ANALYSIS: The 2013 Louisiana Legislature might support Medicaid expansion (but only if they can decide the fate of Louisiana’s Charity hospitals)

A comparison analysis of two Louisiana House floor votes proposing the decide the future of Louisiana Medicaid expansion and state Charity hospitals revealed that 27 House members who voted against HB 233, the only Medicaid expansion legislative instrument to make a floor vote, also voted for HCR 74, the legislative instrument calling for the Joint Legislative Committee on the Budget to review and approve privatization of LSU Charity hospitals.
Many proponents of Medicaid expansion have argued that the continued operation of Louisiana’s state public hospital safety net depends on acceptance of the federal Medicaid expansion under the Affordable Care Act. Likewise some Medicaid expansion proponents also exclaim that for the privatizations to financially succeed, Medicaid expansion must also take place. This posted analysis does not delve into the merits nor validity of these respective assertions. Rather, for Medicaid expansion to become fully accepted by the Louisiana State Legislature, our state Charity Hospital system’s future must be decided first; and be decided in the affirmative (e.g., keeping the LSU Charity Hospital system public).
What follows is the listing of state legislators’ votes on HCR 74. Those listed in bold type also voted for HB 233. Those listed in italics were absent for the HB 233 vote:
Abramson, Anders, Armes, Arnold, Badon, Barrow, Berthelot, Billiot, Bishop, W., Broadwater, Brossett, Brown, Burrell, Carmody, Cox, Danahay, Dixon, Edwards, Franklin, Gaines, Geymann, Gisclair, Greene, Guinn, Harrison, Havard, Hazel, Henry, Hensgens, Hill, Honore, Howard, Hunter, Huval, Jackson, G., Jackson, K., James, Jefferson, Johnson, Jones, Lambert, Landry, T., LeBas, Leger, Leopold, Mack, Miller, Montoucet, Moreno, Morris, Jim, Norton, Ortego, Pearson, Pierre, Pope, Price, Pugh, Pylant, Reynolds, Ritchie, Schroder, Smith, St. Germain, Talbot, Thibaut, Thierry, Williams, A., Williams, P., Willmott [Total 69 YEAS on HCR 74].
NAYS [on HCR 74 and on HB 233 if not listed absent for HB 233]:
Mr. Speaker, Adams, Barras, Bishop, S., Burford, Burns, H., Burns, T., Carter, Chaney, Connick, Dove, Fannin, Garofalo, Harris, Hoffmann, Hollis, Ivey, Landry, N., Lopinto, Lorusso, Ponti, Robideaux, Schexnayder, Seabaugh, Shadoin, Simon, Thompson, Whitney [Total 28 NAYS on HCR 74].
ABSENT: Champagne, Cromer, Foil, Guillory, Hodges, Morris, Jay, Richard, Stokes [Total 8 ABSENT on HCR 74].
[To view the MOTION TO ADOPT tally of HB 233, click HERE].
To determine the prominence of the demand that the state legislature must have the right to vote on the future of LSU Charity system hospitals, 36 the total 37 YEA votes for the Medicaid expansion HB 233 also voted for HCR 74 (and the 37th was absent for the HCR 74 vote). Whether the 27 additional legislators who also voted for HCR 74 but not HB 233 might eventually reconsider their opposition to Medicaid expansion is open for debate. What is evident however is that about the only chance that Medicaid expansion advocates have in the 2013 Regular Legislative Session for such a reconsideration will be through supporting passage of any of the remaining legislative instruments that call for mandating legislative intervention on the LSU Charity hospitals.
Creation of the HCR 74 legislative instrument and House vote quickly arose within days of the approved closure of Earl K. Long Medical Center. It likely would also pass the full Senate — but it has been blocked from even advancing thanks to the efforts of one Senator Jack Donahue, Chairman of the Senate Finance Committee; where HCR 74 has been parked awaiting a hearing for more than a month. While Donahue’s ultimate stance on HCR 74 is unknown, it is abundantly clear that Medicaid expansion is likely dead for this legislative session — unless it can be attached to a bill that would also be supported by those legislators who have clearly demonstrated their interest in keeping our state’s Charity Hospital system open and public.
Medicaid expansion advocates should take a cue from those Louisiana House members who have voted for both HB 233 and HCR 74 to support passage of both. No Medicaid expansion bills introduced this session as of this writing can advance toward full legislative passage; whereas there are remaining bills and legislative instruments awaiting consideration that will either maintain current health services, safeguard particular Charity hospitals to remain publicly-run and financed; or demand legislative intervention to resolve a crisis to overturn Governor Jindal’s demand that our public hospital system be privatized at whatever cost (The Jindal administration now admitted it will be higher).
Tuesday May 28, Louisiana House Floor debate (begins at 1:00pm): Support passage of SB 55 (Provides for Medicaid Transparency); Support passage of SCR 108 (extension of the Medicaid waiver covering the Greater New Orleans Community Health Connection).
Wednesday May 29, 9:30am: Support passage of SCR 25 (Keeping Huey P. Long Medical Center open and viable) and two additional bills (HCR 139 and HCR 140) pertaining to privatization of state hospitals to be considered in House Health and Welfare.

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