Edwards administration delays OK of key Medicaid expansion fundings _lowres

Advocate Photo by MARK BALLARD -- Louisiana's Joint Legislative Committee on the Budget met for the first time Friday, Jan. 29, 2016. The leadership is, from left to right, Senate Finance Committee Chairman Eric LaFleur, D-Ville Platte, Senate President John Alario, R-Westwego, House Speaker Taylor Barras, R-New Iberia, and House Appropriations Committee Chairman Cameron Henry, R-Metairie.

The Edwards administration backed away from the first test of Republican opposition to the governor’s plan to expand Medicaid when it withdrew a request to authorize hiring new employees.

Because of past staff reductions, Commissioner of Administration Jay Dardenne said the state needs to hire 248 more employees to handle signing up and vetting the expected surge in enrollment when Medicaid rolls are expanded. The Joint Legislative Committee on the Budget was to vote on the financing scheme, but the resolution was withdrawn.

Dardenne told legislators at a budget meeting Friday that he didn’t have an opportunity to visit with the House Appropriations Committee, whose members weren’t named until Thursday evening.

Six of the 24 members of the House budget-writing panel are new to the Legislature.

“We want to have a little more time to explain everything and make sure everybody understands,” Dardenne said, adding that he would bring the plan up again in a few weeks.

The newly named Appropriations Committee has only six Democrats. In the past, Louisiana Republicans have steadfastly opposed expanding Medicaid qualifications to allow more people to join, though some have softened their stance in recent weeks.

It’s a key element to President Barack Obama’s Affordable Care Act.

“I hope we’re not going to be in a situation where Washington comes to Baton Rouge and that decisions will be made purely on political motivations,” Dardenne said.

Appropriations Committee Chairman Cameron Henry, R-Metairie, said he didn’t believe postponing consideration indicated opposition among Republicans, though he and other legislators have questions about the federal health care law. He was unsure whether the 248 new employees would be hired temporarily or full time and what would happen to them if the Medicaid expansion did not go forward as planned.

“If you’re going to hire 248 people for the purpose of implementing the Affordable Care Act, you have to make sure you have a consensus in both houses of the Legislature that this is something the state is going to do into the future,” Henry said.

Medicaid expansion would open the rolls to people in households making up to 138 percent of the official poverty level, a complicated formula but, generally, $33,465 annual income for a family of four.

Edwards signed an order on his second day in office that started the Medicaid expansion process. About 300,000 or so people are expected to join the state-federal government program that already pays the health care costs for about 1.4 million Louisiana residents.

The federal government will pick up the full cost of health services under a Medicaid expansion for a short period of time. Louisiana later will have to pay a share, eventually growing to 10 percent of the cost.

In hiring the 248 new employees to handle expansion applications, the federal government would pay 75 percent of the costs, $7.3 million, but the state’s portion will be about $2.8 million.

Physicians, clinics, hospitals and other providers of services to Medicaid patients have agreed to put up enough money to cover the state’s portion, Dardenne said. The money would go to the Baton Rouge Area Foundation, which would pay the expenses. It’s unclear how long the private donors would pay the state employee costs.

Dardenne said the federal government approved the plan earlier this week.

Rep. Patricia Smith, D-Baton Rouge, said representatives and staffers had questions about the process.

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