candidates’ positions on the issue was first up at the forum sponsored by AARP Louisiana, the Councils on Aging and the Louisiana Aging Network Association.
Nursing homes want to be exempt, fearing loss of patients and the taxpayer dollars that go with them. Dardenne said industry officials have expressed that desire to gubernatorial candidates.
Advocates for the elderly and disabled want them included, hoping that dollars would be shifted to more home and community-based services, where there are waiting lists of up to 36,000 people.
“If we have managed care, it needs to be across the continuum of services,” Dardenne said. “It’s the last of three areas and it needs to be applied to everybody consistently.”
Edwards said he would move toward a comprehensive system “so the elderly can stay in their homes longer in community-based settings.”
“We also need to transition to nursing homes when necessary,” he said. “It is my goal that we sit at the table and work this out.”
Angelle, Dardenne and Edwards said they all favored elevation of the Office of Elderly Affairs to Cabinet-level status.
Angelle and Edwards said they would create a separate department.
Both cited the growing population of seniors that, Edwards said, is 900,000 above age 60 today, and the need for more emphasis on issues affecting them.
Dardenne proposed merging the Office of Elderly Affairs into the Department of Veterans Affairs. “I believe there are enough similarities to make it fit,” Dardenne said, adding that 50 percent or more of Louisiana veterans are 60 or older. He reminded audience members that Louisiana voters rejected a proposed constitutional amendment that would have created an additional state department.