Lawmakers hold hearing on federal health care law

Louisiana lawmakers delve into the details of the Medicaid expansion allowed under federal law

BATON ROUGE, La. (AP) -- Gov. Bobby Jindal may have decided Louisiana won't expand its Medicaid program, but state lawmakers don't appear so settled on the issue.

Lawmakers got a crash course Wednesday on the details of the federal health care law for the first time since it was upheld by the Supreme Court, and the Senate and House Insurance committees asked for more analysis.

Sen. Dan "Blade" Morrish, chairman of the Senate committee, said he wants more details about the costs and benefits of an expansion and information from states like Arkansas that are working on alternative program models with the Obama administration.

"The people of this state deserve to know whether we're making the right decision, and I can tell you right now I do not know," said Morrish, R-Jennings.

Rep. Greg Cromer, chairman of the House committee, also said he thinks lawmakers need more information, and the hearing room was packed with legislators who stayed for the full five-hour meeting.

Jindal, a Republican considered a potential White House contender in 2016, calls the Medicaid expansion an inappropriate growth of an inefficient, government-run health program and too costly for states.

Estimates are that anywhere from 260,000 to 400,000 more Louisiana residents could be eligible for Medicaid in 2014 and thereafter if the state chose to expand the program, with the federal government paying most of the costs.

The insurance committees heard from nonpartisan experts on the inner workings of the federal law, called the Affordable Care Act. They also received information from Jindal's health secretary, Bruce Greenstein, and from people urging lawmakers to support the Medicaid expansion.

Morrish asked Greenstein to look at efforts in Arkansas, where state officials say they received permission from the Obama administration to pursue a plan that would allow the Medicaid expansion dollars to be used to buy private insurance for the newly eligible.

But Joy Johnson Wilson, the health policy director for the National Conference of State Legislatures, told lawmakers there is no approved plan for Arkansas so far, just conversations and encouragement for the state to submit a proposal.

Insurance committee members also asked Greenstein and others to look more in detail about potential costs and penalties to businesses if the state doesn't choose to expand Medicaid.

The potential expansion would cover adults making up to 138 percent of the poverty level — $15,420 a year for an individual or $31,812 for a family of four. The federal government will cover the full costs of the Medicaid expansion from 2014 to 2016 and pick up most of the price tag after that, requiring states to pay up to 10 percent.

The nonpartisan Kaiser Family Foundation estimates it would cost Louisiana $1.2 billion over 10 years to expand the program to cover the additional low-income residents in exchange for $15.8 billion in federal funding.

The left-leaning Louisiana Budget Project said the state wouldn't have to put up that additional cash, however, calling it a break-even proposition because Louisiana would save a similar amount that it would otherwise spend on uninsured care over the same decade.

"Critics fail to account for the savings as well as the cost," said Jan Moller, president of the budget project.

Greenstein has said his department hasn't modeled whether savings on uninsured care could offset the state's costs of a Medicaid expansion. Morrish said he'd like to know more about the possibilities.

"If we can get that many more people covered and we can break even, that sounds like a very good deal to me. But I don't know if that's the case," Morrish said.