Legislative efforts aimed at overriding Gov. Bobby Jindal’s rejection of Medicaid expansion took a baby step forward Wednesday as did another bill that would allow residents to ignore mandates in the federal Affordable Care Act.
The state House Health and Welfare Committee approved legislation — pushed by Democrats — that would require the expansion of Medicaid under a private insurance-based model. House Bill 233, as amended in committee, mirrors legislation that cleared a state Senate panel last week.
HB233 went to the full House on a 10-9 vote by the committee.
Also Wednesday, the same House committee advanced a proposed constitutional amendment — fueled by Republicans — that attempts to exempt Louisiana residents from mandatory health insurance requirements in the federal law.
The 8-7 vote sent House Bill 429, the second measure, to the full House with little discussion.
“I want to preserve the rights of individuals, families, businesses and health care providers in Louisiana to continue to make their own decisions free of government coercion and penalties,” said HB429 sponsor, state Rep. Paul Hollis, R-Covington.
State Rep. Patricia Smith, D-Baton Rouge, said HB233 would give Louisiana a chance to participate in the Medicaid expansion.
“It will show the compassion of Louisiana to the people who need compassion,” Smith said, “for them to get access to health care just like you do.”
Republicans dominate both the Louisiana House and state Senate.
Medicaid is the government’s health insurance program for the poor, which is paid for by state and federal governments. The federal Patient Protection and Affordable Care Act, called Obamacare, offers incentives for states to redefine the qualifications for Medicaid in order to make the insurance available to more lower income people.
Jindal opposes Louisiana’s participation in the Medicaid expansion, asserting it will become too costly for the state and builds on a broken federal program.
On Wednesday, two Republican legislators joined with eight Democrats to advance HB233.
State Sen. Ben Nevers sponsored a Senate measure, which like HB233, would use private insurance for the expansion. Arkansas would expand its Medicaid rolls using a similar private-sector plan.
“I would hope that we in Louisiana are not becoming so partisan that we can not look at a good idea and improve on it,” said Nevers, D-Bogalusa. “Let’s have an open discussion with our governor who certainly understands health care and I believe will do something to protect those 290,000 to 400,000 (uninsured) people.”
The Medicaid expansion would provide coverage for adults in households with income up to 138 percent of the federal poverty level. For a family of four, the income cutoff would be $32,499. For the first three years, the federal government pays 100 percent of the costs.
State Department of Health and Hospitals officials testified that the Arkansas private insurance model is not workable or sustainable.
“We do not see the Arkansas model as the worthwhile plan and path forward for Louisiana,” interim DHH Secretary Kathy Kliebert said.
Kliebert complained about the lack of federal flexibility to tailor a Medicaid plan to meet state needs.
State Rep. Kenny Havard, R-Jackson, complained about the Jindal administration’s failure to come up with a plan.
“Right now this is the best plan I think,” Havard said, referring to the private model. “You have given us no options.”
“The options that we need are not available in the Medicaid expansion,” Kliebert said.
She said the administration will rely on federal dollars for uninsured care and new public-private partnerships for management of LSU hospitals to expand health care opportunities for the uninsured.
HB233 would funnel the uninsured into federal health insurance exchanges, which help people shop for coverage. Another provision includes triggers for termination of state participation if promised federal funding drops and yet another would sunset state participation in three years.
Voting FOR expanding Medicaid using a private model (10): State Reps. Andy Anders, D-Vidalia; Regina Barrow, D-Baton Rouge; Kenny Cox, D-Mansfield; A.B. Franklin, D-Lake Charles; Kenny Havard, R-St. Francisville; Dorothy Sue Hill, D-Dry Creek; Katrina Jackson, D-Monroe; Bernard LeBas, D-Ville Platte; J. Rogers Pope, R-Denham Springs; and Patrick Williams, D-Shreveport.
Voting AGAINST HB233 (9): State Reps. Scott Simon, R-Abita Springs; Richard Burford, R-Stonewall; Lance Harris, R-Alexandria; Bob Hensgens, R-Abbeville; Frank Hoffmann, R-West Monroe; Jay Morris, R-Monroe; Julie Stokes, R-Kenner; Lenar Whitney, R-Houma; and Tom Willmott, R-Kenner.
Voting FOR a constitutional to allow Louisiana residents to opt out of Obamacare mandates (8): State Reps Simon, Burford, Harris, Hoffmann, Hensgens, Pope, Stokes, and Whitney.
Voting AGAINST HB429 (7): State Reps. Barrow, Cox, Franklin, Hill, Jackson, LeBas and Williams.