Legislative panels Wednesday killed yet another effort to allow Medicaid expansion in Louisiana.
It marks the third straight year Medicaid expansion efforts by Democratic legislators have died at the hands of their Republican colleagues.
The Senate’s Health and Welfare Committee voted 5-3 against the legislation, which would have provided health insurance to upward of 240,000 Louisiana residents.
The vote was largely — as in past legislative efforts — along party lines with all five “no” votes coming from Republican senators.
Down the hall, the House Health and Welfare Committee voted 9-7 against a different measure with the same goal.
Legislation sponsor Rep. John Bel Edwards predicted that the expansion would occur sooner rather than later. But the unfortunate thing is the state will miss out on 100 percent federal funding, said Edwards, D-Amite.
Gov. Bobby Jindal has been a staunch opponent of Medicaid expansion, claiming it builds on a broken system and would be too costly down the road.
Supporters included the Louisiana AARP, the Advocacy Center, the Louisiana AIDS Advocacy Network, the League of Women Voters and a variety of health care associations.
The Medicaid expansion proposals came this year amid a backdrop of a $1.6 billion budget shortfall and the costs of uninsured care threatening the financial viability of some of the state’s hospitals.
Edwards, who is running for governor, and Sen. Ben Nevers, D-Bogalusa, said the Medicaid expansion would save the state dollars initially; lead to healthier residents reducing health care costs; and pump up the state’s economy because of the billions of new dollars that would be invested in health care.
In addition, both argued that it was the right thing to do both fiscally and morally.
“It does not promote the Affordable Care Act, ‘Obamacare’ or any other name,” said Nevers. “What it does is support the people of Louisiana.”
“We should do the best we can for all the people of the state,” he added.
“My Christian faith leads me to believe we should do the things we are supposed to do for the least among us,” said Edwards.
But opponents argued that the expansion would be a financial drain on state coffers over time. Phillip Joffrion, state director of the Americans for Prosperity, pointed to the escalating expenses as more people are being covered in Medicaid expansion states than originally projected.
In addition, Rep. Richard Burford, R-Stonewall, said Louisiana should not depend on the federal government as “a cash cow.”
Rep. Lance Harris said the Legislature would be obligating a future governor to $1.2 billion in additional expense down the line as full federal funding ends and the state starts contributing.
“I don’t think expansion of Medicaid at this time is prudent in the state of Louisiana,” said Harris, R-Alexandria.
Senate Bill 40, sponsored by Nevers, would have required the state to provide health care coverage to those whose household income is at or below 138 percent of the federal poverty level. That’s $27,724 for a family of three.
Today, federal funds would pay 100 percent of expansion costs, an amount that would dip to 90 percent in later years.
Nevers’ measure specified that no state taxpayer dollars would be spent as Louisiana’s match. He suggested match dollars could come from health care dedications, such as provider fees, already allowed in state law.
SB40 also contained a provision under which the state could opt out of the program if the state share exceeded 10 percent.
“This bill gives DHH the flexibility to create a Louisiana plan. One that fits us, not straight Medicaid expansion,” Nevers said, referring to the state Department of Health and Hospitals.
The expansion would bring an economic boost to Louisiana with $1.6 billion in federal funds coming in for health care, Nevers said.
In the first year alone, he said about 15,000 jobs would be created in the health care services industry, he said.
“This is the best economic development tool we have seen in years,” Nevers said.
House Concurrent Resolution 3 by Edwards would have amended DHH’s administrative rules to allow Medicaid eligibility to conform with the federal laws up to 138 percent of the federal poverty level. It would be up to DHH to structure how the expansion would work. Jindal could not veto the resolution.
Edwards suggested that the expansion could be done under Jindal’s signature Medicaid privatization initiative under which insurance companies are being paid premiums to manage care.
Follow Marsha Shuler on Twitter, @MarshaShulerCNB.