Louisiana needs a good fix.    

Because of the lack of revenues, the Louisiana budget is being carved close to the bone.  Governor Jindal has repeatedly warned of dire prospects should the state not find a solution to the Medicaid FMAP hole  

This FMAP cavity occurred when the federal government determined the amount the state would pay for its upcoming Medicaid costs compared to what the feds would spend.     

The cost-share calculation was tied to the state’s per capita income. 

Under normal times, Louisiana, being a poor state, had a higher chunk of its Medicaid obligation funded by Washington. However, because of the Katrina and Rita hurricane-rebuild money that flushed into the state, the income spiked and the calculation became skewed since it included the increased revenue years from the hurricane-rebuild period. 

Now the hurricane money is coming in drips and the income has returned to normal but not the future Medicaid expenditures. 

Thus, the Louisiana portion of the Medicaid costs is now fixed to the post-storm recovery income and not to the normal and current Louisiana reality.  It means Louisiana will be paying an unfair amount for its Medicaid costs, dollars it certainly cannot afford. 

Governor Jindal called the “FMAP fix” the most important Congressional delegation imperative.   

Ever since Jindal urged the Louisiana delegation to get involved, the only member of the delegation who has made headway with the FMAP solution has been US Senator Mary Landrieu.  Landrieu was able to tie the Medicaid bill to the very controversial health care legislation.  In doing so, she was heavily criticized for making a “back door” deal.  Although it is now questionable that other state- specific projects will make the final health care legislation cut, that Medicaid bill for now appears to be secured as the final health care instrument is debated and voted  upon possibly starting as early as this week. 

Senator Landrieu is in a proverbial “catch-22”.  If the health care bill passes with her vote, it would help fill the FMAP hole.  However, even if her efforts are successful, the opponents to the health care bill will lash out at her for supporting legislation they consider to be public enemy number one.  

But, if the health care bill does not make it to President Obama’s desk, Louisiana will be saddled with an additional dead weight it really cannot afford to bear as the state cuts programs and employees. 

So, what can Louisiana do to avoid the FMAP disaster? 

On Wednesday during a speech promoting the “Louisiana Way” opposed to the “Washington Way” of governing, Governor Jindal brought up the FMAP issue.   Afterwards, during a press conference, the Governor responded to my question on the topic, He said he felt that the solution to the FMAP problem could be through “stand-alone” legislation. 

He said he thought key federal officials agree that the FMAP calculation is based upon unexpected consequences.     

However, so far, for some reason, that “stand-alone” approach has not gotten to first base in Congress.  Ever since Governor Jindal made it public that the Medicaid fix was his top federal concern, the stand-alone bill approach has mustered no momentum whatsoever.     

Upon Bayoubuzz’s request for a response to Governor Jindal’s press conference comments, Robert Sawicki, Landrieu’s Press Secretary sent the following statement by e-mail: “Gov. Jindal requested the Delegation move the FMAP fix as quickly as possible, and in September Sec. Levine’s office even recommended that the Delegation include the fix in the health care reform bill.  Sen. Landrieu followed through by working with Senate Leadership to include this health care provision into the health care bill that was moving through Congress. She remains focused on seeing it across the finish line and delivering these much-needed funds for the people of Louisiana.

http://landrieu.senate.gov/mediacenter/upload/09.09.16_Letter.pdf” 

So, for now, the fate of Medicaid fix is tied to the future of the health care bill.  Should it pass, it will help the state already shocked by the economic downturn.   If the health care bill should fail, it will be back to the drawing board for the Governor and the Louisiana’s congressional delegation to convince the US Congress and the Obama Administration that Louisiana needs to remove a financial shackle caused by a quirk of law and brutal storms.   

Ironically, as Governor Jindal touts the “Louisiana Way” in balancing the state’s budget this year, there appears to be no “Louisiana Way” at all to deal with the immense Medicaid problem.  There is no game plan and nobody calling the shots to effectively deal with Governor Jindal’s main federal initiative.  Instead, for now, the players involved appear to be talking past one another or perhaps not talking at all.