Ignore naysayers, pass Medicaid integrity bill

It’s a bill that would improve matters tepidly, but you would think it heralded the end of the world from the rhetoric emanating courtesy of the far left that favors government as a redistribution machine.

SB 130 by Republican state Sen. Heather Cloud would increase moderately the oversight that the Louisiana Department of Health maintains over Medicaid eligibility: all of regular, expanded, children’s, and waiver provision of the program. It requires LDH to verify independently eligibility information, prohibits relying solely on automatic renewals (and for future waiver program operation prohibits these entirely), prohibits sole use of self-attestation to verify income and assets and mandates verification of residency, and mandates data matching use from a variety of sources on quarterly, semiannual, and annual bases.

Unfortunately, until the last couple of years since Democrat former Gov. John Bel Edwards had entered office, LDH didn’t often utilize these efforts listed in the bill. Vast swaths of verification occurred through self-attestation and what data-based verification did occur usually came in perfunctory form, asking for very little and skipping the finer points of eligibility requirements.

And it purely was intentional. Not only did the Edwards Administration loosen eligibility procedures upon his entering office, it fought against legislative attempts to impose somewhat-similar standards as in the current bill.

Not that the contemplated changes are that substantial. The bill actually was watered down before leaving the Senate, leaving in options to use self-attestation and automatic renewals and reducing the frequency of cross-checking.

But from statements from leftists inside and outside of government about the bill, you would think it’s all an exercise in mean-spiritedness. Hollow claims from people who likely never have interacted with the Medicaid eligibility system on any basis, much less over the long term, and who know few if any people who have either as clients or system employees worked with it, allege the vast majority of otherwise deserving individuals will become ineligible because society and government has failed to equip them to navigate the simple verification steps that LDH bends over backwards to inform them and walk them through. They also assert a good chunk of those who lose eligibility will churn back onto the program at some point, saving relatively little.

 The data show otherwise. The fiscal note to the current, diluted bill version expects within five years average annual savings of $26 million in state taxpayer funds, and attached to that around $211 million annually in unneeded federal funds. This is not far off the $180 million saved annually when some standards were forced upon the Edwards Administration almost a decade ago, so the assumptions used to compute these figures seem in the ball park.

The fact is, the relaxed standards currently employed do allow for a nontrivial level of improper payments that relatively unobtrusive changes can slice into significantly. Legislators must ignore the hyperbole that equates the modest changes with some kind of war on the poor and pass the bill, reassuring taxpayers that what comes out of their pockets has been used wisely on those who genuinely need it.