Did Louisiana’s Junior United States Senator David Vitter just use his seat on the House/Senate Conference Committee that produced the version of the Transportation Billapproved by Congress last week to extract revenge on two rivals — and kill the LSU Health Sciences Center Hospital System in the process?
Louisiana officials, health care leaders and others were stunned to learn that the Conference Committee Report on the Transportation Bill included claw backs of Medicaid money overpaid to the state in 2010. That money had originally been obtained by Senator Mary Landrieu to offset what would have been devastating cuts in federal support for Louisiana Medicaid. An error in the calculation of the money to be paid the state created a claim by the federal government for repayment.
Negotiations had reached something of a standoff until the final version of the Transportation Bill emerged from the Conference Committee, taking back all of the money over the next two fiscal years. The federal Medicaid reimbursement to Louisiana was reduced $425 Million in the state fiscal year that started on Sunday, with another $226 Million in the fiscal year that begins on July 1, 2013.
That cut opened a gaping hole in the Louisiana Medicaid budget that state officials now must address. The state has no additional dollars, so Draconian cuts will have to make up for the 11% cut in Medicaid funding lost in the current fiscal year.
DHH Secretary Bruce Greenstein saidthe cuts would be both deep and widespread:
Greenstein last week outlined cuts that will eliminate programs that care for women with breast and cervical cancer, provide hospice care and offer adult dentures to the poor and uninsured. Funding to the LSU public hospitals and rural hospitals will be slashed, threatening some facilities with closure. The rates paid to the doctors, clinics and other health providers who care for Medicaid patients would be slashed up to 10 percent.
So, how could such shocking harm come to our state from out of the blue?
Senator David Vitter took credit for everything in the bill but the cuts in an email to constituents on Thursday.
In the email (see image, above left), Vitter bragged about being “the only Louisianian” to sit on the Conference Committee for the bill. He said he used his position to make “the case for several major priorities for our state.” Protecting the state’s health care delivery system was not one of them.
The viability of the safety net hospital networks in a state with a high poverty rate, high incidence of chronic disease, higher rates of death from chronic diseases than many other states, and large percentages of working age adults without health insurance, apparently just slipped the Senator’s mind.
Senator Vitter might have been too thrilled at being able to inflict a major budget hit on his Republican rival Bobby Jindal to consider the human and community costs of this provision. Was this a form of Vitter payback to Jindal after having lost their budget skirmishes in the 2012 Legislature? Jindal was only able to get the budget he wanted by relying on the Louisiana Senate where Vitter’s Louisiana legislative political operation, which originally concentrated on the House, does not have as much influence.
The fact that the Transportation Bill took away money that Senator Landrieu had delivered must also have also pleased Vitter.
Topping it all off is the prospect of seeing some — if not all — of the LSU Hospital System in North and South Louisiana shut down because the cuts that Vitter knew were coming but said nothing about. Vitter has long championed this cherished conservative dream. Some rural community hospitals will also likely be in jeopardy as a result of the cuts. Those hospitals and the communities they serve are collateral damage inflicted of what is, in Vitter’s view, the high value win of shutting some or all of the state’s public hospital system.
It must have been difficult for Vitter not to itemize and claim credit for this monstrous bit of score-settling. The fact that he could not mention his role in approving the Medicaid cut in the Conference Committee was testimony to just how hard he worked to achieve them — and how damaging the resulting cuts will be to the state and our people.
For more information contact the Louisiana Democratic Party: 225-336-4155; or email here.
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Originally published: July 6, 2012