Democratic Louisiana flag
Volume 1, Number 9
By Democrats For Democrats
May 5, 2010
Welcome to Democratic Louisiana!

Welcome to Democratic Louisiana!

Today's edition features an indepth look at how Governor Jindal's ideology and ambition have combined to deny him the flexibility he will need to manage the state's role in healthcare in Louisiana during a time of rapid change.

The Governor is more intent on fighting the changes resulting from passage of the Affordable Care Act than he is in figuring out how the state can harness the resources attached to that new law in a way that delivers the greatest benefit to the largest number of people in the state.

He now finds himself locked in a battle with providers and patients in his effort to continue cutting the state Medicaid program during a time when utilization of the program is growing. He's opposing elements of the ACA that will drive benefits to small business owners and middle class families. And, he appears committed to try to close large segments of the LSU Hospital System at a time when Louisiana is going to need more healthcare delivery capacity.

Oh, and his poll numbers are falling, despite the fact that no one has arisen to challenge him on eithe a political or policy level. Is Jindal fatigue setting in with voters? Is there a way for Democrats to take advantage of that?

If you've missed an earlier edition of Democratic Louisiana, we have an archive page. Here's the link.

Thanks for reading!

Mike Stagg, Editor

Democratic Louisiana

Democratic Strategist: Affordable Care Act info is proving a plus

Ruy Teixeira, co-editor of The Democratic Strategist, says new polling data shows that public perception of healthcare reform is improving as more information about the Affordable Care Act (ACA) becomes available.

Teixeira, writing at the Center for American Progress, says a new poll on ACA shows that public perception of the law is improving and that support for individual provisions of the law has broadened.

Tiexeira says that the poll findings present big problems for conservatives who oppose the ACA:

"This is where the conservatives’ big problem comes in. There are a wide variety of changes that will take effect this year as a result of the law. Kaiser tested favorability to 11 of these changes, including “allowing children to stay on their parents’ insurance plans until age 26” (74 percent favorable), “providing tax credits to businesses with fewer than 25 workers that provide health insurance to their employees” (86 percent favorable), and “making it harder for insurance companies to drop someone’s coverage when that person has a major health problem” (81 percent favorable). The average across the 11 changes was 73 percent favorable, with no change lower than 57 percent favorable."

The Affordable Care Act is good for working families, practically tailor-made for what ails healthcare in Louisiana, and will prove to be a winning issue for Democrats.

Playing Chicken with Healthcare

Bobby Jindal got elected governor in 2007 in no small measure because he was viewed as something of an expert on the subject of one of the biggest challenges facing the state — healthcare.

Almost two-and-a-half years into his tenure, Jindal’s Medicaid policies have succeeded in uniting healthcare providers and patients in opposition to his patented brand of continuing budget cuts in the face of growing program utilization. Now, one of those groups — the Louisiana Hospital Association — says Jindal’s Medicaid policies are jeopardizing the affordability of care for those fortunate enough to still have private healthcare insurance.

With Jindal locked into his ‘no taxes’ mindset and the state’s fiscal crisis anticipated to get a lot worse before it gets better, Louisiana healthcare is headed for a session of reckoning in 2011 that will determine the shape of the future of healthcare in Louisiana. It will also have a big impact on Jindal’s ability to win re-election that year.

With a deficit still to be filled in the current fiscal year and a projected deficit to be dealt with in the fiscal year that begins on July 1, Jindal has yet to produce anything resembling a plan that has widespread buy-in on how to navigate these short-term issues.

Couple that with his attempts to somehow keep Louisiana out of participating in the Affordable Care Act — despite the benefits the program would bring to individuals, businesses and state government — Jindal appears to have embarked on a high-stakes game of chicken over healthcare in Louisiana without articulating a vision about what it would look like and with no road map to get there — where ever “there” is.

Community Hospitals: ‘Jindal is Killing Us’

If the television ad and web videos from the Louisiana Hospital Association (LHA) look a bit desperate that’s because the associations members are.

The LHA says its members have been pushed to the brink by Medicaid cuts imposed by the Jindal administration.

“Since February 2009, Medicaid payments for many services provided by community hospitals have been reduced by approximately $140 million (or 15%). In the proposed Executive Budget for SFY 2010-2011, there are additional reductions of 3%,” the LHA says.

The organization notes that 27% of Louisiana residents are on Medicaid, which is just a few percentage points higher than the number of adults who are uninsured. The LHA says its members provide care for 70% of the Medicaid patients in the state, but that the bulk of the money goes to the LSU Hospital System in the form of Disproportionate Share Payments. That is because LSU’s hospitals treat a far larger share of the uninsured than do the LHA hospitals.

LHA’s videos try to tap into perceived public anger about government run healthcare to convince viewers to call Jindal and their legislators to win support for the LHA solution to this crisis — the creation of the Community Hospital Stabilization Fund. HB 1364 authored by Rep. Tom McVea, a Republican from St. Francisville, would create the fund.

According to The Advocate, the fund would receive federal dollars 11 service district hospitals receive to make up for their expenditures not covered by Medicaid or a program that covers care for the uninsured (the Disproportionate Share Program).

Click here to continue reading "Playing Chicken With Healthcare"

Jindal, Vitter abandon anti-fed rhetoric to demand larger U.S. role in BP 'Gulf Gusher'

Governor Bobby Jindal and U.S. Senator David Vitter proved conclusively this week that they hold no principle more derely than that of advancing their political careers.

The evidence cropped up repeatedly at various press conferences and statements the state's leading Republicans made regarding efforts to deal with the emerging impact of the BP's Gulf Gusher.

The Washington Post's Dana Milbank led his accounting of the conservative's 'role of government' whiplash by noting a post on Vitter's blog in which the earstwhile foe of federal involvment in energy and/or environmental policy cast his flip in terms of semi-compassion for BP:

Based on the latest briefings I have received and first hand view of the situation in the Gulf, I strongly believe BP is spread too thin in trying to both cap the well and remediate the damage along our coastline, producing an ineffective response. In my meetings with top Cabinet officials, I have urged all involved to allow BP to focus all of its efforts on building a dome and drilling a relief well at the source of the spill so that federal and state officials can focus on protecting and cleaning up the coast.

This might be a first for Vitter: identifying what he deems an appropriate federal role in environmental protection.

Jindal, though, put Vitter's flipping to shame. As a congressman, Jindal championed the legislation that opened the segment of the Gulf of Mexico that is now home to the BP Gulf Gusher.

Now, though, Jindal has made bashing BP a staple of his press briefings on the Gulf Gusher.

After more than a year of hypocritically bashing President Obama's stimulus spending while claiming credit for the strength of Louisiana's economy that benefited from years of federal disaster recovery spending, Jindal rushed to seek federal aid for fishermen impacted by the closing of fishing areas, as well as aid for parishes and businesses impacted by the gusher.

These are all legitimate steps and the right thing to do, but anyone expecting Jindal and his team to acknowledge their dependence on the federal government for this relief — as well as patching a number of the holes in Jindal's current and proposed budgets — would be advized not to bank on it.

Jindal, his health secretary and his insurance commissioner notified HHS last week that Louisiana will not take part in the high risk pools created to provide coverage to adults denied coverage under pre-existing conditions. The excuse being that the state might be on the hook for some money at some undefined point between now and 2014 when pre-exising condition exclusions are outlawed.

Instead, Jindal's refusal to participate means that the federal government will operate the new high risk pool in Louisiana. So, our supposedly small government governor is taking steps that will directly result in an expanded federal role in healthcare in Louisiana.

Irony is not dead, it's just taken up residency in the Governor's Mansion.
Signs of 'Jindal Fatigue' growing among voters

It should be the best of times for Bobby Jindal.

The Louisiana Democratic Party is still trying to recover from a rough patch. No opponents for his re-election bid have stepped forward. He has the main stream media eating acting as a virtual stenography pool reporting his every utterance as if it was handed down on stone tablets.

With all of that, Jindal's popularity is falling — this according to no less a source than state Republican's pet pollser, Southern Media & Opinion Research.

According to the poll, which was paid for by a Baton Rouge area businessman active in conservative politics in the state, about 61 percent gave Jindal a good or excellent job performance score, while his negative rating was 37 percent. The figures show a steady slip for Jindal during the past two years. He had a 77 percent approval rating in 2008, falling to 68 percent a year ago and 64 percent in October, according to Southern media polls.

With no organized opposition in sight, Jindal's falling numbers are attributable to his policies.

The Governor's national ambitions and the state's toughening fiscal conditions have combined to force hard choices on Jindal. Each time, given a choice between his ambitions and the interests of the people he was elected to serve, Jindal has followed the path that favors his ambitions.

As a result, the 'no tax increases' stance that keeps him in the good graces of national conservative litmus testers is bringing him into conflict with a growing number of Louisiana constituencies who depend on government services for some aspect of their lives.

The first crack in Jindal's armor was self-inflicted when, in 2008, he rolled over and signed a law that repealed the income tax portion of the Stelly Plan. That has had the effect of denying state government something on the order of $330 million per year. It is the hole that keeps on digging.

The national recession, coupled with decreases in levels of federal disaster recovery money flowing into the state have brought more pressure on state budgets and Jindal has refused to take any measures to increase revenues.

He teetered on the brink of igniting a rebellion among sectors of his electoral base last year when he threatened huge cuts in higher education spendin. Four of his predecessors intervened, talked him off the ledge, and higher ed escaped with half the cut Jindal had originally proposed and considered themselves lucky.

Healthcare has been another matter. Somehow Jindal is viewed as an expert in this field when, in fact, all he has ever shown any inclination to do is to cut Medicaid spending. The problem with this approach is that Medicaid spending actually goes to providers — doctors, clinics, and hospitals. Cuts in Medicaid reduce their income, in addition to reducing access to care by Medicaid patients as some providers withdraw from the program. (See top story for more details).

Couple that with Jindal's push to reduce the number of state workers covered by Civil Service (he has no problem hiring unclassified employees at big salaries), and Jindal is antagonizing three constituent bases in his effort to push down Medicaid spending during an era of rising participation in the program.

Jindal's problems are likely to get worse as there are powerful pockets of resistance to the slight of hand tricks he has proposed to balance the state's budget for this year and next. The Louisiana Association of Business and Industry (LABI) and the Louisiana Public Affairs Research Council (PAR) have come out in opposition to his proposal to raid various trust funds to help close the holes in current and future budgets. The Speaker of the House opposes Jindal's proposal to tap the state's Rainy Day Fund to close an anticipated hole in next year's budget.

Yesterday in a House Committee, one version of his administration's plea for budget flexibility was shot down. At one point the full House voted to call upon Congress to investigate Jindal's poor performance in response to the BP Gulf Gusher. It took a blatant disregard for House rules to get that pulled down.

And, Jindal continues to project hard opposition to implementation of the Affordable Care Act as it becomes increasingly clear that the new law will drive significant benefits to middle class families and small businesses, which also were part of Jindal's core constituency in 2007.

So, while Democrats are not prepared to capitalize on Jindal's weakness at this time, the Governor is doing such a fine job of getting in his own way, we should all just stand back and look on in amazement — And let the man keep working his magic!
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