Louisiana Medicaid contracts permitted after weeks of delays

Louisiana Joint Legislative Committee on the Budget approved $15.4 billion worth of Medicaid contracts Thursday (Dec. 14) after weeks of delays due to a power struggle between the House GOP leadership and Gov. John Bel Edwards, a Democrat. The five contracts control the delivery of health care for 1.6 million people in Louisiana.

The Edwards administration recently agreed to tweak the arrangements to ensure the legislative auditor has access to documents and data. The House Republican leadership had initially requested that language be added to the arrangements in November, but the Edwards administration refused to make that or any other change the House GOP leadership wanted at first. The governor’s staff said the language was unnecessary.

As a result, the House Appropriations Committee rejected the contracts twice in November. On Thursday, after the governor’s team had added the language wanted by the House, lawmakers approved the contracts without any objections. 

The Edwards administration had tried to paint the House GOP as being obstructionists for blocking the contracts over several weeks. But legislative leaders said the compromise on the contracts that was eventually reached is an example of functioning democracy — one where the governor doesn’t have too much control. 

“The process worked,” said House Appropriations Committee chairman Cameron Henry, R-Metairie, who led the House’s opposition to the original Medicaid contracts. 

Senate President John Alario, R-Westwego, said the debate over the contracts had been a “healthy exercise in the democratic process.” 

The stalemate over the contracts could have had major consequences if it continued. The current version of these Medicaid contracts expire Feb. 1 and govern health care for about 90 percent of the state’s Medicaid patients, including 700,000 children. They are worth about a quarter of the state’s operating budget.

If they didn’t get implemented, hospitals, doctors and other health care providers for Medicaid patients may have had trouble getting paid after January. The state’s already large budget problems also would have gotten worse. Without the contracts, the Medicaid program would have run out of money by the middle of April, and legislators would have been $350 million short on state funding for the current budget cycle. 

Edwards became so frustrated with the House blocking the contracts that he had announced he would circumvent the Legislature altogether and implement them using emergency contracting rules. By declaring a public health emergency, Edwards was hoping he could use a process to approve the contracts that doesn’t require the Legislature’s vote at all. 

That maneuver by the governor angered state senators who, unlike the House, had voted in favor of the Medicaid contracts and are generally more supportive of the governor’s agenda. They weren’t happy with the idea that the governor would try to cut them out of the approval process…

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