The solid case for expanding Medicaid insurance for the working poor has drawn significant support from business-led groups in recent weeks.
New backing for the idea come from the Baton Rouge Area Chamber, one of the state’s leading business organizations; the nonpartisan Council for a Better Louisiana; and the business-led Blueprint Louisiana reform group.
Thus it is striking that of four major candidates for governor, only one is unequivocally committed to the expansion, and that is Democratic state Rep. John Bel Edwards of Amite.
The three Republicans are much more cautious, and there is reason to worry that insurance for poor people might get lost. The new governor and Legislature will take office in January and a major special session will likely be held in the State Capitol no later than February.
The special session will be chockablock with major issues, given the state’s crumbling financial status and growing concern about the tottering budget. Amid all that, a plan advanced this year by House Speaker Chuck Kleckley, R-Lake Charles, envisions an early vote in 2016 on the revenue source, a hospital fee, that would provide the state match for the expanded Medicaid coverage.
The GOP candidates for governor suggest they are open to Medicaid expansion or a variant thereof; several states with Republican leadership have expanded Medicaid but have insisted on negotiating for specific waivers from federal agencies. Sometimes that takes a long time if the U.S. government does not agree with a state’s proposals.
Tailoring Medicaid coverage appears to meet concerns of the Republicans, Lt. Gov. Jay Dardenne of Baton Rouge, U.S. Sen. David Vitter of Metairie and Public Service Commissioner Scott Angelle of Breaux Bridge — but they have called for “flexibility” (Dardenne) or “a conservative market-based solution” (Angelle) or “increasing work requirements for able bodied citizens who receive help” (Vitter).
The last from Vitter is not particularly relevant, as just about everybody who would benefit is already working anyway, just at low wages that make regular insurance unaffordable.
Leaving those political dodges and weaves aside, the problem is that if a GOP governor wanted to campaign for expansion and then once in office call for waivers that the federal government finds unreasonable, the window of opportunity under the Kleckley funding resolution closes quickly.
We’re not at all suggesting dishonesty on the part of the candidates. Given Gov. Bobby Jindal’s complete opposition to insuring low-wage workers in our state, all four candidates seem to be moving in the right direction.
What is concerning is that the commitments to Medicaid expansion are not ironclad. The groups pushing it need to be aware that they have to keep a close eye on whether they have commitments that realistically can be achieved.