Growth In Louisiana Health Department Spending Scrutinized
BATON ROUGE (AP) — Republican lawmakers on the House budget committee bristled Wednesday at years of spending increases in Louisiana's health department, saying the agency needs to find ways to trim costs amid the state's continued budget gaps.
Spending on the health department has steadily grown each year, reaching $12.2 billion, about 44 percent of Louisiana's entire state operating budget, with a sizable jump this year from the expansion of the state's Medicaid program.
The agency wants to boost its spending by another $2.4 billion in the 2017-18 budget, according to data provided to the House Appropriations Committee, which is combing through next year's spending requests.
"The numbers, they're just astonishing," said Rep. Rick Edmonds, R-Baton Rouge. "I don't know how in the world we can keep that kind of pace up."
Health Secretary Rebekah Gee pushed back against the criticism. She said her agency saved the state money this year — and will again next year — because Louisiana's Medicaid expansion allowed the state to tap into enhanced federal financing rates to cover services.
Gee said her proposal to bump up health department spending next year relies almost entirely on federal dollars, and will save the state about $41 million in general tax dollars that can be spent elsewhere.
"We're being good stewards because we're helping keep everything together," she said.
Of the $12 billion spent on the health department this year, $8 million is federal financing. Another slice is from agency fee collections and other dedicated dollars. About $2.8 million of the budget is paid with general state tax dollars.
Lawmakers on the committee worried about long-term costs when the federal government's share of the Medicaid expansion lessens, and they questioned if the health department was doing enough to cut unnecessary spending and fight fraud.
"No matter if we gave you a billion dollars or a billion-and-a-half dollars, it wouldn't be enough money," said Rep. John Schroder, R-Covington.
There was little discussion of the holes that could be created in Louisiana's budget if President-elect Donald Trump and GOP leaders in Congress are successful in repealing President Barack Obama's health overhaul — and taking with it the Medicaid expansion money.
More than 350,000 have enrolled in Louisiana's Medicaid expansion since the budget year began July 1, and the health department estimates that will grow to 417,000 by June 30.
"Medicaid expansion was a godsend for our budget," Gee said.
The Appropriations Committee is reviewing budget requests lodged with Gov. John Bel Edwards' administration as it builds its recommendations for next year's budget, to be presented to lawmakers Feb. 24. The proposal from Gee, an Edwards appointee, hasn't yet been vetted by the governor's financial analysts.
Requests for increased spending come as Louisiana grapples with budget shortfalls this year estimated to be as much as $600 million, and as the governor's chief budget adviser warned next year might be as grim.
The Department of Children and Family Services is asking for a 14 percent increase next year, about $99 million, largely to deal with child welfare cases.
"We are not serving children and families well," said Secretary Marketa Garner Walters.
The department has taken repeated cuts since 2009, slashing its budget in half. Walters said those cuts hampered agency response to child neglect and child abuse, doubling caseloads and chasing away employees.
– by AP Reporter Melinda Deslatte