The transition of administrations in Washington, DC has caused Louisiana legislators to put off action on Gov. Bobby Jindal’s (R) Medicaid reform proposal until midsummer, according to a spokesperson for the state legislature.
Jindal’s proposal, unveiled in December 2008, would allow Medicaid recipients to move from the government insurance rolls to one of several state-approved private health coverage plans and would replace the current fee-for-service physician reimbursement program with a flat monthly fee to providers, hospitals, and pharmacies who agree to accept Medicaid patients.
State legislators declined to take up the proposal in December without knowing what position President Barack Obama’s incoming administration would take on the proposal, according to a legislative source speaking on condition of anonymity.
Perfection Not Necessary
Jindal’s proposal sparked mixed reviews, with experts calling it far from perfect but conceding the federal government should encourage efforts to improve the bankrupt Medicaid system even if proposals fall short of perfection.
“I would hope that the necessary waiver is granted, regardless of the strengths or weaknesses of Gov. Jindal’s plan,” said Kevin P. Kane, president of the Pelican Institute for Public Policy in New Orleans. “The federal government should be encouraging innovation and experimentation at the state level. Let the states take different approaches to health care, and then compare the outcomes.”
“The current Medicaid system of the feds picking up most of the cost creates an ‘attractive nuisance’ for states to increase Medicaid spending. The more they spend, the more they get from the feds. Louisiana’s waiver moves them closer to a block grant type system that would remove the attractive nuisance and create better incentives for consumers and providers to economize and improve value,” said Jack McHugh, a senior legislative analyst at the Michigan-based Mackinac Center for Public Policy.
‘Step in Wrong Direction’
“I think giving Medicaid folks some choices about the kind of insurance they have is a fine idea,” said Greg Scandlen, director of Consumers for Health Care Choices at The Heartland Institute. “Frankly, though, I’m disappointed in what the Jindal administration is doing there. They tried something similar in Florida, and it didn’t work very well. It alienated physicians even worse than they already were in Medicaid, so I think that’s a step in the wrong direction.”
Scandlen said Louisiana Secretary of Health and Hospitals Alan Levine “is replicating [what he tried in Florida] in Louisiana,” said Scandlen. “He wants bureaucratic control over the health care delivery system. I think it’s wrong. It didn’t work in Florida, and I don’t think it’s going to work in Louisiana, particularly when there are other things they could do that have better prospects.”
Krystle Russin ([email protected]) writes from Texas.