BATON ROUGE, Louisiana — Lawmakers have repeatedly refused to expand Louisiana's Medicaid program, siding with Gov. Bobby Jindal in opposition. But on Monday, they started advancing a proposal that would help pay for an expansion if Louisiana's next governor has any interest.
Without objection, the House Appropriations Committee approved legislation by House Speaker Chuck Kleckley that would let hospitals pool their dollars and use that money to help pay for the state's share of the cost for a Medicaid expansion.
The maneuver could draw down billions in additional federal health care money for patient care available through President Barack Obama's signature health care law, including money for hospitals to compensate them for their care for the poor.
Kleckley, R-Lake Charles, said the proposal — which was crafted by the Louisiana Hospital Association — could help the state's budget. He said it could save $100 million to $200 million a year in state spending on health care that could be shifted to help higher education.
But the Republican-led Legislature has resisted efforts to do a Medicaid expansion. Last week, both the House and Senate health care committees rejected expansion proposals that would have offered government-funded insurance coverage to adults making up to 138 percent of the federal poverty level — less than $33,000 for a family of four.
Backers of a Medicaid expansion say insurance coverage would be extended to up to 300,000 people, giving the working poor better care. Jindal, a likely presidential candidate, has strongly opposed the idea as too costly for the state and as an inappropriate expansion of government-funded health care.
Kleckley said his proposal was about the next governor, to be elected this fall and to take office in January when Jindal is term-limited.
"This governor's made it very clear what his position is. There's not a whole lot I can do about that to change that," Kleckley told the Appropriations Committee. But he added: "We can get this through the process, to have for the next administration."
All four major candidates for governor, three Republicans and a Democrat, have said they'd consider a Medicaid expansion.
The House speaker and Paul Salles, president of the Louisiana Hospital Association, have tried to downplay the connection to Medicaid expansion. They say the legislation doesn't lock Louisiana into doing a Medicaid expansion and doesn't require a specific model, giving the state freedom to devise its own coverage expansion.
"It does not trigger anything," Kleckley said.
The Jindal administration filed notice Monday that it opposed Kleckley's legislation, but no one from the governor's office testified in opposition to the committee.
Kleckley's legislation would expire if Louisiana's governor doesn't expand the Medicaid program by April 1, 2016.
The measure heads next to the full House for debate. It requires a two-thirds vote to pass. Jindal cannot veto the legislation because it's a concurrent resolution that doesn't go to the governor's desk.
House Concurrent Resolution 75 can be found at http://www.legis.la.gov