Medicaid expansion

Johnny Reynolds knew that something was wrong as far back as 2003. That's when he first started experiencing extreme fatigue.

"It was like waking up every morning and just putting a person over my shoulders and walking around with them all day long," says Reynolds, 54, who lived in Ohio at the time.

In addition, Reynolds was constantly thirsty and drank so much water that he would urinate 20 or 30 times per day. "And overnight I would probably get up at least eight or nine times a night," he says.

Finding the way down off the fiscal cliff could be as simple as turning around, and looking back at the path that brought us here.

“The root of our current budget problems goes back to the decision in 2008, under Gov. Jindal, to repeal the Stelly tax changes that voters passed in 2002,” says Louisiana Budget Project director Jan Moller. “That has taken about six to seven hundred million dollars our of our tax base every year.”

During the last legislative session, state Sen. Ben Nevers fought hard for the expansion of Medicaid in Louisiana under the Affordable Care Act. But ultimately, a bill to put the issue on the ballot didn’t even make it out of committee. 

But the legislature did pass another bill from Nevers, compelling the state Department of Health and Hospitals to come up with a plan for Louisiana to pilot “America Next” — Gov. Bobby Jindal’s alternative to Obamacare. 

DHH put out their initial report in response a few weeks ago.


Last year, the Republican playbook for keeping control of the House of Representatives in 2014 and winning the Senate consisted of a fairly simple strategy: Run against Obamacare.

But now that the 2014 races are starting to take shape, that strategy isn't looking quite so simple. Democrats are fighting back. They're focusing on Republican opposition to the health law's expansion of Medicaid as a part of their own campaigns.

Transcript

STEVE INSKEEP, HOST:

Many republican governors have taken a stand against Obamacare by refusing to expand Medicaid. Utah, which is one of the most republican states in the nation, remains undecided. But in a state where the majority of the population are Mormons, one bishop from the Church of Jesus Christ of Latter Day Saints says helping the poor is a moral obligation. Andrea Smardon from member station KUER in Salt Lake City has more.

(SOUNDBITE OF CHECKOUT SCANNER)

Supporters of Medicaid expansion gather on the state capitol steps. April 23, 2014.
Amy Jeffries / WRKF

At the conclusion of nearly five hours of emotional testimony, Senate Health and Welfare Committee Chairman David Heitmeier read the names of those weighing in on Senator Ben Nevers’ bill. The proposal would have put a constitutional amendment to expand Medicaid under the Affordable Care Act before voters in Louisiana.

“You’ve got a lot of support here, Sen. Nevers," Heitmeier said.

But Nevers didn’t have the support of the committee. His bill was stopped on a 6 to 2 vote that fell along party lines.


Baton Rouge General's mid-city emergency room at night.
Sue Lincoln

It’s been nearly a year since the state started implementing public-private partnerships for the LSU Hospital System, formerly known as Louisiana’s Charity Hospitals. The plan was pushed as a cost-saver for the state. How is it working out? Good for some and not so good for others—with patients and hospital caregivers caught in the middle.

A recent report by the Public Affairs Research Council of Louisiana concludes that with the privatization of the charity hospital system, Louisiana’s safety net is being reinvented. 

The reinvention will likely come up again in the legislature when it convenes in March as lawmakers dig up debate on Medicaid expansion under Obamacare. And the candidates for governor will be staking out positions on healthcare reform.


Republican Party leaders say opposition to the Affordable Care Act is their No. 1 campaign issue for the midterm election.

Giving poor people health insurance, the belief was, would decrease their dependence on hospital emergency rooms by providing them access to more appropriate, lower-cost primary care.

But a study published in the journal Science on Thursday finds that's not the case. When you give people Medicaid, it seems they use both more primary care and more emergency room services.

Pages