November 17, 2014

Despite Chuck Todd actually trying to do his job and push Louisiana Governor Bobby Jindal on the Medicaid expansion on Sunday's Meet the Press, Jindal was having none of it. But he did manage to lie his way off the show without any penalty for it.

Jindal's excuse for turning away the Medicaid expansion goes like this:

CHUCK TODD: Yeah, but you have 200,000 not insured at all, though.

GOV. BOBBY JINDAL: Well, but no, I'm saying for every uninsured person you're covering, you're taking more than another person out of private insurance. In Louisiana in particular, we inherited a decades-old public hospital system, unlike other states. We're the only state, we had ten state-operated hospitals. The private sector, public/private partnerships, we've actually improved healthcare access and outcomes.

For one example, it used to take ten days to get a prescription filled, now you can get it done in ten minutes. Through Bayou Health, we reformed our program, we had before 5% of our adults were getting preventive care screenings, now over 80% of our-- Chuck, my point is This. There are better ways to provide healthcare to the vulnerable, to the uninsured. The answer's not for the government to be running healthcare. The answer is not to expand a failed program, a one-size-fits-all approach like Medicaid.

What private insurance would Medicaid-eligible people under the ACA expansion be giving up?

The privatized Medicaid insurance program in Louisiana that doesn't pay for any hospital care -- Bayou Health. What Bobby Jindal has crafted is a private Medicaid system for primary care with only a charity hospital system as the hospital safety net.

Because he refused to expand Medicaid, hospitals are closing emergency rooms around the state. Worse yet, that charity hospital system is being privatized, which means hospitals will not get the benefit of federal dollars to defray the costs of treating the poor.

In other words, that claim of Jindal's that people will leave private insurance is a straight-up lie because all he needed to have done was present a plan simillar to the one his cohorts in Arkansas and Pennsylvania did to allow private carriers to cover Medicaid-eligible residents of Louisiana.

It's taken a toll, not only on the uninsured, but also on providers. A terrible toll.

The money shortage at Baton Rouge General Mid City ought to get his attention, though. There are multiple reasons for the hospital's difficulties. The state's closure of Earl K. Long Hospital has led to an infusion of poor patients at Baton Rouge General's Florida Boulevard location, which is not where the patients were expected to go.

"We'll never know if Medicaid expansion would have kept the lights on," Louisiana Budget Project director Jan Moller said. But the expansion certainly would have reduced the number of patients who are unable to pay for care.

The squeeze is likely to get worse. Early projections estimate the state will face a $1.2 billion shortfall for next fiscal year. Health care and higher education are typically where lawmakers make cuts.

Right now, if you are really, really poor in Louisiana -- earning no more than $5,000 per year -- you can get Medicaid coverage, but only for primary care, and only through privatized Medicaid carriers. If you earn more than $5,000 but less than the federal poverty level, that's just too bad for you. Die and die quickly, and possibly not even in a hospital.

Jindal is courting the ultra-conservatives for his presidential bid in 2016. But if they were really conservatives and not simply billionaire pigs, they'd realize that Jindal made the very worst fiscal decision for the state he could have made.

Future Medicaid expansion seems unlikely as long as Gov. Bobby Jindal is in office and given the balance of power in the state legislature. Jindal is emphatically opposed to expansion, stating in an editorial that it would be “bad for Louisiana’s taxpayers and bad for our health care system.”

However, an Urban Institute study shows just the opposite. The study finds that the state would spend $1.2 billion over 10 years on expansion. Yet over the same period, the state will lose out on $15.8 billion in federal Medicaid funding and $8 billion in hospital reimbursements.

What would have been awesome? For Chuck Todd to have these numbers and this information ready when he tossed out the BS lie about people dropping their private insurance. Then viewers might have gotten the real story.

Here it is, with links and facts for the next time Jindal tries to pull the wool over everyone's eyes. 

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