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Medicaid contract renewal leads some to posture

Short memories and posturing politicians make for spreading blame aplenty as Louisiana considers how to extend management of Medicaid services to the end of Democrat Gov. John Bel Edwards’ term.

The Joint Legislative Committee on the Budget last week considered renewing contracts with the five providers for Louisiana’s Healthy Louisiana program. These allow operators to manage the state’s Medicaid care, although for services not dealing with mental health not for the elderly nor disabled, nor including those who live in nursing homes. Amid calls for further study by committee members, the panel postponed consideration until this week.

Republican state Sen. Jack Donahue helpfully pointed out more and better metrics would help evaluating whether the deals best benefit taxpayers. Less productively, Democrat state Sen. Eric LaFleur said the time to take this approach had long passed, claiming that he and other lawmakers didn't dissect the deals enough when first put in place, criticizing the Republican then-Gov. Bobby Jindal Administration for a hurried contracting process with too little quality assurance.

Which means LaFleur must have done quite a bit of daydreaming in the 2007-12 period and did not pay attention to what went on while he sat in the state’s upper house. While in the House, he voted for Act 243 of 2007 that started the process. In 2008, Jindal announced the basic outline of the program, with legislative cooperation. The request for proposals went out in April, 2011, bids came in by the end of June, and the state announced the winners by the end of July, with all the details online (until removed by the Edwards Administration over four years later). By the end of the year, the JLCB had given the green light to proceed (all substantial contracting by the state must get its approval).

There was nothing rushed about any of this. LaFleur or anybody else had plenty of time to vet the details and raise objections to any perceived shortcomings prior to implementation beginning in 2012. He also did not seem to have anything to say at the end of 2015, the last time the JLCB took a look at the contracts. The only thing that changed from then to now is Jindal left office, allowing LaFleur to feel unburdened to let loose with criticisms regardless of actual merits of these.

But he wasn’t the only Democrat making hollow complaints. From the administrative side, Department of Health Secretary Rebekah Gee agreed with Donahue’s sentiment, but alleged her agency’s oversight hampered by insufficient resources, blaming the Jindal Administration for cuts causing that.

Which means if one wants to look up the definition of chutzpah, there will appear Gee’s picture. Her department has seen a dramatic boost in budget authority since Edwards came into office, rising $4 billion or 42 percent to comprise presently almost 48 percent of all state spending. And she can’t find the money to hire a few more analysts?

Not that money doesn’t lay around and go to functions about which she doesn’t really know, or even know if these expenditures should exist. She admitted as much in 2016 testimony to the House. And, to top it all off, she told the JLCB that “If I ran a private business, if I ran a Google, there is no way I would do it with so few people because it’s wasteful,” despite that past testimony about potential wasted spending by her agency as well as the fire hose of cash pouring into it. Additionally, keep in mind that Gee never has worked in the private sector, so she doesn’t exactly have a lot of credibility in making statements such as that.

The truth is, as she and her spokesman conceded earlier this year in reference to adding to the managed care contracts nursing home clients (which would permit the state to realize $200 million extra, but Edwards won’t do it), her priority has been to expand as quickly as possible Medicaid, a wasteful program in its own right, putting everything else on the backburner. If she wanted to, she could find the money to increase oversight activities, but she just doesn’t desire that.

Such blatant excuse-making by politicians allied with or working for Edwards would come off as embarrassingly comical if not for the billions of dollars at stake that deserves thoughtful use, not as a prop to try to score partisan political points. As legislators ponder these deals, let’s hope they base decisions on taxpayer, not political, needs.

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