House overwhelmingly refuses to expand Medicaid

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BATON ROUGE, La. (AP) — The Louisiana House overwhelmingly refused Tuesday to provide government-subsidized health insurance to thousands of people with the Medicaid dollars available under the federal Affordable Care Act, in a vote that appears to shelve the issue for the legislative session.

Only 37 lawmakers out of the 105-member chamber supported the Medicaid expansion proposal, while 59 lawmakers voted against it. A day earlier, the Senate budget committee jettisoned a similar bill.

Republican Gov. Bobby Jindal opposes the expansion.

Rep. Pat Smith's bill would have required the state health department to seek federal approval for a program using the Medicaid expansion dollars to provide private insurance coverage to adults making up to 138 percent of the poverty level — less than $32,000 for a family of four. The federal government would have covered the full cost for the first three years.

"With the condition our state is in as far as health care, we are not in the position to pass on this Medicaid expansion," said Rep. Jared Brossett, D-New Orleans. "Our people could use this money."

About one in five Louisiana residents are uninsured. Estimates are that as many as 400,000 uninsured people would be eligible for Medicaid under the insurance expansion.

The nonpartisan Legislative Fiscal Office estimates the Medicaid expansion could save Louisiana as much as $510 million over 10 years, with the state receiving up to $15 billion in federal funding. The Jindal administration disputes the fiscal office analysis.

Jindal says the increased insurance coverage would be too costly for Louisiana and could shift people from private insurance to government-funded health care.

His health secretary, Kathy Kliebert, told lawmakers in committee hearings that the modified bill seeking to use the federal Medicaid money for private insurance doesn't change the administration's concerns. She said federal restrictions governing the Medicaid funding were too inflexible to tailor an insurance program to Louisiana's needs.

Critics of the bill didn't outline their concerns on the House floor Tuesday, however, knowing they had enough votes to kill the measure.

Only Rep. Rogers Pope, R-Denham Springs, spoke in opposition, saying he didn't mean to cast the deciding vote that let the Medicaid expansion proposal out of committee. He said he didn't realize he was voting in support of the bill at the time.

"I don't think it's in the best interest of this state," Pope said.

The leader of the House Democratic Caucus, Rep. John Bel Edwards, asked lawmakers to look beyond the partisan politics. He said rejecting the Medicaid money would mean Louisiana's tax dollars pay for people in other states to have health insurance while people remain uninsured at home.

"For me this is not a question of whether you voted for President Obama or whether you think the Affordable Care Act is the best law we could possibly have. It is the law of the land," he said.

The vote fell largely along party lines, with Republicans voting against the bill and most Democrats voting for it.

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Online:

House Bill 233 can be found at www.legis.la.gov

The vote on the bill can be found at: http://1.usa.gov/YXR7aA

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