Louisiana Voice

George Orwell, writing in Chapter 10 of his literary classic Animal Farm, said, “All animals are equal but some animals are more equal than others.”

Never was that well-worn quote more obvious than when, on July 1, 2011, Gov. Bobby Jindal cast aside the civics class principal of the three equal branches of government by exercising his veto power over legislative oversight of one of his pet projects—privatization.

The vote was 36-0 in the Senate and 100-0 in the House but Jindal still pulled rank on the Louisiana Legislature and vetoed SB-207 by Sen. Willie Mount (D-Lake Charles), as well as three provisions of HB-1 that would have given the legislature some say into the governor’s privatization of the state’s Medicaid program.

The vetoes left no doubt as to the determination of the governor to move forward with his sweeping privatization of several state government programs even though one report said that the proposed privatization of the Office of Group Benefits it dead—at least for this year.

Jindal has already privatized one agency a year ago, the Office of Risk Management, but failed in his efforts to sell three state prisons earlier this year.

He was less than specific in giving his reasons for the vetoes, saying only that the three provisions that he stripped from HB-1would delay implementation of one program while eliminating the flexibility of the Department of Health and Hospitals (DHH) to initiate changes in two other.

In one case, he said that legislative involvement could delay implementation of a program that provides care for youth who have behavioral health problems that put them at risk of being institutionalized.

Language in HB-1 would have required DHH to submit a report providing details of the programs structure, service delivery provisions, population served, and estimated costs for budget committee review at least 30 days prior to awarding a contract.

The administration is presently evaluating a dozen private companies that have submitted proposals to establish networks of health-care providers, including physicians and hospitals with which Medicaid recipients would enroll in an effort to cut costs and better coordinate health care. Ten of those companies are insurance companies.

Jindal’s “coordinated care networks” would use state revenue to pay private insurance companies and other private entities to provide the medical needs for two-thirds of the state’s 1.2 million Medicaid recipients.

Mount, chairperson of the Senate Health Committee, said she was disappointed in the governor’s veto.

“This (Jindal’s privatization) is a significant change in the way we are offering health care,” she said, adding that the legislature should be an “active and engaged” partner to ensure that health care outcomes are both improved and cost-effective.

Jindal also cited “contingencies” in vetoing the proposals but legislators earlier this year complained that Jindal himself included “contingencies,” in his original budget proposal, including the proposed sale of three state prisons that would have required legislative approval before the funds could be appropriated.

Rep. Eddie Lambert (R-Prairieville) said Jindal apparently had a different perspective on contingencies when considering vetoes as opposed to drafting his budget.

“I’m somewhat surprised he would veto those things because the more oversight you have in government, the better taxpayer interests are going to be served,” said Lambert, vice chairman of the House Appropriations Committee.

“The governor is not too keen on legislative oversight,” said Sen. Lydia Jackson (D-Shreveport), who said she has long been a proponent of the idea that the Legislature should exercise more independence in budgeting. She is vice chairperson of the Senate Finance Committee. “Maybe these vetoes will be the kick in the pants for us to exert ourselves a little more,” she said.

Not only did SB-207 receive unanimous support in both the Senate and House, it also was endorsed by the Louisiana Hospital Association, the Louisiana State Medical society, and the New Orleans Metropolitan Hospital Council.

Jindal, in his veto message, said Mount’s bill “terminates Louisiana’s Medicaid reform initiative, Coordinated Care Networks, as well as the Community Care Program on Dec. 31, 2014.

“Coordinated Care Networks will provide a medical home for 800,000 Medicaid recipients, providing better access to primary and preventative care, improved health outcomes, with an anticipated savings of $24 million in the upcoming fiscal year and $135.9 million in state fiscal year 2013.

“Inserting a termination date for this important reform and preventing Louisiana from improving the performance of outcomes in our current Medicaid system sends the wrong message, that we are incapable of providing better care to our people, and we can do no better than our ranking of 49th in the nation for health outcomes. I am not content with the outcomes of our current Medicaid program and am committed to reforming our Louisiana health care system.”

Now that’s making a case for being more equal than others.