By Bruce Alpert
Sen. Mary Landrieu, D-La., Monday called on Gov. Bobby Jindal to reverse course and implement provisions of President Barack Obama's health overhaul law. Landrieu said that if Jindal wants to offer changes in the law, she stands "ready to work" with him. But she called on Jindal to accept the reality that with the president's re-election last month, Republican efforts to repeal the law won't succeed.
"The Affordable Care Act is not perfect and that is why I remain open to making smart changes to the law to improve it, if warranted," Landrieu said in her letter to Jindal. "I am open to your suggestions and I hope that we can both work to find real solutions to this serious issue. But now that we know the law is here to stay, simply refusing to engage in the process is not leadership."
The letter is a continuation of a spat between the Republican governor and Democratic senator that began in June when Landrieu complained Jindal wouldn't contact House GOP leaders to try and protect Medicaid funding that was being stripped from the state. Republicans said the funds were allocated by mistake, but Louisiana members of Congress, both Democrats and Republicans, argued that the money shouldn't have been recouped in the middle of a fiscal year when the money had already been budgeted.
In her letter Monday, Landrieu asked Jindal to reconsider his refusal to implement state run health insurance exchanges to provide coverage to those who can't afford to buy it through existing markets, as well as implement an expansion of Medicaid to help low-income state residents get health care coverage.
"In just under two weeks, on Dec. 14, you must make a final decision on whether Louisiana will be allowed to establish its own state-run health care exchange or whether you will cede that authority to the federal government," Landrieu said. 'As a strong states' rights advocate, it seems you would surely want to retain this flexibility for Louisiana."
Asked to respond to Landrieu's comments, Jindal spokeswoman Shannon Bates brought up the bill that cut Louisiana's Medicaid allocation by $800 million.
"We would like to urge Senator Landrieu to reconsider her vote to cut over $800 million from Louisiana's Medicaid program," Bates said.
The Medicaid provision was attached to a transportation bill that also included The RESTORE ACT, which allocated 80 percent of Clean Water Act fines from the BP spill to Louisiana and four other Gulf States. The RESTORE Act was a top priority of the Louisiana congressional delegation.
Landrieu was joined by the entire Louisiana delegation in voting for the bill. That included all seven Louisiana Republicans.
Landrieu said only three states have a higher uninsured rate than Louisiana's 20 percent. And Landrieu said that because of rapidly rising premiums, employers and families with coverage have been "forced to move to skimpier health insurance plans that cover fewer benefits and a smaller share of the cost."
If Jindal acts soon, Landrieu said, the state could create a state-run health exchange designed to fit the unique needs of its citizens.
In a Nov. 16th letter to Department of Health and Human Services Secretary Kathleen Sebelius, Bruce Greenstein, the state's secretary of Health and Hospitals, said the Affordable Care Act is bad policy and that state therefore has opted not to participate in the state-run exchanges.
"The (act) remains a flawed piece of legislation that fails to fix the fundamental problems in the United States health care system, particularly the unsustainable rising costs faced by American families and small businesses," Greenstein wrote. "Instead, we are faced with a more tightly controlled federally-run health insurance market that will increase costs, undermine the private health care marketplace and weaken private sector job creation."
The Medicaid expansion that Jindal has said the state won't participate in would be fully paid by the federal government for the first three years, after that the state cost share would gradually rise to a maximum of 10 percent.
Landrieu said that a 2010 report commissioned by the Jindal administration estimated that federal funds would cover $25 billion of the $26.8 billion in costs for the Medicaid expansion over 10 years, leaving the state responsible for $1.8 billion.
That money would be a huge benefit for state residents who would get insurance coverage, and it would give a major boost to the state's economy, especially health care providers, Landrieu said.