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Friday, May 24, 2013

Editorials

Posted 10:09 pm  Thursday, January 31, 2013


Jindal’s approach more reasonable
Gov. Rick Perry has pledged not to cooperate with the Affordable Care Act (Obamacare), and promised not to expand Medicaid in accordance with it.

That’s a pretty bold stance; Obamacare is now the law of the land. A U.S. Supreme Court ruling and Mitt Romney’s loss in November cemented it.

That’s why Louisiana Gov. Bobby Jindal’s very different response is so intriguing. He’s calling on President Barack Obama to meet with Republican governors to talk about it.

Here’s what Gov. Perry said in his “State of the State” address on Tuesday: “We have made it clear Texas will not expand Medicaid under the ACA … We won’t set up a state exchange … Texas will not drive millions more into an unsustainable system, and that stance has not changed an iota.”

Now, here’s what Gov. Jindal wrote in the Washington Post, on Monday: “A number of Republican governors have asked to meet with President Obama to discuss their solutions, but the White House has ignored these requests. The president claims that he wants to work across party lines to get things done for the American people, so perhaps he could start by meeting with Republican governors who want to solve our nation’s health-care problems.”

Jindal makes his case clearly, and convincingly.

“As the implementation of Obamacare unfortunately nears, every governor must decide whether to expand Medicaid,” he wrote. “This is not a simple question. Expanding Medicaid will significantly burden state budgets across the country. Our state’s analyses, and reports by organizations that have supported Obamacare, such as the Kaiser Family Foundation and the Urban Institute, estimate that such an expansion would cost Louisiana more than a billion dollars over the first 10 years.”

As he explained, Medicaid isn’t the cure, it’s the underlying syndrome.

“Medicaid operates under a 1960s model of medicine, with inflexible, one-size-fits-all benefits and little consumer engagement and responsibility,” he wrote. “Expanding the entitlement program as it stands would further cement a separate and unequal tier of health coverage. Without fundamental reform, Medicaid will continue to deliver what it has for decades: limited access, poor quality and budget deficits.”

Jindal doesn’t merely offer resistance; he offers responsible solutions.

“First, the process to determine eligibility should be simple, accurate and fair,” he wrote. “There are far too many complicated categories of Medicaid eligibility. The process should be easier for consumers to navigate and for states to administer… States should be allowed to design their programs to promote value and individual ownership in health-care decisions. This includes using consumer-directed products, flexible benefit design, and reasonable and enforceable cost-sharing requirements.”

Jindal’s overall focus is flexibility — and that’s exactly what Gov. Perry wants, as well.

“Instead of rushing to expand Medicaid as-is, the president … should first engage in earnest discussions with state leaders,” Jindal wrote. “Many of us are eager to reform existing programs rather than spend more money on a rigid and expensive program that won’t work for states, beneficiaries or taxpayers. So, let’s meet, Mr. President.”

It will be interesting to see whether Jindal’s approach works any better than Perry’s.



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