Legislators Leveraging Hospitals to Pressure Governors to Expand Medicaid

Mid City ERNew Orleans       In Florida, there is a well-publicized breech between the Republican Governor and the Republican-controlled legislature over their budget shortfalls and the need to bridge the gaps by expanding Medicaid.  The governor, Rick Scott, has gone to wild extremes of suing the federal government to try to force a change in the already settled matters of disproportionate share funding and blaming the federal government rather than adding Florida to the list of Affordable Care Act states.   Scott believes the hospitals, desperate for more funding and some in danger of closing, are lined up against him.

Interestingly in Louisiana much the same Republican-on-Republican division has also quietly broken out over disagreements over budget gaps and health care needs.  The legislative session is almost over, but rifts are huge.  Governor Bobby Jindal is so dedicated to his ambition to fail as a Republican presidential candidate in hopes some other Republican will win and give him a job, that he has chained himself to the hospital door to prevent the expansion on Medicaid for the 400,000 uninsured in the state.  Interestingly, the Jindal “no-tax” pledge of the state’s health to Grover Norquist has created devastating economic consequences in Louisiana especially with the cataclysmic dip in oil prices.

Public education is more popular in Louisiana than poor people or their health care, and the evisceration of the higher education funding under Jindal has also reached crisis proportions.  In a slick political move in the funding chess game, House leaders, who are obviously disproportionately Republican decided to fund higher education – against the Governor’s budget recommendations – in the next year leaving the state’s health care system at least $200 million short.   And, this starves a health care system that is invariably ranked near the worst in the country, and also threatens dubious agreements that Governor Jindal concocted with private companies to take over Louisiana’s public facilities.  Another $33 million in state is also needed to leverage federal funds to finish building the new hospital facility in downtown New Orleans that was designed to replace the Charity Hospital, shuttered after Katrina.

Tellingly the Advocate reported that “…Capitol insiders said they believe House leaders left health care alone on a limb to create pressure for the Legislature to expand Medicaid…a proposal that Jindal and the Republican controlled Legislature have rejected so far.”  The same report, referencing again unnamed “Capital insiders” added that they “…also suggested that House leaders left health care unfunded to cause hospital and other health care lobbyists to rev up their considerable sway to pressure anti-tax lawmakers to approve more tax measures.”

Regardless of what the Supreme Court decides about subsidies under Obamacare and any number of other issues, it seems the only thing stopping expansion of Medicaid, even among hardcore “hospital door” politicians trying to block health care for the poor, is political stalling and logrolling as Republicans try to position their “never Obamacare” positions with the desperate needs of their own health care systems and their longtime supporters and friends in their state hospital facilities with their deep community support and large payrolls.  Last minute, Hail Mary, lawsuits and meaningless pledges to DC power players are not going to be enough to protect the ideologues from their own citizens and their needs.  It seems the clock is ticking in our favor, if people can live long enough to make it.

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This song goes out to a faithful reader who made the suggestion of posting this great video on the next blog about health care.  Thanks Mike.

Pokey LaFarge’s  Close the Door – Live 

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