While it’s fashionable and in fact reasonable in an election season for his challengers to criticize Gov. John Bel Edwards, one of the incumbent’s signature issues isn’t likely to be changed: Medicaid expansion.
Two major Republican challengers to Edwards took slightly different tacks during a public event talking about issues in the Oct. 12 primary.
Both Eddie Rispone, a businessman from Baton Rouge, and U.S. Rep. Ralph Abraham, of Alto in north Louisiana, a physician, have been critical of the management of the expansion, pointing to reports some recipients weren’t eligible under the law.
Sensibly, Abraham said he would not seek to pull Louisiana out of the program, a move which is legally questionable under the terms of the U.S. Affordable Care Act.
"I want the voters to understand nobody's going to get kicked off the rolls. But are we going to make this program better for the taxpayer and those that need the program? Absolutely, and that's just good common sense," Abraham said at the event hosted by Associated Builders and Contractors. The congressman made a similar statement at a forum put on by the Public Affairs Research Council.
While he’s been involved in state issues including education and workforce development, this is Rispone’s first bid for elected office. He said he'd try to "freeze" the Medicaid expansion program to keep from adding new people and make sure we have a program that's "implemented properly."
The critics ought to wake up and smell the coffee about the real-world problems of administering such a big program. The state, beginning before Edwards took office in January 2016, has been meeting federal standards for checking whether Medicaid recipients are eligible; lately, Edwards’ administration has further tightened the state’s ability to monitor eligibility.
“Freezing” an entitlement program — for that is what Medicaid is — is almost certainly not going to pass muster with the federal agency that works with the state.
Edwards expanded the program to cover about 500,000 adults, the working poor who were out of luck when they got sick. At best, they clogged emergency rooms, the most expensive and least efficient entry portal for medical care.
The state's stepped-up enforcement of income qualifications for Medicaid resulted in some 30,000 leaving the rolls this spring. The bad news is that they were not being checked often enough before; the good news is that in an improving economy, at least some of them probably went to work at jobs that offered better pay and possibly private insurance.
We see Medicaid expansion as being a benefit for the state, and not just because higher federal rates of matching funds help Louisiana’s general fund balance. A healthier population remains a fundamental building block of a better economy. Rural hospitals, in particular, benefit from Medicaid expansion.
We should not “freeze” it, nor invent ways to kick hardworking folks off the rolls, but we welcome sensible initiatives to make it more efficient.