Here’s why.  Over the past few days, Senator Mary Landrieu has been getting “reamed” for her vote this past Saturday.  There have been hundreds of articles and columns suggesting a “Louisiana purchase” in a “deal” between Harry Reid and Senator Landrieu for the specific benefit of Louisiana involving Medicaid costs to Louisiana. 

Thus, I have had a number of questions since the Saturday vote.

I did not fully understand why Senator Landrieu voted to continue the debate on the healthcare legislation.  Nor, did I know what involvement, if any did other Louisiana members of Congress or the Bobby Jindal administration have regarding the Medicaid money that Louisiana would not be forced to pay as part of a federal match.  That legislation has become a very well-discussed issue related to the Senate legislation.

In my efforts to get to the bottom of these questions, I contacted Senator Landrieu’s office this morning and then Governor Bobby Jindal’s Secretary of Health and Hospitals, Alan Levine around noon today.   This morning, Senator Landrieu’s office did not have the information requested since most of the office is on Thanksgiving vacation. 

While the picture of this past controversial week is becoming more clear, I admit there are some unanswered questions and some conflicts.

More than the “who did what story”, it is important to note Louisiana has a major problem that Secretary Alan Levine, the Jindal Administration and Senator Landrieu is attempting to explain to the nation and it just so happens that the issue has become intertwined with that of the very hot and controversial health care legislation.    

In my early afternoon conversation with Secretary Alan Levine, I was told the following: 

The Jindal Administration had submitted language that it wanted the federal government to pass.  It did not directly request or know that the legislation that it was submitting to Senator Landrieu, Congressman Cao (and perhaps others) was going to a part of the health care legislation.

Late Wednesday night, Alan Levine and top Administration officials discussed the legislation they had discovered was included in the Senate bill that could benefit Louisiana.  However, they did not know the exact language or how much Louisiana would benefit from the Senate Health Care legislation. 

Over the next two days, they had communications with the Landrieu office over whether the amount was 100 million or 300 million dollars.

Levine said the Jindal administration has been against the health care legislation and still is against the legislation.   Levine believes that if the current version of the legislation is passed, insurance premiums will go up and the costs of the program will likely be more than is anticipated.  He also said that the Congressional Budget Office scoring of the amount that Louisiana would benefit  for the controversial Medicaid Fmap program was confusing and that alone scares him in terms of the health care legislation’s accuracy.  For instance, based upon the CBO’s numbers, the Jindal administration after discovering the existence of the legislation late last week did not know whether the benefit to Louisiana would be 100 million or 300 million dollars . 

Levine said the ultimate language was submitted by Jindal administration to be federal legislation was different from that which was in the final Senate Health Care legislation.  The Secretary said that the amount the administration wanted in general as part of the legislation was more than what was in the Senate legislation but he could understand the problem that Landrieu might have been having with the Senate Finance Committee and that she might have received a compromise. 

Levine said that he applauds Senator Landrieu for standing up for Louisiana but still believes she made the wrong vote.

Levine acknowledged that quite often government agencies will submit or attempt to attach parts of legislation to bills that appear that they might pass and said that apparently that is what Senator Landrieu tried to do, by attaching language that could help Louisiana for its Medicaid problem within the Senate Health Care bill.

Levine also said that Louisiana is getting unfairly attacked.  Louisiana would be only receiving a 300 million dollar benefit while some other states are benefitting much more from the legislation in terms of the Medicaid match reductions and other programs, including Nevada, the home of Democrat, Harry Reid.

Levine emphasized the way things are going, the Medicaid system could be “unsustainable”.  One problem is that the states such as Louisiana might have problems with its state match.  For instance, Louisiana is being forced to pay more of its share in Medicaid costs since its revenues have spiked during the post-Katrina days.   Levine also said the Medicaid Fmap problem (which Landrieu tried to address) could cost Louisiana up to 2.5 billion dollars over the next five years.  On top of that, Levine said that once the stimulus stops in January 1, 2011, Louisiana will not be receiving 400 million dollars per year for Medicaid funding and approximately 600 million dollars over five years from another program called DSH. 

Thus, it appears that Louisiana is looking at an approximate 3.5 billion dollar shortfall over the next five years in Medicaid.

What is apparent from my conversation with Secretary Levine is this:  Louisiana has a major Medicaid funding problem over the next five years which might include its ability to fund its share of the program. 

Despite Glenn Beck referring to  Senator Landrieu as a "high-class prostitute." "She may be easy, but she ain't cheap," and Rush Limbaugh later echoing Beck's calling Landrieu "the most expensive prostitute in the history of prostitutes.", the practice of institutions including states, their representatives and legislators attempting to ride legislation onto apparently winning bills is widespread and common. 

Secretary Levine and the Jindal Administration have tried to address a major unfair shortfall it is going to have with Medicaid in various pieces of legislation.  Levine said that the Jindal administratin opposed and opposes the Health care legislation and created their own language that would be multi-state in nature and not just for Louisiana and that they did not know the legislation would be in the Senate Health Care bill nor did they know it would only cover Louisiana. 

However, they did know about the existence of the Louisiana Medicaid legislation in the health care bill on the Wednesday prior to the vote.  They also attempted to ascertain the exact language of the legislation and the amount of reduced obligation that Louisiana would benefit.  It appears that once Louisiana received this information at the very minimum, the state did not  stop Senator Landrieu in trying to obtain that money.  It is uncertain if the state could have done anything anyway since the language was part of the Medicaid bill.  Also, according to Secretary Levine, the Jindal administration did not know how Landrieu would be voting despite the Medicaid language benefiting Louisiana. 

Levine believes the legislation is bad for the country and would be bad for Louisiana.  He said he certainly cannot tell Senator Landrieu how to vote but he realizes that she has stated she has real problems with the public option, has  spoken in favor of tax credits for small business and has problems with the Senate legislation that is now up for debate after Saturday’s vote. 

Right before publishing this column and approximately one hour after I discussed this issue with Secretary Levine, I received the following from the Communications Director for Senator Landrieu, “I can confirm that the State did draft and submit language to be inserted into the Senate health care bill. It is our understanding that they were working with Rep. Scalise to insert language they drafted into the House bill.

Obviously, there are inconsistencies between the statements made to me by Senator Landrieu’s office and that by Louisiana Secretary Alan Levine.  For the record, at the time I am puzzled by those discrepancies regarding just what language did the State draft (if any) and submit to the State “to be inserted into the Senate health care bill”.  I hope this discrepancy is resolved.  Without knowing more, I feel there are inconsistencies but would not question the veracity of the Communications Director, Aaron Saunders or Secretary Alan Levine since we need many more facts and documents.  

Nonetheless, to the extent that the Jindal administration (and others) might have helped solve a very difficult and unfair Medicaid problem, and if they did draft language specifically for the Senate Health Care bill (even if they opposed it), I hope that they provide more information to us so we can get the full story.  I likewise hope that the Landrieu Administration is able to do the same.

Again, I strongly believe that submitting legislation on a bill you oppose is no crime, nor is it unethical.  It is done all of the time.  It is in essence saying, I hope this legislation fails, but, should it pass, this is what I want in it.

Also, when outside critics (and even critics within Louisiana) blame a Louisiana Senator for trying to fix a major problem for the state and has made it very clear on the record that she is not necessarily voting for the legislation or for the fix but just wants the debate to continue, yet, she is being called words such as “prostitute”, it is time for those critics to get schooled very quickly that before they start launching verbal assaults, they should realize that the practice of creating legislation to benefit a state and then at the same time supporting or not supporting legislation or procedural legislation (such as what occurred Saturday) is systemic, it cuts across state, parish and county lines and political parties.  

If we want to change this practice, we should stop it across the board.  We should also speak out despite the political risks when one of our Congress persons do the work of the local officials--whether the local government knew about it in advanced, knew about it before the vote or even helped the Congressperson with the specific language even if it disagreed with the main bill. 

Last, “Houston, Louisiana has a major Medicaid problem”.  We must work together to fix this issue.  It is going to engulf of upcoming state budgets.  For those who submit that one Louisiana US Senator has sold her vote in the  new “Louisiana purchase”,  just ask Alan Levine how serious this problem is and will be in the future.  Regardless of where anyone of us stands on the issue of health  care reform,  the Medicaid system needs to be addressed immediately.  Alan Levine is crying out and saying that the system might not be sustainable.  That might be the most important news and the largest Thanksgiving turkey of all.

Also, before national spokespersons speak out and slander an elected official, they should try to get all the facts and they should realize that the people they extol sometimes and even often engage in the same practices they are so quick to criticize.