La. is center stage in D.C.
The U.S. Supreme Court's ruling on health care last month shook the nation, but what Congress did the day before rocked Louisiana, for better and worse.
The House and Senate's agreement on the transportation bill included the RESTORE Act language, which directs 80% of up to $20 billion in oil spill fines against BP to five Gulf states, with Louisiana in line to get the largest share.
This time, Congress is doing right by Louisiana from the start, as it did not do in the aftermath of Katrina. If the total fines come in on the high end, the state will have secured the first big chunk of funding for its 50-year, $50 billion coastal restoration plan.
In May, the Legislature missed an opportunity to act maturely by failing to pass a proposed constitutional amendment to lock in all the fine money for coastal work. But Congress likely will provide adult supervision by attaching coastal strings to those funds.
Beyond that, the actual transportation portion of the bill included a bigger-than-usual share of highway funding for Louisiana, along with more money for dredging and maintaining its ports. And Louisiana residents will benefit as much or more than anyone from the five-year extension of the flood insurance program.
Our delegation's success would have been complete had Congress ignored Louisiana for the rest of the day. Instead, it singled out this state's Medicaid program for a $650 million haircut, which becomes a $1.1 billion loss with federal and state matching funds factored in.
The reduction was take-back for Congress' earlier faulty math, which extended Louisiana's favorable post-Katrina match rate for two years too long. It will force a cutback in medical services to the poor and steeper cuts to hospital and doctor providers, whose undercompensated costs eventually are shifted to everyone else.
The good news and bad news for Louisiana was overwhelmed by the court's health care decision the next day.
But the state still found its way to the spotlight, or its governor did. Taking the lead among his GOP colleagues, Gov. Bobby Jindal quickly announced the state would opt out of key provisions of the law by not setting up an insurance exchange and by not expanding its Medicaid program. But the first order of business, he said, would be to elect Mitt Romney president so that the law could be disabled if not outright repealed.
With his health care background and his role as a governor, Jindal figures to be the party's point man on that issue in the fall campaign. As such, he will take incoming fire from Democrats on his own record, which started Sunday in his joint appearance on Meet the Press with former Democratic National Chairman Howard Dean. Dean charged that for Jindal to reject extending Medicaid coverage to 340,000 of 860,000 uninsured residents was “crazy,” a term once applied to the former presidential candidate after his on-camera scream in 2004.
Jindal did get in that 96% of Louisiana children have insurance coverage, though that is due largely to another expansion of Medicaid.
What state government does or does not do to implement the health care law by 2014 hangs on what voters do this November. If Republicans win the White House and Congress, they might not be able to completely repeal the law, but they would drastically change it.
The Medicaid expansion, if not rolled back, could be turned into a block grant for states, free from restrictive federal rules, which is what Jindal has long called for.
But should President Barack Obama be re-elected, Jindal might reconsider his refusal of the Medicaid expansion, at least until he checks his own math. Under the law, the federal government would bear all the costs of the expansion for three years, and then pay 90% after that.
The estimated additional $100 million or so per year cost to the state could be cheaper than to have those people crowding into emergency rooms, especially if the federal government, as planned, cuts back on payments to safety-net hospitals. Yet also, one would be naïve to believe that Congress will go on picking up 90% of those costs forever, especially after what it did to Louisiana on Medicaid this year.
Taking the conservative hard-line position on the law may be good for Jindal's politics, until November, after which he will have time to consider what's best for the state.
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