Louisiana’s six major candidates for governor agree that health care needs to be a priority

Louisiana’s six major candidates for governor agree that mental health services and preventative health care need to be priorities for whoever takes the office next year.The lion’s share of Louisiana’s annual state operating budget goes to health care. The Medicaid budget alone was close to $18 billion in the last budget cycle and provided health insurance to 2 million residents, including more than half of the state’s children and a third of its adults.

“It’s the only area of government where we spend billions,” Treasurer John Schroder, one of the Republican candidates running for governor, said of health care.Gov. John Bel Edwards’ decision to expand Medicaid in 2016 was one of the earliest and most consequential of his administration. It added almost 500,000 more people to the government-backed health insurance program prior to COVID-19 and helped Louisiana’s overall uninsured rate drop precipitously.None of the candidates running for governor has said they intend to roll back Medicaid expansion, a $5 billion program in the last fiscal cycle. Even Attorney General Jeff Landry — who once sued the federal government to get rid of Medicaid expansion — has assured the state’s health care industry he won’t scuttle it.“As governor, we will ensure the much-needed healthcare services for our State’s most vulnerable are not jeopardized,” Landry said in a written statement to the Illuminator.

Five of the six major gubernatorial candidates agreed to interviews about their health care priorities last month. Landry answered questions submitted to his campaign via email.

Medicaid changes

A repeal of Medicaid expansion may not be on the table, but candidates had some suggestions of how to change the program.

Schroder said the state needs to make Medicaid more efficient and focus on combating fraud in the program. State Sen. Sharon Hewitt, R-Slidell, wants Louisiana to improve forecasting of the state’s Medicaid population so the state has better financial projections of its spending.

Shawn Wilson, Edwards’ former transportation administrator and the only Democrat in the race, said the state needs to train more nurses and other medical professionals to ensure there are enough providers to treat people with Medicaid insurance. Attorney Hunter Lundy, who is running as a political independent, said the state needs to increase reimbursement rates for health care providers who treat Medicaid clients to encourage more professionals to accept patients with Medicaid coverage.

When it comes to the ongoing Medicaid disenrollment, none of the candidates expressed an interest in making adjustments to that process, which involves checking the status of all of the state’s Medicaid enrollees to make sure they still qualify for the program.State lawmakers initially wanted to speed up the process from a 14-month timeline to nine months, but the Edwards administration pushed back. Disenrollment, which will result in tens of thousands of people losing Medicaid coverage, is currently on track to wrap up in April.“The unwinding program will be nearly completed by the time we take office,” Landry wrote. “I will be focused on our people moving forward, not armchair quarterbacking what has happened so far.”

Landry, the frontrunner in the governor’s race, did not answer a question this about whether he might pursue work requirements for Medicaid enrollees, a controversial measure Republicans in Congress are pushing.

Only one state, Georgia, currently requires people receiving Medicaid to have a job, take classes or volunteer when accessing those government benefits. Even in that state, the work requirements are only imposed on new Medicaid enrollees, not those already in the program.

The Medicaid work provision is also costing Georgia taxpayers more money to implement than a traditional Medicaid program would.

More mental health, preventative careEvery candidate said the state needs to expand mental health services in Louisiana.“We need to put considerably more funding toward addressing the mental health crisis,” Hewitt said. “People who don’t get the services they need end up in a hospital or jail right now.”Former business lobbyist Stephen Waguespack, a Republican candidate, said K-12 school districts that provide mental health counseling should be rewarded with a funding boost.

Waguespack also said the Medicaid program should also use more “carrots and sticks” to incentivize people to participate in preventative health care programs. For example, women need to be encouraged to attend doctor’s appointments early in their pregnancies so complications can be diagnosed and treated as soon as possible.

Hewitt said the state also needs to be more aggressive with outreach to Medicaid enrollees about preventative health services, which are often available at no cost.“Many people who are on Medicaid don’t know that they are on Medicaid,” she said. “We are already paying for those services that they aren’t using.”Landry also said he would make preventative services a priority.“It is 2023 and Louisiana’s maternal mortality rate is roughly double the rest of the country. That is unacceptable,” he wrote. “An ounce of prevention is worth a pound of cure. People on Medicaid deserve preventative services, not just treatment of disease.”More optionsWaguespack, who has a child on the autism spectrum, said he would also focus on expanding services and opportunities for adults with disabilities if elected governor.The Louisiana Workforce Commission should develop a database of jobs opportunities that would potentially be a good fit for people with disabilities, he said.More safe housing needs to be developed for adults with disabilities, Waguespack added. Those types of developments could be incentivized by the state through tax credits and other benefits.

Lundy also said he wants to attract more private health insurance companies to Louisiana. Three or four more major providers would make the state’s health insurance market more competitive and should lower rates for businesses and consumers, he said

— The Louisiana Illuminator is an independent, nonprofit, nonpartisan news organization driven by its mission to cast light on how decisions are made in Baton Rouge and how they affect the lives of everyday Louisianians, particularly those who are poor or otherwise marginalized. 

This article originally appeared on Shreveport Times: Louisiana’s six major candidates for governor agree that health care needs to be a priority