Kathy Kliebert - Jindal's interim health secretary, confirmed to the Senate Health and Welfare Committee that the Arkansas proposal lacked flexibility and future financing was very uncertain. Arkansas has proposed to use the Medicaid funding to buy private insurance, which Obama administration is considering.
Lawmakers in Louisansa have been urging Department of Health and Hospitals to copy Arkansas and use the federal to cover 400,000 uninsured under private insurance.
"We have looked at it, but no, we are not entertaining it," Kliebert said.
Senator Fred Mills,R-Breaux Bridge, said the Arkansas model appeared to address the concerns outlined by the Jindal administration about Medicaid being an inefficient and outdated way of providing health care, because the Arkansas program would use the expansion money to pay for private insurance.
"I think the risks are still just too high for us," Kliebert said.
John Matessino - President of Louisiana Hospital Association wanted a steady financing for doctors, hospitals and other providers, "While it is critically important for Louisiana to take advantage of the significant federal resources available to expand health care coverage, such an expansion must be done in a thoughtful manner," Matessino said.
Kliebert said Medicaid has poor outcomes and inefficient spending. The overhaul was being rushed with insufficient guidance, and she questioned whether states could rely on the promised federal financing or if that would later shrink.
Kliebert also said the expansion would cost Louisiana $1.7 billion over the first 10 years, the high end of DHH estimates. But in some scenarios in DHH's own analysis, the state could save millions instead by shrinking its costs for uninsured care.
Even if Louisiana could save money, Kliebert said the state's residents still would be on the hook for its federal tax dollars covering the costs of the program.
"This is not free money," she said.
Senators expressed doubts about the state being able to refuse federal aid for Medicaid expansion as financing in other areas for uninsured would be shrinking.
Senator Dan Claitor, R-Baton Rouge was frustrated at not seeing an alternate plan on the lines of the Arkansas model, to cover more uninsured
"I for one would like a more visible plan," Claitor said. He added, "If you guys aren't going to come with it, we are."
Hannah Punitha (IRDA Licence Number: 2710062)
Melinda Deslatte, April 2013