BATON ROUGE, La. (AP) — Lawmakers began whittling away at a deficit in the state’s Medicaid program Friday, filling more than two-thirds of the gap but leaving a $22 million hole that will have to be closed before the fiscal year ends.
The House and Senate joint budget committee agreed to $59 million in budget shuffling to help close the $81 million gap. The remaining shortfall must be filled before June 30, the end of the fiscal year.
Louisiana Health and Hospitals Secretary Alan Levine has proposed cuts to hospitals and hospice care, but lawmakers have resisted the idea because facilities on the chopping block warn that could harm patient care.
The committee on Friday delayed taking action for the third time on Levine’s recommended hospital and hospice reductions.
“Once again, you dodged a bullet,” Sen. Mike Michot, R-Lafayette and chairman of the joint budget committee, told the hospital leaders in the meeting room.
Levine warned the cuts needed to balance the Medicaid budget will grow deeper if lawmakers continue to delay voting because there will be fewer months in the year to spread out the reductions. He also said he’s asked for recommendations of other areas to cut but has received no suggestions from legislators.
“If you have other things you want us to reduce, tell us what to cut and we’ll incorporate that into the plan,” he told Sen. Francis Thompson, D-Delhi, who said he opposed any reductions to the rural hospitals.
“I wouldn’t cut the rural hospital fund. Are you clear on that?” Thompson said.
“I’m perfectly clear, and now I’ll take recommendations on what to cut instead,” Levine replied. Thompson didn’t offer a list.
To fill much of the gap, the committee agreed to shift $59 million from other parts of the health care budget that weren’t expected to be spent this year, but lawmakers wouldn’t approve $6 million in cuts to rural hospitals, $1 million in cuts to hospices and $15 million in reductions to private and community hospitals.
Levine proposed cutting the room and board rates Medicaid pays to hospice providers for patients they care for in nursing homes. The largest adjustment involves changing how Medicaid pays hospitals for inpatient admissions, to update 1995 criteria to present-day standards.
“You’re paying for services that are not medically necessary,” Levine said.
The hospitals and their legislative allies said the facilities are struggling with money problems, aren’t getting paid enough for the care they provide to Medicaid patients and are facing rising costs for caring for uninsured patients. Further cuts, they said, would exacerbate the problems and could harm patient care.
The Louisiana Hospital Association also questioned the data used to determine the Medicaid program had a shortfall.
The deficit is small compared with the massive $7 billion Medicaid program for the poor, elderly and disabled, but the state is constitutionally required to maintain a balanced budget.
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