Louisiana’s cavalcade of cowardice on Medicaid expansion

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By Robert Mann

Just how much do Louisiana Republicans despise President Barack Obama? The result of Wednesday’s appalling vote against providing health insurance for Louisiana’s working poor in the Senate Health and Welfare Committee suggests it’s quite a bit.

After a hearing on Sen. Ben Nevers’ bill to put the issue of Medicaid expansion to voters this fall in the form of a constitutional amendment, the committee voted along party lines to reject the bill. The vote was 5-2 against helping the working poor.

Accepting federal Medicaid dollars under the Affordable Care Act is not only an act of justice and compassion; it’s a good deal for Louisiana. The federal government will pay 100 percent of the costs of providing health insurance to hundreds of thousands of working poor in Louisiana for the first three years. Thereafter, Washington will cover 90 percent of the cost.

Jindal and Republicans in the Legislature say it’s too much to ask the state to pay 10 percent. They say it will potentially bankrupt the state (this from a party that will give us a billion-dollar budget shortfall next year). Never mind that in 2008, Jindal proposed his own Medicaid expansion program to Washington, in which he volunteered Louisiana to pay 30 percent of the costs.

That, of course, was before the Affordable Care Act passed and Jindal decided to run for president. Now, nothing can get in the way of his presidential aspirations, not even protecting the health of his state’s working poor.

I understand why Jindal won’t take the money. He cares more about being elected president than helping working people in need. That’s clear.

What I don’t get is how state legislators don’t understand that helping Louisiana’s working poor is good politics and good policy.

Rep. Vance McAllister used the issue to win a congressional seat last year in one of the most conservative regions of the state. McAllister had the guts to tell his constituents the truth about the benefits of accepting the Medicaid dollars. They elected him to Congress. 

If only Sen. Dan Claitor, now running for Congress in the 6th congressional district, would exhibit the same courage. Claitor, instead, took the faint-hearted route and opposed Nevers’ bill on Wednesday. The would-be congressman lacked even the courage to put the question to a vote of the people.

Politically, this shouldn’t be a difficult decision.

Polls show that the Louisiana public supports accepting the federal funds to expand Medicaid. Just yesterday, a New York Times survey of Louisiana voters showed that 52 percent believe the state should accept the federal dollars. LSU’s Public Policy Research Lab (PPRL) has also polled the issue. In its annual “Louisiana Survey” in 2013, the PPRL reported that 70 percent of respondents said the state should expand Medicaid.

Now there’s evidence that the program is a very good financial deal for states like Louisiana. Just last week, the nonpartisan Congressional Budget Office (CBO) cut by more than a third its estimate of what the program would cost states.

In February, the CBO said that states would collectively spend an extra $70 billion from 2015 to 2024 in matching funds to obtain federal support for expanding Medicaid and for their children’s health insurance program (CHIP). CBO’s most-recent estimate is that this amount will, instead, be $46 billion.

As the Center on Budget and Policy Priorities noted, “States will spend only 1.6 percent more on Medicaid and CHIP due to health reform than they would have spent without health reform. That’s about one-third less than CBO projected in February. And the 1.6 percent figure is before counting the state savings that the Medicaid expansion will produce in state expenditures for services such as mental health and substance abuse treatment provided to the uninsured.”

As former Sen. John Breaux (for whom I worked for 17 years) noted in his testimony Wednesday to the Louisiana Senate committee, Republican governors in Arizona, Iowa, Michigan, Nevada, New Jersey, New Mexico, North Dakota, Ohio and Utah have agreed to take the money because they recognize that it’s a good deal for their states.

Of course, only one of those states – New Jersey – has a governor plotting a presidential campaign. Jindal’s argument about fiscal responsibility collapses in the face of so many GOP governors who have examined the numbers and concluded that accepting the Medicaid dollars is a great deal.

This debate really shouldn’t be about President Obama or what you believe, in general, about Obamacare. Before Obama entered the White House, Jindal thought expanding Medicaid and paying 30 percent of the costs was a wonderful idea.

For Jindal, this is about fighting anything Obama supports. It’s about Jindal’s ability to brag to tea party activists in Iowa that he hates Obamacare more than any other governor does. It’s about putting politics ahead of the health and welfare of Louisiana’s working poor.

“Your constituents might love or hate President Obama, but that is not the issue,” Breaux correctly told state senators on Wednesday. “The issue is whether Louisiana should take advantage of increasing the number of Louisiana citizens who could gain access to quality health care by expanding the eligibility for Medicaid.”

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7 Responses to Louisiana’s cavalcade of cowardice on Medicaid expansion

  1. John Kline says:

    Just a bunch of narrow-minded, bigoted hate-mongers. Hypocrites to the max.


  2. John Bel Edwards says:

    Excellent piece.

    Sent from my iPhone


  3. Fredster says:

    How foolish and ridiculous was this! They could have put the idea before the electorate and should it have passed, could have said it was the will of the people and they themselves had nothing to do with it. They could have retained their Republican “cred” and provided health care to the poor without having to take ownership of the idea. Really sad.


  4. Patrick Robinson says:

    Recently we were told the Feds are going to withhold Medicaid payments totaling hundreds of millions of dollars to Louisiana, not to mention the hundreds of millions of dollars we will have to repay. This because the Jindal Administration has refused to answer questions on the Privatization of the LSU Hospitals, but not to worry, Kristy Nichols states we will appeal the action by the Feds. To whom and on what basis, she didn’t say, but obviously the plan is to delay until Jindal leaves office. I hope for the sake of Louisiana, the Legislature has a PLAN C, because PLAN A is a very expensive failure and they have rejected PLAN B. For those Legislators who are against participating in the Medicaid Expansion Program, the day will come when those of us who pay taxes are going to have to repay the Feds those hundreds and hundreds of millions of dollars Jindal is “borrowing” to pay for PLAN A. I hope you realize when that day does come, ALL of your constituents are going to hold you responsible for the mess we will find ourselves in!


    • Fredster says:

      Kristy Nichols states we will appeal the action by the Feds.

      Hate to say it, but I’ve never believed a word that comes out of that woman’s mouth, not evah.


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