The Louisiana House decided Wednesday to open the possibility for Medicaid expansion next year after a new governor takes office.
“This resolution does not expand Medicaid nor does it make it easier,” House Speaker Chuck Kleckley told his colleagues. “It gives an option for the next governor.”
The House action came quickly and with no debate.
Republicans, who have blocked numerous Medicaid expansion efforts over the past three years, joined with Democrats, who have been pushing it.
Some Republicans rethought their vote later in the day. At least five state representatives walked to the microphone as the House was wrapping up proceedings to change their votes from “yea” to “nay.”
House Concurrent Resolution 75 would allow Louisiana hospitals to assess fees on themselves to attract more federal dollars for uncompensated care of uninsured patients. But it would only take effect 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 Medicaid expansion and has threatened a veto if the Legislature approved any expansion plan.
But a resolution could be passed by both chambers of the Legislature without going to the governor for his signature, thereby avoiding his veto.
None of the four major gubernatorial candidates has completely ruled out expansion as Jindal has done. Republican candidates Public Service Commissioner Scott Angelle, Lt. Gov. Jay Dardenne and U.S. Sen. David Vitter have expressed interest in exploring the state’s options. Democrat state Rep. John Bel Edwards has been a consistent expansion vote.
Under the resolution, Medicaid coverage expansion would have to occur prior to April 2016 in order for the assessment to be triggered. A new governor takes office in January 2016.
Kleckley said the measure provides the financing mechanism for the state’s hospitals to pool their dollars together and pull down matching federal funds “to take care of some of our health care needs in the state.”
The hospital dollars also will free up $100 million to $200 million in state general fund dollars for other budget needs, Kleckley said. “These are real dollars we can save in the state general fund,” he said.
Federal law allows expansion of Medicaid eligibility to 138 percent of the federal poverty level. That’s about $26,700 a year for a family of three.
The House adopted one change under which small rural hospitals would be excluded from paying an assessment.
Jindal has contended that Medicaid is a broken system and the expansion would cost the state too much down the road. The federal government’s contribution would decline gradually to 90 percent of the cost with the state making up the difference.
Earlier, Louisiana Hospital Association President Paul Salles said the extra hospital dollars would be used to draw down federal funds to cover the Medicaid expansion costs. “This legislation is a commitment, a significant commitment by hospitals to be a part of the health care solution in Louisiana,” he said.
Follow Marsha Shuler on Twitter @MarshaShulerCNB. For more coverage from the State Capitol, follow Louisiana politics at http://blogs.theadvocate.com/politicsblog/