Any program driven by politics instead of policy is doomed to fail, and Gov. John Bel Edwards’ management of the Medicaid system is failing Louisiana.
He’s failing the taxpayers, on the hook for untold millions in waste, fraud, and abuse. He’s certainly failing the 600-plus workers who stand to lose their jobs. He’s failing the voters, who have a right to expect transparency and trust instead of allegations of corruption and cronyism. And, too often left out of this discussion, he’s failing Medicaid recipients, who deserve to be treated with compassion and competence instead of as pawns in a political game.
The Advocate’s Mark Ballard wrote in a recent column that the controversy engulfing Louisiana’s Medicaid managed care organization (MCO) contracts could “prove to be the Achilles heel in the re-election bid of Democratic Gov. John Bel Edwards.” The Associated Press’ Melinda Deslatte writes that the issue is “becoming an unwanted election-year complication that could mess up his story line.”
“Mess” is certainly the word for it.
The current scandal has exposed this administration to deep embarrassment at best and allegations of corruption and political payback at worst. Based on the filings from Aetna and Louisiana Healthcare Connection, Edwards administration officials alternately fell asleep during presentations, emailed gleeful smiling emojis about an adverse ruling against one company, and improperly destroyed public records.
Sadly for our state, this is simply the latest shoe to drop in more than three years of Medicaid mismanagement that has been marked at every turn by a governor who puts political expediency ahead of good policy.
It began with Governor Edwards’ executive order expanding Medicaid in Louisiana, signed the day after he took office. Regardless of your position on Medicaid expansion, we can all agree that implementing such a massive program merits careful planning and preparation. How could that level of planning be done barely 48 hours into a new administration? Spoiler alert: it wasn’t.
Last year, the Legislative Auditor’s Office released a report finding that Louisiana taxpayers had spent as much as $85 million in less than two years on individuals newly enrolled in Medicaid who were not eligible for coverage. The audit found that the state lacked “a sufficient process to determine recipient eligibility,” and therefore could not “ensure that Medicaid dollars are spent appropriately.”
Under fire, Governor Edwards reverted to his favorite campaign tactic – blaming Bobby Jindal. Referring to flaws in the state’s computer system, Health Secretary Rebekah Gee “said the Jindal administration scrapped earlier plans to upgrade the system.” Understand, this is referring to a system that was never built to handle Medicaid expansion.
In her efforts to tout the revamped technology, Gee revealed that Edwards had known about the problems all along, stating: "We needed this system. This was something we knew was an issue at the very beginning of this administration.” This erases any doubt that the governor chose to expand Medicaid, knowing the state wasn’t ready, rather than risk keeping his Democratic voting base waiting.
Since eligibility checks were put into place, more than 50,000 enrollees have been disqualified from the program. An analysis showed that 1,600 individuals making more than $100,000 in annual income had been enrolled. The total cost of these errors is difficult to calculate but almost certainly runs higher than the $85 million estimated in the audit. And here's another spoiler alert: The Department of Health has temporarily stopped kicking people off the Medicaid rolls if they don't respond to requests for annual renewal information because the department couldn't handle the heightened volume of calls and information. Seriously?
Now, tens of thousands of erroneous enrollments and tens of millions of dollars wasted later, we have an enrollment system still riddled with glitches and deeply troubling allegations of political gamesmanship with government contracts. What a mess.
Congressman Cedric Richmond, usually an ally of the governor, said the state’s technology problems would make it impossible to shift Medicaid enrollees to new MCOs without "at least some of these patients falling through the cracks for a time." Isn’t that exactly what the governor promised Medicaid expansion would prevent?