The Public Affairs Research Council on Tuesday called on Gov. Bobby Jindal to provide specific policy ideas for revamping Medicaid as he continues to reject federal expansion because it lacks “flexibility.”
“The governor should explain his alternative path for health care coverage for Louisiana’s uninsured if he chooses not to expand Medicaid, and the Legislature should play a role in shaping that policy,” a new PAR report concludes.
The nonprofit governmental research group said Jindal has laid out some “broad ideas for reforming Medicaid” instead of embracing the plan called for in the federal Affordable Care Act, known as Obamacare.
“If he has specific policy requests for flexibility under ACA and has not formally sought approval, he should make those requests to the U.S. Department of Health and Human Services. If an alternative plan to Medicaid expansion can be tailored to Louisiana, it deserves the public’s consideration,” according to the PAR report.
PAR does not make a recommendation on Medicaid expansion.
“We have not said we need to jump out there and go with it,” PAR president Robert Scott said. “It may not be the cookie-cutter approach, as they say, is the best for Louisiana.”
However, Scott said, “It’s obvious there are other states that are out there trying to work for an alternative way in dealing with the uninsured population.”
The PAR report comes as Arkansas Gov. Mike Beebe said the Obama administration is willing to let Arkansas use an alternative to Medicaid expansion that would provide private insurance to an estimated 250,000 residents instead of adding them to the Medicaid rolls.
The release of the report comes as the joint Louisiana House and Senate Insurance Committees prepare to meet Wednesday to discuss the pros and cons of Medicaid expansion. State health and insurance leaders as well as national analysts are expected to testify.
Jindal has said in the past that the private sector route is the way to go, instead of expanding the broken government health insurance program for the poor and uninsured.
Jindal declined a request for interview made through his press office.
State Department of Health and Hospitals Secretary Bruce Greenstein discounted reports of an Arkansas agreement. He said no formal plan that he knows of has been filed for Obama administration approval.
Greenstein said he has not talked with Arkansas officials about what it is proposing.
“We made the decision to not expand, so we’re not putting a great deal of time in what-ifs,” Greenstein said.
Greenstein said Jindal does have a “concept paper.”
Jindal has consistently rejected the Medicaid expansion, contending it would be too costly for the state and it did not give states enough flexibility.
The Medicaid expansion is projected to provide health care coverage for between 200,000 and 400,000 Louisiana uninsured depending on which group’s figures are used.
Under the ACA, all adults who earn 138 percent or below of the federal poverty level would be eligible to enroll in Medicaid beginning in 2014 if their states opt in. Today, that would mean individuals earning up to $1,285 a month. For a family of four, the earning level would be up to $2,651.
The federal government initially pays 100 percent for the first three years. Then states would pay a small portion after that, up to 10 percent annually.
Jindal has said the expansion would end up costing the state more than $1 billion over the first ten years.
A recent national report done for Families USA concluded that the $1.1 billion annually spent by the federal government to provide that medical care would have a ripple effect, creating 15,600 new jobs and $1.8 billion in increased economic activity by 2016.
PAR recommended that the governor and the Legislature conduct a more thorough cost-benefit analysis of Medicaid expansion because “key factors have not been considered in previous analyses ... Louisiana deserves no less.”
Greenstein said the agency has been doing “analysis and research for quite some time.” He said the agency is relying on a 2010 survey by Mercer for much of its analysis.