BATON ROUGE, La. (AP) — The Louisiana Senate on Tuesday overwhelmingly backed proposals that would make it more difficult to reduce dollars paid to private hospitals and nursing homes for taking care of Medicaid patients.
Approval of the two measures came despite concerns that locking up an estimated $1.9 billion in the Medicaid program would leave public colleges more at risk to cuts during budget shortfalls, because higher education would be the least-protected part of the state budget.
Over the years, lawmakers have shielded many areas of the budget through constitutional and statutory requirements for spending, and these bills would seek to do the same for certain private health care providers.
The bills were heavily lobbied by the powerful Louisiana Hospital Association and Louisiana Nursing Home Association. Gov. Bobby Jindal's administration raised concerns about the measures, but they were framed as constitutional amendments, so Jindal can't veto them.
Sen. Sherri Buffington, R-Keithville, said the proposals would stabilize funding for health care services and help protect them from cuts. She said hospitals are currently being reimbursed for about 60 cents on the dollar for services provided to Medicaid patients.
"I think every one of us knows Louisiana hospitals are in crisis and, frankly, what that means is that the patients that they care for are at risk," Buffington said.
Sen. Robert Adley, R-Benton, said the proposals would ensure hospitals, doctors and private health care providers get their money, not that patients get specific services. He warned lawmakers that they would be sorry that they tied their hands further in the budgeting process, when additional cuts fall on colleges.
"You're going to dedicate one more time. You're going to make a huge mistake. You're going to regret it. But I can't make you believe it, I know," he said.
Currently, Medicaid provider rates are set by the state Department of Health and Hospitals. The proposals would eliminate DHH's ability to cut rates without support from lawmakers.
One measure would let hospitals pool their money and use those dollars to draw down federal Medicaid money. In exchange, cuts to hospital payments would be limited and require a two-thirds vote of lawmakers.
That bill received final legislative passage with a 33-5 Senate vote.
The other proposal would set a floor on Medicaid patient reimbursements paid to nursing homes, pharmacies and institutions for the developmentally disabled based on next year's Medicaid reimbursement rates. Cuts to payments also would face restrictions and would require the support of two-thirds of lawmakers.
Before voting 34-4 for the measure, senators took out language in the nursing home bill that would have required the rates to go up annually with inflation. That change needs approval from the House before getting final legislative passage.
The proposals, both by House Speaker Chuck Kleckley, R-Lake Charles, would need approval from voters in a statewide election next year before they could take effect.
The nonpartisan Public Affairs Research Council of Louisiana described the bills as establishing winners and losers in the private marketplace. The council said the measures would give some facilities protection, while excluding others like home- and community-based care and leaving them more vulnerable to cuts if Medicaid funding is reduced.
"This is a remarkable level of rate protection to be included in a state constitution," the council wrote in an analysis released Tuesday.
Buffington said the facilities whose rates would be protected generate dollars that are used to bring in the federal match money and should be afforded some level of protection for that effort.