Louisiana House leadership filed legislation late Wednesday setting in motion a voter-approved plan that allows Louisiana hospitals to assess fees on themselves to attract more federal dollars for patient care.
But there’s a caveat. The new assessment is conditioned on expansion of Medicaid coverage.
The state’s hospitals, like other groups that rely on government health care dollars, are continuing to face major cuts because of continuing state fiscal problems.
House Speaker Chuck Kleckley, R-Lake Charles, and Speaker Pro Tem Walt Leger, D-New Orleans, filed the legislation — House Concurrent Resolution 75 — as part of an effort to stabilize Louisiana hospitals’ Medicaid financing.
“This is a vehicle we will use to allow the hospitals to pool their money together and pull down some federal funds and help with their (Medicaid) reimbursements,” Kleckley said.
“We are continuing to explore options and working with the Louisiana Hospital Association in dealing with ways to address the shortfall and continued reduction in reimbursement rates,” Leger said. “We have a ways to go to accomplish this.”
“We are just going to look at it,” Kleckley said.
Kleckley and Leger said it’s a revenue-generating option that needed to be put on the table as budget balancing struggles continue. Lawmakers fear that the shortfall in revenues could lead to deep cuts in funding for health care for the poor, roughly one-fourth of the state’s population.
Medicaid provides healthcare coverage for the poor and is paid for, partially, by the state’s taxpayers, but mostly by the federal government. The program accounts for about a third of the state’s annual budget.
The hospital aid plan was the last piece of legislation to be introduced before Wednesday’s filing deadline. A constitutional amendment that voters approved last fall requires the Legislature to pass a resolution, like this one, to set up the assessment process. The resolution provides for a hospital stabilization formula, including an assessment and a base reimbursement level.
Unlike bills, Gov. Bobby Jindal does not have to approve a resolution, but two-thirds of both legislative chambers would have to approve.
“We think it’s an opportunity, an option that should be on the table,” said Louisiana Hospital Association President Paul Salles. “If the state does come up with an expansion of Medicaid coverage model, then hospitals are on-board. We want to contribute.”
“We would use an assessment to pay for a share of the cost,” he said.
What type of assessment would be imposed is not delineated. Salles said that would be determined once the go-ahead is given to a Medicaid expansion.
Jindal has refused to accept Medicaid expansion that’s a part of the Affordable Care Act, known as “Obamacare.”
The federal government pays 100 percent of the costs today but the federal share dips to 90 percent in the future. The expansion would provide insurance coverage to about 240,000 working poor in Louisiana.
Salles said the resolution is silent on the type of Medicaid expansion that would be used. He noted that other states have developed their own models and received federal approval.
The legislation could potentially help with Medicaid financing in the budget year that begins July 1, Salles said, noting that Jindal leaves office in January.
“We will have a new administration in the fiscal year which creates an opportunity for that (Medicaid expansion) to happen,” he said.
Follow Marsha Shuler on Twitter @MarshaShulerCNB. For more coverage of the state capitol, follow Louisiana Politics at http://blogs.theadvocate.com/politicsblog/.