Wednesday, October 21, 2015

One of these is not like the others

Louisiana should have accepted the federal money for expanding Medicaid as soon as it became available a few years ago. Unfortunately, the Governor was already running for President on a platform based on adherence to a crazy cult of cruel austerity and so we've already thrown millions of dollars away that we'll never see again. 

Because they are also in the crazy cult, three of the four candidates running to replace him are running the risk of throwing away even more.
And the longer the state takes to obtain a waiver, the more it costs: Under the current Medicaid program, the state is reimbursed for just over 60 percent of costs for Medicaid patients. Under the Affordable Care Act, the state receives 100 percent reimbursement. Many states have waited more than a year for federal approval of a waiver.

Also, the reimbursement starts to phase out in 2017, meaning the state will have to start paying a 5 percent match that year until it gradually increases to a 10 percent match in 2020. So if the state is going to expand Medicaid, it will save more money the sooner it begins getting the 100 percent match.

There is added pressure to expand Medicaid sooner rather than later because of a deadline the Legislature agreed to during the spring legislative session. If Louisiana expands Medicaid by April 1, 2016 the Louisiana Hospital Association's members have agreed to cover the state's matching funds starting in 2017 using a fee charged through hospitals.
The three crazy cult members are crazy, though. Louisiana has already painstakingly "reformed" its Medicaid delivery system according to their preferred privatized model. There's no need to appoint any new committees to study the issue and there's no need to apply any sort of "waiver."  All we need to do now is take whatever is left of the federal money the law entitles us to.  Only one candidate says he understands this. 
Edwards: We should stop sending our federal tax dollars to Washington, D.C., so they can send it to the 30 states that have expanded the Medicaid program. I'm not going to back down, I do support the Medicaid expansion because it's the right thing to do.
Last month, Gambit recommended a candidate who clearly does not.  They did this either because they are too stupid to understand it (not likely), or they believe their readers are (possible).  In either case they're putting their fear of being embarrassed by David Vitter's hookers over articulating a clear policy choice for Louisiana. And they're asking you to accept the costs of that choice.

No comments: