Dr. Jeff Sadow has become a reliably wrong commentator for The Advocate, and his Jan. 17 column on Medicaid expansion is no exception. Leaving aside the benefits of having a healthier workforce with more access to health insurance and care, Sadow ignores three key fiscal impacts: billions of federal dollars coming to Louisiana, millions saved by hospitals from lower uninsured patient costs and higher Medicaid revenues and thousands of health care sector jobs — and their tax payments — created in the process.

Former Gov. Jindal’s own Department of Health and Hospitals released a report in March 2013 estimating that the state could save $368 million over 10 years by expanding Medicaid under the Affordable Care Act. That initial low-ball estimate should be seen in the context of the almost $16 billion in federal funds that rejection of the expansion would have cost Louisiana over the next decade.

President Obama’s offer of the full three years of full federal coverage of Medicaid expansion to states whose governors had rejected it makes the fiscal benefits even more important to Louisiana, as we try to dig out of the hole that Jindal and the GOP-dominated Legislature have put us in. As Stephanie Grace asks in her column of the same date, Louisiana’s Republican Congressional delegation can choose to help the state, rather than indulge their rage at Obama during his final year in office, by supporting this offer.

We know that Jindal’s decisions were made to further his delusional quest for the U.S. presidency. Had he accepted the Medicaid expansion in 2012 when House Republicans engineered the $600 million “clawback” of federal funds for the program, Louisiana could have kept its public hospitals open and not endangered the lives of its most vulnerable citizens by making access to health care more difficult. Not surprisingly, Jindal’s hastily contrived hospital “partnerships” are not saving the state money.

Now we have a governor who is acting in the best interests of Louisiana’s citizens, rather than his own political ambitions. Will the same legislators who enabled Jindal’s fiscal disasters now block Gov. Edwards, merely to oppose a Democrat? If they follow Sadow’s lead in opposing billions of dollars and thousands of jobs coming to Louisiana, we know the answer.

Linda Kocher


New Orleans