The ink was barely dry on Thursday’s United States Supreme Court decision upholding the Affordable Care Act before Louisiana Governor Bobby Jindal announced his intention to deny tens of thousands of Louisiana businesses and hundreds of thousands of Louisiana citizens the benefits of that act.
Talking Points Memo reports that in a national press call with other Republican governors, Jindal declared his intent to pretend that the law does not exist.
“We’re not going to start implementing Obamacare,” Jindal said flatly. Under his watch, Louisiana will not set up any of the required state heath care exchanges where, starting in 2014, Americans will be able to buy subsidized private health insurance.
Despite the Supreme Court decision declaring the Affordable Care Act the law of the land, Jindal’s early statements are stark stark examples of him putting his political ambitions ahead of the interests of the people of the state he was elected to govern.
By any objective measure, the Affordable Care Act is good for what ails Louisiana. We are a state with a large percentage of working age adults (19-64) who do not have health insurance.
Blocking the Exchange
The ACA fixes that in two ways. First, it creates health insurance exchanges in each state where businesses and consumers will be able to shop for their health insurance in a transparent market place. Think of it as an online comparative shopping site. Users will be able to compare apples-to-apples when buying health insurance, comparing coverages, premiums, co-pays, and deductibles.
Under the provisions of the law, these exchanges are to operate as partnerships between the federal government and the states. The Jindal administration has made clear that it wants no part of the exchange that will operate in Louisiana. It first rejected the planning money in 2011. During the 2012 Regular Session, he and his allies made sure that a bill to have the state participate in the exchange was killed.
Ironically, the Governor will force an expansion of the federal government’s reach into Louisiana by his refusal to take part in the health insurance exchange. Jindal’s refusal to allow the state to participate in the creation of the health Insurance exchange also denies the state the state the ability to influence the kinds of health plans that are offered through the exchange.
So, the Governor’s refusal to participate in the exchange will exact a cost from Louisiana businesses and consumers who will use the exchange. But, in Jindal’s world, that is acceptable collateral damage for the higher goal of landing a seat on the Romney ticket.
Medicaid Obstructionism
The second way that the ACA addresses the state’s large percentage of uninsured working age adults is through an expansion of eligibility for the Medicaid program, starting in 2014. As anyone who has paid any attention to state budget issues in recent years knows, Medicaid is the largest single item in the Louisiana budget because we are a state with high levels of poverty. Medicaid is targeted primarily to assist the poor. Under the ACA, it is expanded to provide coverage to working age adults who cannot afford to participate in the private health insurance market.
But, instead of wrecking state budgets, the federal government will pay for 100% of the cost of the Medicaid expansion in the states.
According to the Kaiser Family Foundation, the ACA will bring somewhere between 360,000 and 500,000 Louisiana citizens into Medicaid. The expense for this will be covered by the federal government for the first three years of the program, before falling to a 90/10 split in 2017. Louisiana currently has the most generous federal/state Medicaid split in the country at 70/30.
Jindal is quoted in the Times-Picayune as saying the state will not participate in the expansion of Medicaid even though the federal government is picking up all of the cost for that expansion. His opposition cannot be based on any fiscal reason, as the Governor has been particularly reckless with state finances during his tenure, giving away tax breaks and exemptions at a clip that has now almost eliminated corporate tax revenue from the state budget.
On the issue of the expansion of Medicaid — as with the matter of the health insurance exchange — the Governor has placed his national ambition above the wellbeing of the citizens of the state he was elected to govern. His opposition to the expansion of Medicaid has him putting the health of up to half-a-million Louisiana citizens somewhere below his top priority of getting a high profile job outside of Louisiana where he can continue his pursuit of his national ambition.
Those ambitions are all that stand in the way of Louisiana businesses and consumers being able to use a health insurance exchange where they can make informed decisions about the best health insurance values for themselves and their loved ones. Those ambitions are also going to prevent as many as 500,000 Louisiana residents from being able to have affordable access to health care through the expansion of the Medicaid program here.
Has Louisiana ever had a governor who displayed such contempt for the wellbeing of our state’s citizens? Has Louisiana ever had a governor who has shown so little regard for the business owners of this state as to be willing to sabotage a market reform that will help those businesses make better choices regarding a key business expense?
Call the Governor’s office and tell Bobby Jindal that the Affordable Care Act is the law of the land now and that Louisiana businesses and consumers should be able to take full advantage of the benefits of that law as citizens of any other state. Here’s the number: 225-342-7015.
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Originally published: June 30, 2012