Louisiana Spotlight: Louisiana senators dodge health law questions

BATON ROUGE— Louisiana’s two Republican U.S. senators aren’t saying much about where they stand on Senate GOP leaders’ proposed rewrite of the federal health care law, even though what they decide can have sweeping implications on their state’s health system.

The proposal, which Republicans continue to tweak behind the scenes, would heavily scale back federal spending on a Medicaid program that provides health coverage to 35 percent of Louisiana’s population. About $13 billion is being spent on Louisiana’s Medicaid program this budget year, with nearly three-quarters of that money coming from the federal government.

Perhaps that’s why Sens. Bill Cassidy and John Kennedy have decided they don’t want to get out front on a bill that isn’t yet set for a vote and that is being renegotiated in private as Republican Senate leaders try to rally support for passage.

An analysis by the nonpartisan Congressional Budget Office says Medicaid cuts in the legislation would shrink projected federal spending on the program 35 percent by 2036. That would shift a heavy cost to states if they want to continue many of their Medicaid services.

Gov. John Bel Edwards said the changes would devastate Louisiana’s health care system.

“There’s not a lot of redeeming qualities about the bill. I would hope they throw it out and start over,” the Democratic governor said.

Extra money given to states that expanded their Medicaid programs to cover the working poor would be phased out, which Edwards said would force Louisiana to end the health coverage it provides to more than 430,000 people — most of whom were previously uninsured.

In addition, a new per-capita payment calculator would cap spending on the Medicaid program that existed before the Affordable Care Act. That program covers 1.2 million low-income people in Louisiana: pregnant women, children, elderly residents and people with disabilities.

Cassidy and Kennedy both have criticized the quality of health care provided through Medicaid and said the program needs changes to give states more flexibility to govern services and to rein in taxpayer-financed spending.

While he hasn’t staked out a position on the Senate health bill, Louisiana’s senior senator at least hasn’t ducked the public. Cassidy took hits about health care at recent meetings.

At a town hall held in a north Baton Rouge church, several people spoke against repealing the law and said Republican proposals are an effort to give large tax breaks to the wealthy at the expense of poor people’s coverage. Audience members shouted over Cassidy’s answers. Some chanted: “Vote no! Vote no!”

Cassidy told the audience: “I am doing my best to make sure that we continue coverage, care for those with preexisting conditions, eliminate mandates and lower premiums.”

However, he never explained if he thinks the Senate draft legislation dovetails with those priorities. Instead, he said: “We have not yet seen what the legislation will be upon which we will vote.”

A doctor who worked for years in Louisiana’s charity hospital system, Cassidy is seen as more open to bucking GOP congressional leadership on the health law rewrite because of his detailed knowledge of the subject, his background taking care of poor patients — and his criticism of similar legislation passed by the U.S. House.

Edwards, Louisiana advocacy groups and beneficiaries of the federal health law have focused squarely on Cassidy in their efforts to maintain the law, with perhaps more modest adjustments.

“I’m hopeful that Sen. Cassidy especially will be very influential in (rejecting the Senate legislation) or failing that, making tremendous fixes in the bill,” Edwards said on a recent conference call with Montana Gov. Steve Bullock, a Democrat who also opposes the Senate bill.

Kennedy, who campaigned that he’d “rather drink weed killer” than support the current health law, is seen as a more solid vote for any Republican plan to upend the law and redesign the health care framework.

The new senator, in office since January, hasn’t held an in-person town hall meeting. Instead, he’s done three of what his office describes as “radio town halls,” where he takes callers’ unscreened questions live on a radio show.

Melinda Deslatte has covered Louisiana politics for The Associated Press since 2000. Follow her at http://twitter.com/melindadeslatte