BATON ROUGE, La. (AP) — Gov. Bobby Jindal’s hallmark proposal to revamp Louisiana’s Medicaid program passed its first legislative test Thursday, with a procedural vote in a joint meeting of the House and Senate health care committees.Lawmakers on the committees, without objection, agreed to let the Jindal administration begin formal negotiations with federal officials on allowing Louisiana to restructure its Medicaid program, which is funded with state and federal money.A second state legislative panel, the joint budget committee, also must agree before an application is filed with the federal government. That committee is scheduled to vote on the matter Friday.But while the health care committees agreed to move forward with negotiations, lawmakers insisted the vote shouldn’t be perceived as blanket approval of the Jindal plan. Instead, legislators said they thought the details of the Medicaid redesign needed more thorough debate.”Ultimately, we would have the final word,” said Sen. Sherri Cheek, R-Keithville.Jindal wants to provide Medicaid health care services through managed care networks run by private and competing companies, instead of the current system of paying doctors and hospitals directly for care. The proposal would begin as a pilot program in certain areas of the state, steering about 380,000 low-income residents in Medicaid, mostly children, into the networks.Trying to ease legislators’ worries, Rep. Kay Katz, chairwoman of the House Health and Welfare Committee, said lawmakers still will have to approve the Medicaid budget and legislation to enact specific parts of the restructuring plan before it could begin.”If there’s any portion of it we don’t like, we don’t have to fund it,” said Katz, R-Monroe.Supporters said the plan, called Louisiana Health First, would better coordinate care for Medicaid recipients, catch chronic diseases earlier and help rein in rising costs.Jindal said the state spends too much money for the poor health outcomes of its residents.”Anyone who looks at the current system and is satisfied is not looking hard enough,” said Jindal, who spoke to the committees at the start of the hearing. He didn’t stay for the hearing.Critics said the administrative costs would eat into dollars that should be used for patient services and the plan would leave Medicaid recipients vulnerable to for-profit companies that could limit their benefits and restrict care.”At best the proposed reforms will not solve the problems, and at worst, they may make the problems worse,” said Steve Kauffman of the Advocacy Center, which provides legal services to people with disabilities and to senior citizens.The health care committees voted to move forward with a revamp by asking federal officials to waive some restrictions governing Louisiana’s Medicaid program.Department of Health and Hospitals Secretary Alan Levine, said the vote on the so-called “waiver” application wouldn’t lock lawmakers into the Jindal proposal, but would let Louisiana negotiate with federal health care regulators about changing its Medicaid program.”You will continue to have the opportunity to weigh in on the specific details,” Jindal said.Representatives of the Louisiana chapter of the American Academy of Pediatrics, an outspoken opponent of Louisiana Health First, disagreed. Steven Spedale, chairman of the chapter’s Medicaid policy committee, said a vote for the waiver would equate to support for the managed care proposal.”Make no mistake. To vote today and tomorrow on putting children into managed care organizations is the step. Once you go down that road, you can’t come back unless you abandon the program,” Spedale said.A quarter of Louisiana’s residents, about 1.1 million people, are Medicaid recipients, and the costs of the program are projected to double within 10 years.Under the Jindal plan, Medicaid recipients would choose a “coordinated care network,” that would lock patients into receiving care from a specific group of health care providers, like clinics, hospitals and doctors’ offices that would manage and track care.The networks would be run by private management companies, like insurers, that would contract with the state and negotiate payment prices with health providers. The managed care plans could vary the benefit packages and care received by Medicaid recipients.The networks, which Levine said he hoped would begin operating by the end of 2010, would begin as pilot programs in the New Orleans, Baton Rouge, Lake Charles and Shreveport areas, with about 380,000 participants — an estimated 278,000 of them children.Other features of Louisiana Health First include:—Expanding Medicaid eligibility statewide for about 60,000 low-income parents or caretakers whose children already are covered under the program.—Shifting up to $15 million that currently flows to the LSU hospital in New Orleans to expand the care provided to the uninsured at outpatient clinics in the region.—Starting a pilot program in the Lake Charles area that would steer money from Moss Regional Medical Center to offer insurance coverage to uninsured residents. Moss, a charity hospital run by LSU, would stop offering inpatient care and become an outpatient clinic.