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“Pretty Heartless” – Public Testimony on Budget

“Louisiana is going backward.” – Jeanne Abadie, Advocacy Center of Louisiana

Public testimony days are never easy, but this session’s Senate Finance committee hearing on HB 1 was particularly torturous, as Louisiana’s lawmakers annually transform citizens into beggars.

This time, instead of merely asking for funding for more waivers, the yellow-shirted disabilities advocates were literally pleading for their lives.

“What am I going to do? Who will help me survive?” asked wheelchair-bound Travis Stafford from St. Tammany Parish.

“I have a spinal cord injury,” said Jamie Duplechine of Lafayette, who is also in a wheelchair. “If you pass this budget as is, I would lose my job, my home, and my life.”

The budget, as it came over from the House, cuts $538-million state dollars from the Department of Health, which – when coupled with the federal matching funds – results in an overall reduction of $1.8-billion in health care funding. Overall, an estimated 45,000 residents – disabled children, adults, and the elderly – will lose services.

Pediatric Day Care, for children with disabilities and chronic medical needs, is being eliminated completely.

“My daughter Avery has a rare form of epilepsy,” Abby Benjamin of Monroe told the committee. “Right now, she gets nursing care, occupational, physical and speech therapy, each day while my husband and I both work. This budget completely eliminates the Pediatric Day Care program, which helps my daughter and 795 other fragile children in this state.”

Sen. Regina Barrow (D-Baton Rouge), tears running down her face in empathy with those crying as they voiced their fears, said, “I want to apologize that you have to go through this again.”

In addition to eliminating Pediatric Daycare, the Louisiana Department of Health plans to cope with the funding reductions by capping income eligibility for many waiver services at the bare minimum allowed under federal law: $750 per month.

The administration announced it’s preparing to send out notices to 37,000 current Medicaid recipients on Thursday, advising them the eligibility process is changing, severely reducing the amount of income they are allowed to receive to retain their Medicaid benefits. Among those being notified are those in group homes, as well as approximately 17,000 nursing home residents.

The argument from Republican House members had been “Nursing home residents won’t be put out on the street. That’s an exaggeration. There’s an appeals process, and residents will get to stay where they are during their appeals. By then, we’ll have ‘found’ more money.”

Sen. Barrow asked Mark Berger with the Nursing Home Association, “What happens if – God forbid – we don’t fund the Long Term Care program?”

“We are required to provide a ‘safe and orderly discharge’,” Berger said. “But there is no other place for them to go. So if we can’t safely discharge them, legally our only option is to close down our businesses.”

“How many people does Louisiana’s nursing home industry employ?” asked Sen. Greg Tarver (D-Shreveport).

“Twenty-six thousand,” Berger replied.

“This sounds like mass chaos,” Sen. Barrow remarked. “This is unconscionable!”

“It makes us look pretty heartless,” Senate Finance chairman Eric LaFleur said.

Indeed.

“The people you’re hearing from are being forced to imagine how their lives will be harmed on July 1,” Jeannie Donovan, health policy analyst with the Louisiana Budget Project said.

“Other states have similar budget issues. Are we the only one taking these extreme measures?” Sen. Barrow asked Donovan.

“Louisiana is not unique in having fiscal stresses, but when the chickens come home to roost, other states have reversed course and changed their tax structure,” Donovan said. “I don’t think any state has cut health care services as deeply as what is currently proposed in HB 1. This budget cannot be fixed without restoring or replacing some of the revenue that expires July 1, therefore I urge you not to pass a budget, but wait until you have another chance to replace expiring revenue.”

But since that has not yet happened, Louisiana health officials must proceed as if it won’t, and let the federal Centers for Medicaid Services know what could be coming. LDH Undersecretary Jeff Reynolds testified later in the day, “We have already started talking to CMS about the impending cuts to Medicaid programs. The feds are sort of aghast that this is what we are considering.”

Republicans on the Finance Committee, conveniently ignoring the fact that their party peers in the House perpetrated this scheme, criticized LDH for instilling fear in nursing home residents by sending out the required notifications.

“I don’t see how in good conscience you can do that to these older folks,” Sen. Bodi White (R- Baton Rouge) said.

“The program reductions require mass mailings to comply with federal law,” Reynolds replied. “It is not to scare anybody.”

Sen. Sharon Hewitt, who was outed by this publication last week for posting a deceptively edited video from another committee hearing, doubled-down on her conviction that rampant Medicaid fraud is what’s causing the fiscal problems, rather than the loss of “temporary” tax revenues.

“I am very concerned about the letters you are sending out,” Hewitt told Reynolds. “Your time would be better spent making sure people applying for Medicaid are not doing so fraudulently, and saving money there, rather than kicking grandma and grandpa out of the nursing home.”

Yet for folks like Jamie Duplechine, still unable to ascend the Capitol steps, it’s not about holding to some ideologized concept of somehow finding savings. It’s about not losing her life.

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