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Louisiana Department of Health Secretary Dr. Rebekah Gee speaks during a press conference to introduce the GRACE Program, which will provide care coordination services to expectant mothers struggling with opioid use disorder during pregnancy, Tuesday, September 11, 2018, at Woman's Hospital in Baton Rouge, La.

Since taking the helm of the Louisiana Department of Health nearly three years ago, Dr. Rebekah Gee has served as a lightning rod for critics of Gov. John Bel Edwards' administration.

House Republican leaders have complained when she missed a hearing at the State Capitol and frequently castigated her when she has attended to answer questions about her agency's $11 billion-plus budget.

Gee, who lives with her husband and children in New Orleans, has faced insinuations about whether she's in Baton Rouge enough and was widely seen as the target of ultimately unsuccessful legislation regulating agency heads' work requirements.

Even before Gee took on the full-time Health secretary job, some openly objected to her appointment over claims that Gee, an OB-GYN, once gave a speech at a "Pro-Choice Massachusetts" meeting.

This week, U.S. Sen. John Kennedy became the latest to take aim at Gee, calling for her resignation after an audit turned up improper Medicaid payments.

"Actions ought to have consequences," Kennedy, of Madisonville, told reporters on a call from Washington, D.C., on Wednesday. "If this was in the private sector, Dr. Gee would have been fired an hour after that report."

Gee, previously the state Medicaid medical director, declined The Advocate's request for an interview this week, with an LDH spokeswoman citing scheduling conflicts.

Edwards has repeatedly gone to the mat to defend Gee against the bouts of criticism she's faced since joining him at the start of his administration — often in a way that he hasn't had to for other officials in his administration.

This week, shortly after Kennedy's comments made the rounds through news reports and on social media, the governor again affirmed his continued "full confidence" in Gee.

"Under Dr. Gee’s watch the uninsured rate in Louisiana has been cut in half, and we’ve saved hundreds of millions of dollars thanks to Medicaid expansion," Edwards spokesman Richard Carbo said. "(Kennedy)’d be doing our country and state a great service by focusing on the job he ran for three times, rather than meddling into issues he knows nothing about."

Kennedy, a Republican and frequent critic of the Edwards administration, is expected to announce this month whether he will challenge the incumbent Democratic governor in next year's election.

The Louisiana Legislative Auditor's report this week highlighted as much as $85 million that may have been misspent on Medicaid coverage for people whose income exceeded the current threshold. The estimation was based on a random, limited sample of the Medicaid expansion population.

Shortly after its release, LDH announced it had launched a new eligibility system this week.

“This transition is like upgrading from an old flip-style cellphone to a modern smartphone,” Gee said in a news release. “The new system will better ensure eligibility by connecting with state and federal databases to automatically provide more information about income, disability, citizenship status and other eligibility requirements."

The tech upgrade had been in the works a year before its launch this week, and LDH has spent months training employees to use it.

"This administration is increasing income verification checks by 400 percent, which will address the long-term problem described in the audit," Carbo said.

Shortly after taking office in January 2016, Edwards signed an executive order expanding Medicaid, which is optional for states under the federal Affordable Care Act. More than 481,000 Louisiana adults, mostly the working poor, have been added to the program since it went into effect in July 2016.

Gee, a vocal proponent and de facto face of expansion, has offered advice to other states related to Louisiana's quick implementation. She often credits the expansion for improved state health outcomes and a drastic drop in the state's uninsured rate.

Under the expansion, adults whose household income falls below 138 percent of the federal poverty level, about $16,600 for a single person or $33,940 for a family of four, are eligible for government-funded health care coverage.

But the price tag, and explosive enrollment growth since the start of expansion, has made it a target, particularly among Edwards' Republican critics who argue that, even though most of the funding for it comes from the federal government, the ballooning program will become unsustainable and eventually put pressure on state finances. The expansion has also prompted increased calls for rooting out any potential fraud in the program, which were reignited after the release of this week's audit.

During often tense budget hearings at the State Capitol over the past two years, Gee has defended her budget and rejected suggestions that LDH may have some fat to trim.

House Republican lawmakers last fall temporarily blocked contracts for managed care companies that coordinate services for the state's Medicaid program, urging LDH to see if additional savings could be gleaned.

Earlier this year, a House Republican-backed bill meant to regulate when and how Cabinet members do their jobs was met with wide-spread speculation that it was targeted at Gee, though its supporters denied that it was directed at any agency head specifically.

Gee, who often tells her story of moving to New Orleans in 2009 after attending Jazz Fest and falling in love with the city, has an office there in Benson Tower, in addition to her downtown Baton Rouge office. The proposal, which ultimately failed to pass the GOP-controlled House, would require department heads to work "full time" — seven hours a day and 40 hours a week — and "report to work on each day that his (or her) agency is open to the public."

The bill also was seen as directed at Gee's continued occasional clinic work, without pay, at the LSU Uptown Clinic on St. Charles Avenue in New Orleans, as it sought to prohibit agency heads from performing any outside work related to their state government jobs in some cases. As health secretary, LSU Health Sciences falls under Gee's purview, which prompted questions about whether the proposal would have prevented her from any further practice there.


Follow Elizabeth Crisp on Twitter, @elizabethcrisp.