Jindal’s administration has received approval to negotiate with federal officials to restructure health care for the poor and uninsured in four regions of the state, including Baton Rouge .  Which means, the administration can get federal permission to go outside rules governing Medicaid, the government’s insurance programme that cares for approximately 1.1 million Louisiana residents today

With only House Speaker Pro-tem Karen Peterson, D-New Orleans objecting as the Joint Legislative Committee on the Budget voted to advance the plan, Gov. Bobby Jindal can initiate his insurance-based managed-care system in the Baton Rouge , Lake Charles , New Orleans and Shreveport regions, whereby premiums would be paid for coverage.

Wanting to abandon the current system which pays fees to physicians, hospitals and other health-care providers for services provided, Jindal says the system is far too expensive, without improving people’s health.

However, some lawmakers are uncomfortable with Jindal’s administration getting a federal waiver for Medicaid rules, giving the state greater flexibility to redesign its’ Medicaid program, heavily dependent on federal funding.  Seeking assurances from the Department of Health and Hospitals Secretary Alan Levine, they reiterated that they were not convinced Jindal’s proposed re-design was the best version.

However, those supporting his plan stress the plan would better co-ordinate care for Medicaid recipients, improve health outcomes by catching and treating chronic diseases earlier, including reining in rising costs resulting from Medicaid fraud and overuse of expensive emergency room care.  The savings, Levine says would help expand Medicaid eligibility statewide, providing health coverage to more Louisiana residents.

The Louisiana chapter of the American Academy of Pediatrics, the most outspoken critics of Jindal’s plan say, child patients representing three-quarters of the Medicaid recipients, would be the most affected by the redesign.  They, including Speaker Tucker, prefer modelling Louisiana ’s health reform on North Carolina ’s Medicaid programme that excludes for-profit, managed care companies.