Gov. Jindal confirms Louisiana won't do health insurance exchange ...

Gov. Bobby Jindal confirmed to the Huffington Post that Louisiana will not implement its own health insurance exchange, the new marketplaces for purchasing coverage that are supposed to be created within a year. The article, posted Wednesday morning, said that Louisiana officials will send the rejection letter on Friday, the due date for states to inform the federal government of their intentions.

Louisiana Health and Hospitals Secretary Bruce Greenstein said in March 2011 that the state would opt out of setting up an exchange, a position that Jindal reiterated before the recent presidential election.

But when asked if the state might reconsider its position after the re-election of President Barack Obama last week, the Jindal administration didn't respond to a request for comment.

Obama's re-election means that the federal government will be moving forward with the health law passed in 2010. The Huffington Post article noted that Florida's Republican governor, Rick Scott, on Tuesday seemed to be reconsidering his objection to establishing an insurance exchange, saying the election outcome figured in his thinking.

The decision to reject a state-operated exchange means the U.S. Department of Health and Human Services will set up the marketplace for Louisiana consumers. This is expected to happen in many states, although the exact number of states won't be known until Friday.

In his phone interview with Huffington Post, Jindal didn't elaborate much on his objection to the exchange concept. "It doesn't make sense for us to do that," he is quoted as saying. Jindal is currently in Las Vegas, where he will become the head of the Republican Governors Association this week at the group's annual conference.

In a March 2011 interview, Greenstein offered more specific objections, saying he was concerned that any premium increases would be blamed on state regulators or the Jindal administration. Greenstein also said the state hadn't received much guidance from the federal government on the rules for the program.

On Wednesday, Greenstein said the Jindal administration is working on a letter outlining their objections to the exchange, saying it would be sent to the feds later this week.

The idea behind these exchanges is to give people a consumer-friendly place to compare and purchase insurance plans. Hundreds of thousands of Louisiana residents are expected to be eligible for subsidies to help them buy health insurance under the federal health law. At the exchanges, consumers would, in theory, be assisted in picking coverage and figuring out what kind of financial assistance they can receive.

Proponents hope the exchanges will foster competition in the insurance markets, which in many states, including Louisiana, are dominated by a small number of insurers.

In the Huffington Post article, Jindal also challenged the Obama administration to give states greater flexibility in running the Medicaid program that provides coverage to the poor, as well as disabled people and many nursing home residents.

Jindal said the federal health agency should give states waivers to rework their Medicaid programs, such as embracing the concept of "premium support." That idea usually involves giving program recipients vouchers to buy insurance on their own instead of signing up for a state-based program. Jindal said it would make the Medicaid program "a lot more flexible, market-based and efficient."

Jindal has rejected the Medicaid expansion that is part of Obama's health bill. The expansion would provide Medicaid coverage to as many as 400,000 people in Louisiana starting in 2014.

In an interview on Wednesday, Greenstein said the Jindal administration hasn't changed their position on expansion. But with the election completed, he is interested in talking with federal health officials about changing the Medicaid program.

"We would definitely be interested in having a discussion about what a modernized, flexible, state-centric Medicaid program would look like," Greenstein said, later noting that the time frame for expansion is still more than a year away.

Source: http://www.nola.com/health/index.ssf/2012/11/gov_jindal_confirms_louisiana.html

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