House committee tables new Medicaid requirements

By Kaylee Poche and Ryan Noonan, LSU Manship School News Service

BATON ROUGE — Haley Saucier has a rare autoimmune deficiency that requires her to have medication infusions once a week. Medicaid covers her $10,000-a-month medication.

Saucier graduated from Loyola University in New Orleans a few months ago and has not been able to find a job. She testified Thursday, Feb. 22 that it is hard to find an employer who understands her condition, which may require her to take several days off from work at a time due to pain.

Saucier appeared at a hearing of the House Health and Welfare Committee, which ended up tabling proposals to impose new requirements on Medicaid recipients after running into blowback from legislators on both sides of the aisle.

Democrats and Republicans expressed concerns about the administrative costs of a bill, sponsored by the committee chairman, Frank Hoffmann, R-West Monroe, that would require able-bodied adults on Medicaid to complete 20 hours of work weekly, especially with the state’s looming $1 billion deficit.

“I’m not against work requirements, I’m about what’s best to do with the taxpayers’ dollars,” Rep. Dustin Miller, D-Opelousas, said.

“Right now, when we’re trying to figure out how to fund TOPS, higher education and LDH,” he added, referring to the Louisiana Department of Health, “and $350 million software, to me, isn’t the answer. I would rather give that money to a TOPS kid.”

State Medicaid director Jen Steele said that while in some cases, work requirements would be easy to prove, investigating an estimated 340,000 recipients would require further scrutiny.

Another concern was the lack of details about how work requirements would be verified and enforced.

“I know my district would support the spirit of giving people hope and a future,” Rep. Dodie Horton, R-Haughton, said. “But what bothers me about this is that there are so many unknowns.”

After hearing both committee members and the Medicaid recipients voice concerns,  Hoffmann pulled his bill to potentially be discussed at a later date.

Similarly, an estimated $1 million administrative cost was a concern for a bill by Rep. Tony Bacala, R-Prairieville, designed to root out fraud in Medicaid eligibility determinations. Bacala ultimately deferred the bill, much to the frustration of Rep. Larry Bagley, R-Stonewall.

“I’d like to vote for something,” Bagley said. “I’m tired of this.”

But Bagley did not get to vote before the meeting adjourned. Sen. Jack McFarland, who sponsored the last two bills on the agenda dealing with Medicaid copays and premiums, deferred his bills immediately after being called to present them.

“I’m not going to sit here to have it voluntarily deferred, so I voluntarily defer it,” said McFarland. “I can read the tea leaves.”

Health experts say that 70 percent of Medicaid adults are already working, and due to exemptions for full-time students and the disabled, the bill would probably only affect about 10 percent of Medicaid recipients.

Lawmakers have said that the federal Medicaid rules would preclude the state from enforcing any medical co-pay requirements, forcing hospitals to absorb those costs.

The deferral of the Medicaid bills mirrored what has happened this week to other bills designed to generate revenue to ease the budget shortfall. Republicans have insisted that the changes to the Medicaid program need to be approved if they are going to support proposals by Gov. John Bel Edwards to raise revenue to replace an extra penny of sales tax that expires this summer.

The inability of the committee to pass any of the Medicaid measures was another sign of the difficulty the Legislature is having in reaching any consensus this week since Republican leaders and Edwards have voiced general support for the Medicaid changes.

The committee also heard from New Orleans resident Bill Murphy whose ex-wife, a Medicaid recipient, was diagnosed with a rare disease. Her diagnosis took over a year, and applying for disability took about four years, a lag that he argued would be hard to factor in when determining exemptions for work requirements.

Murphy argued the bill would punish rather than incentivize Medicaid recipients.

“I don’t know about Baton Rouge, but in New Orleans, a stick is a stick, and a carrot is a carrot,” Murphy said.

Saucier, a New Orleans resident, said she has been down this road before. She was on food stamps for a month in college before being kicked off for being unable to attend a job training seminar. At the time, she was a full-time student and working two jobs, and she said she had submitted letters from her school counselors and employers proving that.

“I’ve already had a negative experience with fulfilling work requirements,” Saucier said, “and I don’t trust the state to manage that for my health which is potentially life or death for me.”

“This is not something that’s abused by recipients,” she added. “It’s abused by providers, and that’s where reforms should be made.”