The state Senate Health and Welfare Committee advanced a measure that could lead to Louisiana participating in that key component of the federal Affordable Care Act.

House Concurrent Resolution 75 is now headed to the Senate floor for its last vote in the legislative process.

HCR75 would allow Louisiana hospitals to assess fees on themselves to attract more federal dollars to pay for uncompensated care of uninsured patients. But the money is available only if the state agrees to change Medicaid income qualifications to sign up uninsured people who make too much to get the government coverage but too little to buy adequate insurance on the private market. An estimated 240,000 additional Louisiana residents would be eligible.

Gov. Bobby Jindal opposes Louisiana participation in Medicaid expansion. And the Republican legislative majority has blocked legislative expansion efforts for the last three years.

But Republicans joined Democrats in supporting HCR75 as it sailed through the Louisiana House with no debate.

And Jindal cannot veto the measure because it is a legislative resolution.

House Speaker Chuck Kleckley said the resolution is not a mechanism to expand Medicaid, nor does it make it easier for expansion to occur. He said it simply provides an “option” for when a new governor assumes office.

“It’s very, very clear the current governor’s position on Medicaid expansion. The reality is in a little over six months we will have a new governor,” said House Speaker Chuck Kleckley, R-Lake Charles. Kleckley said the major candidates have already said they are open to Medicaid expansion in one form or another. “When they are sworn in they will have an option ... to go forward.”

Sen. Sherri Buffington, R-Keithville, noted that the legislation does not address what type of Medicaid coverage expansion would take place. “You are leaving it open to a new administration.”

If the option is used, Kleckley said the Legislature’s fiscal advisers estimated it would save between $100 million and $200 million in state funds which could be used for other budget requirements.

Health and Welfare Committee Chairman David Heitmeier wanted to know whether the funding mechanism could be triggered now to help with current funding gaps in health care.

Kleckley and Louisiana Hospital Association President Paul Salles said expansion would have to occur in order for the state to be able to tap the funds.

Salles said the state maxed out on its ability to draw down federal funds for care of the poor and uninsured. “The monies are largely obligated right now,” he said, noting LSU hospital public-private partnership agreements.

“I love what you guys are doing. My concern is, is it an option we could use today,” said Heitmeier, D-New Orleans, adding that higher education budget gaps have been covered, but health care remains wanting.

He said he wants to explore whether there is any more federal funding capacity so the hospital funds could be used “to help with this year’s budget.”

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