Editor’s Note: A guest post by Lafayette CPA Steve Gardes, whose critique of Louisiana’s Medicaid program also appeared in another guest post last week here at The Hayride.
In response to State Representative Beryl Amedee’s request (“Time to ask some tough questions about La. Medicaid”, The Advocate, July 8th), I would like to ask our candidates for Governor to answer in the upcoming TV debates their positions on the following questions:
1) The Task Force on Structural Changes in Budget and Tax Policy made formal recommendations to the Governor and Legislature in 2016 to, in part, “establish a formal multi-year spending forecast for Medicaid.” Furthermore, The Centers for Medicare and Medicaid Services (CMS) has projected that Louisiana’s Medicaid costs will increase 184% by 2026, going from $3.3 billion last year to $6.1 billion. Today Louisiana is having a hard time paying the $3.3 billion, yet there has been no conversation about the state’s projected cost of Medicaid in the future. If elected Governor, will you implement formal multi-year Spending Forecast and present a Budget Plan to the state taxpayers and Legislature on how you propose to pay for the projected increases in Medicaid?
2) Our present Medicaid program is basically an open checkbook system paying benefits to all who show up and qualify, and then seeking reimbursement from the federal government for their “match” portion. If the Legislature determines that the state can no longer afford the existing program, would you as Governor promote efforts to convert our Medicaid program to a Block Grant funding from Washington in order to control our spending to what we can afford?
3) The Task Force on Coordination of Medicaid Fraud Detection and Prevention Initiative has proven to be invaluable in attacking fraud, waste and abuse in its two plus year existence, but lapsed in the last legislative session. If elected Governor, will you promote the re-establishment of this Task Force?
4) Shockingly, we have seen Medicaid Recipient Fraud bills die in Senate Committees controlled by Democrats in the last two years; why? Our Legislative Auditor has been prevented from having access to tax records to test eligibility, even though he has saved the state over $100 million per year using alternative audit procedures. Our Attorney General has been prevented from letting his fraud unit prosecute recipient fraud, even though recipient fraud is rampant. Democrat Senators say that these bills were unfair attacks on the poor – – yet common sense tells us these bills only attacked those fraudulently claiming to be poor. If elected Governor, will your Administration support these bills attacking Recipient fraud in the future?
Medicaid is causing significant fiscal problems for half the states in the country, including Louisiana. As Representative Amedee said, “it’s beyond time we get to the bottom of what’s really going on with Louisiana Medicaid.”
Steve Gardes, CPA