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On the Ballot: Tying Up Hospital Funding

Should Louisiana hospitals be guaranteed a set amount of state health care funding—if they put up part of the money themselves? That’s what Constitutional Amendment 2 on Tuesday’s ballot is asking voters to decide.

“Over the last 6 or 7 years, hospitals have been cut by 26 percent.”

Sean Prados, vice president of the Louisiana Hospital Association, is referring to the state’s reimbursement rates for uninsured and Medicaid patients. He says a “yes” vote on Constitutional Amendment 2 would stabilize those rates.

“This is a way to generate additional available funds for health care without raising taxes or passing along the cost of this to patients,” Prados says.

If approved by voters, hospitals in the state would self-impose new fees that Louisiana could then pool and use as the state match for drawing down more federal health care dollars. Approximately 40 other states have a similar program in place.

But former state Medicaid director Don Gregory says there’s a problem with that plan. The pool of matching funds available is shrinking.

“When Congress passed the Affordable Care Act, they envisioned more people would have health insurance and they envisioned there would be less need for money to pay for uninsured individuals in our country,” Gregory explains. “And so they directed the federal Department of Health and Human Services reduce the funding for that.”

Available federal funds will drop by $18-billion over the next five years. And while the available federal match amount dwindles, the new hospital fund will be virtually untouchable for any other purpose.

“We want to make sure these dollars are going for health care services and not for other reasons,” Prados admits.

The amendment, if approved, guarantees hospitals a certain reimbursement rate—whether the feds match it or not. That could mean state dollars for other health care services and higher education would have to be funneled to hospitals during future tight budget years. The Council for a Better Louisiana, LSU’s System president, and most newspapers around the state are recommending a “no” vote on this amendment.