League of Women Voters ask for Special Session

By Zoe Sullivan
Contributing Writer

The League of Women Voters of Louisiana has issued a call for an extraordinary session of the legislature to address the dramatic cuts to the state’s healthcare budget. At the end of July, the Department of Health and Hospitals announced cuts totaling $353 million. The cuts, which followed budget reductions earlier in the year, will have broad consequences. These will include staff layoffs and the closure of Southeast State Hospital in Mandeville, an in-patient psychiatric hospital that also serves as a training facility for medical professionals from the New Orleans region.

Ironically, these cuts come at a time when the U.S. Supreme Court has upheld the constitutionality of the Affordable Care Act, which allows states to take advantage of expanded federal medicaid funds. Under the program, the federal government will cover 100 percent of the expansion’s costs until 2016, and will cover at least 90 percent of these costs in subsequent years.

“The League of Women Voters is questioning whether traditional safety-net institutions such as the LSU Healthcare System, Charity Hospital in New Orleans, and the regional mental health institutions are being financially broken in order to outsource their operations,” the press release calling for the special session states. “They are asking whether the overturning of state-supported healthcare operations by repeated budget crises is due to political choices of elected officials.”

The press release also criticized the state’s management of the private contractors that have been managing some state health services in recent years. “The profit margins, transparency, oversight, and cost effectiveness of the two state contractors, Bayou Health and Magellan, for years three through five of the contracts as well as the total cost prior to the contracting are unknown,” it stated.

Some, including state Demo-cratic Party leader Karen Carter Peterson, have questioned whether Governor Jindal is using the state’s policies as a platform for proving his credentials as a conservative. Peterson emailed a statement to The Louisiana Weekly regarding the League of Women Voters proposal.

“Working families can’t sustain this constant punishment to critical services and investments from this administration,” she said, affirming that “The legislature is a check on the power of the Governor’s office.”

New Orleans Health Commis-sioner, Dr. Karen DeSalvo, while declining to comment on the call for the special session, expressed concern about the state’s most vulnerable population in urban and rural areas. “This literally could impact whether people live or die,” she told The Louisiana Weekly in a phone interview. DeSalvo also highlighted dual concerns around the cuts’ longer-term consequences as well as the lack of consultation with those affected by them. “All of this is going to happen really quickly without anyone thinking about the downstream consequences,” she said. Relating the situation to New Orleans, she described tensions around the new LSU hospital. “They’re up to the 3rd floor. This is of concern to us. Maybe they [state officials] have a plan, but they haven’t shared that with us.”

The President of the League of Women Voters of Louisiana, Thetis Cusimano, echoed DeSalvo’s sentiments in a conversation with The Louisiana Weekly. She said that the legislature should “be creative and not go so fast to take apart so many hospitals and services, not this quickly and without knowing the consequences.”

The situation is dramatic enough to be gaining attention in national publications. Healthcare Finance News estimated that Louisiana has 900,000 uninsured residents. Stateline, which is published by the Pew Center on the States, noted in an August 6 article that Louisiana’s refusal to participate in the expanded medicaid coverage available as a result of the Affordable Care Act actually deals a double blow to “safety net” hospitals, such as the Louisiana State University system.

“Hospitals that serve large numbers of the uninsured receive federal ‘disproportionate share’ payments (DSH) to cover the extra costs that this imposes on them. DSH subsidies are the single largest source of funding for these hospitals. The federal health law assumed the Medicaid expansion would be mandatory, and called for a reduction in DSH payments. The theory was that fewer people would be uninsured when the law takes effect, and safety net hospitals would no longer need as much help to cover the expenses of uncompensated care.”

The Governor’s Office and the State Department of Health and Hospitals did not respond to The Louisiana Weekly’s requests for comment on the League of Women Voters’ proposal.

This article was originally published in the August 13, 2012 print edition of The Louisiana Weekly newspaper